What are febrile seizures in children and what first aid should be provided? Febrile convulsions at a temperature in children: what should be done? Febrile convulsions treatment.

Many are familiar with the feeling when, at a high temperature, against the background of SARS, the body begins to break. A child's body with an undeveloped central nervous system sometimes reacts to high temperature with convulsions. This phenomenon is called febrile convulsions.

Most often, febrile convulsions at a temperature are observed in babies up to one and a half years. But they can continue up to 6-7. They spread to the whole body or to the arms or legs.

• The body of the child is stretched, the eyes roll back;
• Loss of consciousness;
• The back is arched;
• Arms and legs make involuntary movements;
• Does not respond to speech.

This phenomenon resembles an epileptic seizure, but has nothing to do with it. The convulsive state can last up to 15 minutes, but the bowl does not exceed 5 minutes. Sometimes it goes in series for several seconds.

The reasons

Febrile convulsions in newborns can occur during colds with a high temperature (above 38.3º), during teething. Sometimes overheating of the body can also become the cause of spasm and convulsions. The baby's body cannot independently regulate its temperature until a certain age.

Doctors argue about what are the true causes of leg cramps in a child. Some tend to believe that they occur only in the case of a genetic predisposition. If a parent is suffering nervous disorders or chronic diseases blood vessels, the risk of seizures in the baby is increased. Others believe that the causes of febrile seizures lie in the imperfect nervous system of the child. With age, this frightening phenomenon for parents manifests itself much less frequently.

First aid

The baby must be examined by a doctor. Need to call ambulance. And before arrival, try to alleviate the condition of the child. Parents must do the following:

1. Do not leave the baby unattended;
2. Lay on the back and turn the head so that the child does not choke in case of vomiting.
3. Create coolness around the child's body.
4. Remove clothing.
5. Try to put candles to reduce the temperature.
6. Do not give water or pills.
7. You can wipe the child's body with a damp cloth dipped in a slightly acidic solution. A teaspoon of vinegar essence in a glass of water is enough.
8. During an attack, breathing may stop, you need to make an artificial one.

Febrile seizures in children are not a complex disease. Treatment is required only in cases of persistent recurrence at high temperatures. It is important to prevent the occurrence of convulsive conditions. Therefore, it is recommended not to wait until the baby's body temperature rises more than 37.5-38 degrees.

Survey

If the case of seizures is a single one, then you should not worry. However, it is worth discussing what is happening with the pediatrician. If any increase in temperature causes an attack or causeless convulsions occur in a child in a dream, it is necessary to be examined by a neurologist. This condition may be a symptom of a serious illness and will require intensive therapy anticonvulsants.

What is important for a doctor to know:

• how long the seizure lasted;
• which parts of the body were involved and in what way;
• was there a loss of consciousness;
• have had seizures before.

Approximate scope of examinations:

• General blood and urine tests;
• Electroencephalogram of the brain;
• Blood test for calcium (with rickets);
• Tomography and cardiogram;
• In case of suspicious abnormalities, a spinal cord puncture may be required to clarify the diagnosis.

If the disease that causes convulsions is not identified, but with an increase in temperature, the condition repeats over and over again, the doctor may prescribe anticonvulsant drugs.

Prevention

Statistics show that most often febrile convulsions are observed in weakened and sickly children. Colds and SARS reduce the immunity of the child and adversely affect the nervous system and blood vessels.

Also, relapse is most likely in cases of:

• The first episode of febrile seizures occurred before the age of 18 months and there are cases of seizures or epilepsy in parents.
• On the eve of the first attack, the child had heat, which lasted less than an hour, or the temperature was immediately under 40 ° C.
• The first attack was accompanied by complex febrile convulsions - more than one episode in one period of fever.
• Child visits Kindergarten- this increases the chances of contracting any infection.

The combination of these factors is not an indication for the appointment of regular anticonvulsants. The side effects of medications are significant, while the cramps themselves are not so terrible.

Studies have shown that the use of the drug to reduce the temperature perfectly prevents the development of seizures. However, there may be exceptional circumstances in which treatment is recommended to prevent recurrence of febrile seizures. For example, when convulsions in a child begin against the background small temperature or seizures continue for a considerable time.

In these situations, the child may be prescribed special drugs that must be taken at the first sign of fever.

To avoid frightening conditions, you need to take care of the health of the baby in advance:

1. Hardening the body with the help of various methods will help improve immunity.
2. Observe the baby's daily routine.
3. Don't neglect outdoor activities.
4. Observe the temperature regime in the room. Temperatures above 20-22 degrees can cause overheating of the body in children under 3 years old.
5. Pay close attention to nutrition. The food of the child should be fresh with a sufficient content of vitamins.

The mental state of a growing baby can affect his development and health.

Febrile seizures in children are convulsions accompanied by loss of consciousness, pallor of the skin and significant tension of the skeletal muscles.

This condition can occur at a certain age category. With the appearance of febrile convulsions, a small patient must be given urgent medical care. The cause of seizures is identified with the help of a special complex of examination of the child.

What it is?

Febrile seizures are classified as neurological disorders.

The condition is characterized by tonic-clonic and tonic seizures.

Among the provoking factors, a special place is occupied by hereditary predisposition and disruption of the central nervous system.

Children under 18 months of age are at risk for febrile seizures. In older children, attacks are less common.

During febrile convulsions, the child's body assumes a characteristic posture, the limbs twitch, the muscles tense up as much as possible.

Causes

Install exact reasons febrile seizures in a child is not always possible.

In medical practice, there are several types of factors that can increase the risk of such conditions or provoke relapses.

An important role in this case is played by genetic predisposition. If parents have a tendency to, then the risk of febrile seizures in children rises to a great extent.

provoke Febrile seizures can be caused by the following factors:

• damage to the body by viral infections;
• a process accompanied by an increase in temperature;
• negative reaction of the body to vaccines;
• bacterial damage to the respiratory system;
• diseases of the digestive system of a bacterial nature;
• excessive overheating of the child's body;
• immaturity of the central nervous system;
• various etiologies;
• endocrine pathologies accompanied by temperature;
• complications (including on);
• psychogenic factors that provoked hyperthermia.

Can they occur at high temperatures?

Increase in body temperature is the main factor necessary for the occurrence of febrile seizures in a child.

Any diseases and conditions accompanied by hyperthermia can provoke attacks.

The risk of convulsions increases with body temperature from 38 degrees. Hyperthermia can be provoked not only by diseases, but also by a temporary reaction of the child's body to external factors.

How to recognize?

Febrile seizures in most cases occur within a day after the child's body temperature rises. above 38 degrees. The duration of the attack can be up to fifteen minutes.

Within half an hour, several short-term convulsions may occur. The state of the child during convulsive conditions resembles epileptic seizures.

When symptoms of febrile seizures appear, provide first aid to a small patient as soon as possible and be sure to undergo a comprehensive examination in a medical institution.

Subsequence symptoms febrile seizures:

Origin mechanism febrile seizures occur in a specific pattern. When stopping an attack, the normalization of the child's condition occurs in the reverse order.

After suffering a neurological disorder, a small patient will feel for some time body weakness. At this stage, excessive drowsiness or fainting may occur. Skin may temporarily acquire a pale or bluish tint.

What are dangerous?

In most cases, febrile convulsions do not cause significant harm to the child's body and disappear when they reach a certain age.

However, the consequences of seizures directly depend on the overall clinical picture of the health status of a small patient.

Some types of complications are life-threatening and can drastically disrupt the functioning of vital systems.

Complications febrile seizures can be the following pathologies:

• impaired mental function;
• epilepsy;
• persistent deficiency of intelligence;
• neurological pathologies.

Providing first aid

What to do? Eliminate febrile seizures at home impossible.

The first pre-medical aid is to exclude injury to the child and to maximally alleviate his condition.

When symptoms of an attack occur, immediately call an ambulance. You can stop seizures only with special medications.

Action algorithm with febrile convulsions in a child:

1. Call an ambulance.
2. Lay the small patient on a flat surface.
3. Remove all objects that could accidentally injure the child.
4. If breathing is difficult, the baby should be turned to the left side.
5. Ensure fresh air supply.
6. Remove or unfasten tight clothing.
7. In the presence of elevated body temperature, you can use candles based on paracetamol.
8. It is not recommended to give antipyretic tablets or suspensions to a child.
9. You should not try to unclench the child's teeth during an attack or press it to the surface (there is a risk of injury and fractures).
10. In case of loss of consciousness, moisten a cotton swab or cloth with ammonia and bring it to the baby's nose.
11. If it is not possible to restore breathing, then there is an urgent need for artificial respiration.

How to distinguish a chill in a child from convulsions? find out right now.

When is urgent medical attention needed?

Urgent medical assistance necessary in all cases occurrence of febrile seizures.

At the time of the onset of an attack, it is impossible to determine the degree of its intensity and the reaction of the child's body.

Consequence seizures can become a serious disorder respiratory function and heart attack. Parents need to know the algorithm first first aid and call the experts immediately.

After stopping the convulsive state, it is imperative to conduct an examination in a medical institution.

Diagnosis and with what differentiate?

A pediatrician and a neurologist are involved in the diagnosis of febrile seizures. If it is difficult to confirm the diagnosis, it may be necessary consultation of specialized specialists.

At the initial stage of examining a small patient, doctors collect an anamnesis, find out the likelihood of the baby’s genetic predisposition to seizures and general state child's health. Next, a complex of laboratory and instrumental studies is assigned.

The diagnostics uses the following procedures:

• general analysis blood and urine;
• karyotyping;
• biochemical analysis of urine and blood;
• blood test for calcium;
• electroencephalography;
• spinal puncture;
• CT and MRI of the brain;
• differential diagnosis, epilepsy, hypercalcemia and hypoglycemia.

Treatment of FS attacks

Therapy for febrile seizures depends on many factors.

Doctors take into account the individual characteristics of the child's body, the frequency of seizures, family history, the presence of chronic and infectious diseases.

Attacks are provoked by an increase in the body temperature of the child. An obligatory stage of treatment is the elimination of the underlying pathology that caused hyperthermia. After the main course of therapy, the specialist may prescribe the use of strengthening and restorative drugs.

In the treatment of febrile seizures, the following are used: types of medicines:

• anticonvulsants (phenobarbital, phenytoin);
• antipyretics (Paracetamol, Nurofen, Ibuprofen);
• benzodiazepines (diazepam, sibazon);
• drugs for symptomatic treatment of existing pathology.

Komarovsky's opinion

Dr. Komarovsky explains in detail the cause of febrile seizures in children. In the first years of a child's life, his body is characterized by the immaturity of internal systems. Increase in body temperature provokes a reaction in the brain.

In most cases, young patients outgrow the tendency to seizures and by the age of six their condition is normal.

Forecast

With timely identification of the causes of febrile convulsions and complex therapy forecasts will favorable.

Seizures may recur periodically, but after the age of six, the child's condition stabilizes.

If the cause of seizures is established and excluded, then the chances of a complete recovery of the child and the exclusion of complications increase significantly. Unfavorable forecasts are possible with damage to the central nervous system of the child and the brain.

Problem Prevention

In the presence of good immunity and the absence of health problems for the child no specific prophylaxis required febrile seizures.

Parents need to follow elementary rules (diet control, replenishment of vitamins, etc.).

If the baby has there is a predisposition to seizures, then prevention will include special measures and regular examinations of a small patient by a neurologist.

Prevention consists of the following recommendations:

• prevention and timely elimination of metabolic abnormalities;
• complete therapy of infectious diseases;
• strengthening the child's immune system from the first days of life;
• taking sedatives in the presence of excessive sensitivity of the psyche;
• course therapy with drugs that strengthen immune system child;
• timely diagnosis of any deviations in the operation of internal systems.

Febrile seizures are dangerous to the health of the child and can provoke disruption of vital systems organism.

To exclude deviations in the work of the brain, neurological disorders and deviations in the development of the baby, it is necessary to follow all the instructions of doctors and not self-medicate.

Why do febrile seizures occur? What to do and which doctor to contact?

At present, it is preferable to speak not of "febrile convulsions", but of "febrile seizures", since in clinical picture given state not only convulsive, but also non-convulsive paroxysms can be observed.

Febrile convulsions/seizures(hereinafter referred to as AF) is a benign, age-dependent, genetically determined syndrome (in which the brain is susceptible to epileptic seizures that occur in response to high temperature), occurring after 1 month (usually from 3 months to 5 years ) life in children with a febrile illness not associated with a neuroinfection, as well as without previous unprovoked seizures and not meeting the criteria for other acute symptomatic convulsive episodes. If a child has AF, there is a possibility of their transformation (2 - 5%) into afebrile convulsions and epilepsy (see below - "complex AF").

note! Seizures that occur against the background of neuroinfection cannot be attributed to AF; cases where afebrile seizures precede AF; seizures with clear symptoms in the clinical picture symptomatic epilepsy(including seizures on the background of an acute metabolic disorder that can cause convulsions). According to the 2001 draft classification, AF is classified as a condition with epileptic seizures that does not require a diagnosis of epilepsy.

The frequency of FS in the pediatric population is 2 - 5%; more often observed in boys - 60% of cases. The peak onset of AF occurs between 1 and 2 years of age. Recurrent attacks after the first AF occur in 1/3 of patients, and most relapses occur within 1 year after the first AF. When assessing the risk of developing AF recurrence, one should take into account the child's age, gender, hereditary history, neurological status, degree of fever, and the frequency of diseases occurring with hyperthermia.

Issues of the etiopathogenesis of AF have not been fully studied. In the occurrence of AF in children importance have the following factors: genetic predisposition (defect in the genes that control sodium channels and GABA receptors), morpho-functional immaturity of the brain, perinatal pathology CNS, hyperthermia. Morphofunctional immaturity of the brain, manifested in increased excitability of subcortical structures, lability and rapid generalization of excitation, weakness of inhibitory processes in the cortex, insufficient myelination of conductors, instability of metabolic processes, increased vascular permeability and the hematoliquor barrier, hydrophilicity of brain tissues contribute to the development of AF.

AF are paroxysms of varying duration, which, as a rule, occur in the form of tonic or tonic-clonic seizures in the limbs in children at a body temperature of at least 37.8 - 38.5 ºС (with the exception of convulsions initiated by infections of the central nervous system). [ ! ] During a febrile illness, chills and involuntary movements of the child can be mistaken for convulsions. With chills, trembling is visible throughout the body, but usually does not capture the facial and respiratory muscles and is not accompanied by loss of consciousness, which makes it possible to distinguish it from convulsions. AF are observed during the first day of hyperthermia. Any infection may cause AF. AF most often occurs against the background of acute respiratory viral infections and acute intestinal infections predominantly viral etiology. Up to a third of cases of AF in children of the first year of life are manifested against the background of infections caused by the herpes virus type 6. There are typical (simple) and atypical (complex) AF (75% of all AF are simple):

■ simple AF are characterized by the following features: age of debut from 6 months. up to 5 years; a high percentage of family cases of AF and idiopathic epilepsy among relatives of the proband; seizures, as a rule, generalized tonic-clonic convulsions; the duration of the attacks is less than 15 minutes, in most cases 1-3 minutes, and do not recur within 24 hours; seizures stop on their own; high probability of AF recurrence; occur in neurologically healthy children; epileptiform activity in the EEG in the interictal period is not recorded; there are no changes in the brain during neuroimaging; AF resolves on its own after reaching 5 years;

■ complex AF are characterized by the following features: onset age from several months to 6 years; absence of family cases of AF and epilepsy among relatives of the proband; generalized tonic-clonic or secondary generalized seizures (often with a predominance of a focal clonic component), less often focal motor (including hemiclonic) or automotor; duration of attacks more than 30 minutes; possible development of status epilepticus; often the occurrence of post-attack symptoms of prolapse (Todd's paresis, speech disorders, etc.); the presence of focal neurological symptoms in the neurological status; mental, motor or speech development; the presence in the EEG study of continued regional slowdown, more often in one of the temporal leads; detection of structural changes in the brain during neuroimaging (typically hippocampal sclerosis), which may not occur immediately after AF, but develop with age; high risk of transformation into symptomatic focal epilepsy (the most likely risk of developing epilepsy after febrile seizures in case of detection of local signs on the EEG, as well as their occurrence in the first year of life, especially the first half of the year or with a later debut - after 3-4 years).

In the presence of hyperthermia in children with a history of AF, it is necessary to take measures to reduce body temperature, including rubbing with water at room temperature. According to the WHO recommendation, for children with a history of AF, the threshold for prescribing antipyretic drugs can be reduced to a level of 37.5 - 38 ºС. The antipyretic of the first choice is paracetamol in a single dose of 10-15 mg/kg (up to 60 mg/kg/day). Ibuprofen is also recommended in a single dose of 5-10 mg/kg (20-40 mg/kg/day).

A child with a generalized seizure should be laid on his side, head gently pulled back to ease breathing; forcibly open the jaws should not be because of the danger of damage to the teeth; release if necessary Airways. With typical AF, long-term use of antiepileptic drugs (AEDs) is unacceptable. 2 methods of therapy are possible: intermittent administration of AEDs orally during fever and parenteral administration of drugs at the beginning of an attack that has developed. Intermittent AED prophylaxis is carried out during the whole fever and 2-3 days after it. The drug of first choice is phenobarbital at a dose of 3-5 mg / kg / day in 2 doses with a 12-hour interval. The second choice drug is clobazam at a dose of 0.5 mg/kg/day in 2 divided doses. We will use convulex (valproic acid) in the form of prolonged-release tablets at a dose of 30 mg/kg/day for 7 days. At the time of the onset of attacks, parenteral administration of drugs is recommended to stop the attack and prevent the development of a prolonged attack and epistatus. Diazepam is shown intravenously or intramuscularly at a single dose of 0.25 mg/kg (possible administration 2 times a day), as well as convulex intravenously in a stream of 10-15 mg/kg/day.

In atypical AF and the presence of risk factors for recurrence of seizures, it is recommended to prescribe continuous anticonvulsant therapy in accordance with the nature of seizures for a period of at least 2 years. The drug of choice is valproic acid at a dose of 20-40 mg/kg/day twice a day. Prophylactic anticonvulsant therapy in AF is not indicated.

Children with complex AF are sent to a neurological hospital to exclude the onset of epilepsy. Children with AF (simple and complex) should be included in the dispensary observation group. Dispensary observation is carried out up to 5 years of age. The frequency of visits is 2 times a year with an active call of patients to the clinic. With an increase in AF, a change in the nature of the attack, the appearance of seizures at normal temperature, the appearance of focal symptoms in the neurological status, it is necessary to refer the child to the neurological department.

more in the article Febrile seizures in children. Modern aspects of the definition, classification, pathogenesis and treatment of A.I. Khamzin, Kyrgyz-Russian Slavic University. B.N. Yeltsin, Kyrgyzstan (journal "Neurosurgery and Neurology of Kazakhstan" No. 4, 2016) [

Febrile convulsions- paroxysms of various duration, occurring mainly in the form of tonic or tonic-clonic seizures in the limbs and occurring in infants, young children and preschool children at a body temperature of at least 37.8-38.5 ° C (excluding convulsions in neuroinfections), with the possibility transformation into afebrile convulsions and epilepsy.

Etiology. To date, the etiology of febrile seizures has not been definitively deciphered, although as possible causes several factors are considered. The etiological factors that cause febrile convulsions are divided into (1) infectious (any infectious disease can provoke febrile convulsions) and (2) non-infectious, this is primarily teething, hyperthermia of the endocrine, resorptive, psychogenic, reflex and central genesis; the role of metabolic disorders of some macro- and microelements (Ca, etc.) is very significant in the development of febrile convulsions; numerous observations confirm the genetic predisposition to febrile seizures (the type of inheritance of febrile seizures has not been finally established, but autosomal dominant or polygenic transmission is assumed).

Pathogenesis. Most authors believe that the key links in the pathogenesis of febrile seizures are acute cerebral hypoxia and cerebral edema. cerebral circulation at the same time, it simply “does not have time” to maintain an adequate supply of neurons with oxygen and trophic substrates due to the sharply increasing intensity of metabolic processes during fever. The development of febrile convulsions is also facilitated by age-related anatomical and physiological features of the central nervous system, which are characterized by increased hydrophilicity of the nervous tissue, the predominance of irrigation processes over inhibition processes, the intensity of metabolic processes and the imperfection of their regulation.

Clinic. More often, an attack of febrile convulsions proceeds as a generalized epileptic seizure (symmetrical tonic-clonic convulsions in the limbs), but the symptoms of this condition are not always so unambiguous. There are (1) typical and (2) atypical febrile seizures.

(1 ) typical (simple, benign) febrile seizures have a short duration - up to 15 minutes, generalized; indicators of psychomotor development usually correspond to age, there are no typical changes in the EEG, the absence in the anamnesis of indications of organic lesion central nervous system; typical for typical febrile seizures is that they manifest against the background of severe hyperthermia - during a rise in temperature or directly at the peak of fever;

(2 ) atypical (complex) febrile seizures characterized by a longer attack - more than 15 minutes (up to several hours), they also have generalization (a focal component is possible); characteristic lateralization; sometimes postictal hemiplegia occurs (in 0.4% of cases), focal changes are not uncommon on the EEG; the frequency of perinatal lesions of the central nervous system and craniocerebral injuries is high; Complicated febrile convulsions occur at significantly lower values ​​of hyperthermia than typical febrile convulsions, while the manifestation of paroxysm is delayed from the moment of temperature increase or develops after fever relief.

Diagnostics. The diagnosis of "febrile convulsions" is eligible at the age of 6 months to 6 years. Criteria for febrile seizures are: (1) under 6 years of age; (2) the absence of a disease of the central nervous system, an acute metabolic disorder capable of causing convulsions; (3) no history of afebrile seizures. The diagnosis of febrile seizures is established on the basis of anamnesis, assessment of somatic and neurological status, psychomotor and emotional development, features of the course of an attack (duration, localization, generalization, lateralization, the presence of post-attack hemiplegia, etc.). With a typical clinical picture of febrile seizures ( ! ) no additional examinations (MRI, CT, EEG) are usually required, since there are no specific changes in febrile convulsions.

The diagnostic value of laboratory and instrumental methods in the pathology under consideration is limited. results biochemical research blood tests allow to detect various metabolic disorders that can provoke convulsive syndrome. An EEG study reveals specific changes in 1.4–22% of children with febrile seizures. Lumbar puncture is performed if a child is suspected of having a neuroinfection with seizures (against a background of febrile temperature).

Treatment. Diazepam (0.2-0.5 mg/kg/day), lorazepam (0.005-0.02 mg/kg/day) or phenobarbital (3-5 mg/kg/day) are used. To reduce body temperature, physical methods of cooling are used: wiping the body with water or alcohol solutions, undressing the child, airing the room, etc. Also, with febrile convulsions, the appointment of antipyretics is indicated (for example, paracetamol - 10-15 mg / kg / day, rectally up to 20 mg / kg / day and ibuprofen in a single dose of 5-10 mg / kg no more than 4 times a day). ( ! ) With febrile convulsions, elevated body temperature begins to decrease even when its level has not reached febrile figures. It should be emphasized that regardless of clinical features febrile convulsions, common emergency measures are: a horizontal position of the body with the child turned “on its side” to prevent aspiration, restoration of upper airway patency, oxygen therapy through a mask. Absolute indications for the appointment of anticonvulsants are febrile status epilepticus, complicated variants of febrile seizures, as well as serial simple febrile seizures.

Preventive treatment. In the first two days of fever, children who have previously had febrile convulsions are prescribed diazepam at a dose of 0.3-0.4 mg / kg every 8 hours for prophylactic purposes; as an alternative, clobazam is used at 0.5 mg / kg / day, in 1-2 doses. The effectiveness of both drugs has not been proven. At present, the whole world is leaning towards a complete rejection of drug prevention typical febrile seizures. For atypical febrile seizures and/or recurrent episodes, chronic or intermittent antiepileptics are sometimes used, with carbamazepine and phenobarbital being preferred. In our country, pediatric neurologists often use the anticonvulsant properties of acetazolamide (Diacarb) to prevent recurrent attacks of febrile seizures.

Dispensary observation for children who have had febrile convulsions, is carried out by a pediatrician and a neuropathologist. The main tasks of specialists are the correct diagnosis of febrile seizures, additional examinations, determination of indications for hospitalization, treatment tactics and prevention of recurrent febrile seizures. Dispensary observation allows in many cases to avoid the recurrence of convulsive paroxysms, timely exclude organic pathology of the central nervous system, prevent side effects used anticonvulsants and prepare children for vaccination.

Risk factors for the development of epilepsy in febrile seizures include: (1) indications of the presence of neurological disorders or disorders of psychomotor development; (2) a family history of afebrile seizures; (3) the complex nature of febrile seizures. In the absence or presence of only one risk factor, the likelihood of developing afebrile seizures is only 2%. In the presence of two or more risk factors, the likelihood of epilepsy increases to 6-10%.

Febrile seizures are generalized seizures that occur during elevated temperature body. This condition may develop in case of acute respiratory viral infection, otitis. In most cases, such convulsions are observed in children aged three months and can last up to five years. As a rule, convulsions appear if the body temperature rises above 38 degrees. The attack begins with the fact that the child's body freezes in a tense state, after which convulsive twitches of the arms and legs develop.

The causes of febrile seizures in children are not fully understood. However, it has been established that one of the main causes of this condition is an insufficiently mature nervous system and weakness. inhibitory processes- this is what creates all the conditions for the appearance of febrile convulsions.

It should be noted that such attacks can occur only against the background of an increase in temperature. The provoking factors in this case can be anything - teething, vaccination, SARS, colds.

One of the important points in this case is hereditary predisposition - for example, the presence of epilepsy in the child's parents or his relatives.

Signs and symptoms of febrile seizures

It should be noted that doctors do not regard febrile convulsions as a form of epilepsy, although they have a number of symptoms similar to this disease. There are several forms of febrile seizures, in particular:

1. Tonic convulsions - they are accompanied by a significant tension in all the muscles of the child's body. It can be bending the arms to the chest, rolling the eyes, straightening the legs, throwing back the head. Then this state is replaced by rhythmic twitches or shudders, which become less and less frequent and gradually disappear.
2. Atonic convulsions - they are characterized by instant relaxation of the muscles of the body, as well as involuntary defecation and urination.
3. Local convulsions - accompanied by rolling the eyes, twitching of the limbs.

In most cases, the child does not react in any way to the words or actions of the parents, he stops crying, loses contact with reality, may turn blue or hold his breath. It should be borne in mind that every third child who has previously experienced such attacks will suffer from them and subsequently with an increase in body temperature.

What do febrile seizures look like?

The seizure usually begins with the child losing consciousness, and after a while his whole body and limbs become rigid. At the same time, the head unbends back, after which rhythmic twitching of the limbs is observed.

The skin may become pale or pale blue. As a rule, febrile convulsions stop after a couple of minutes, after which the child regains consciousness, but weakness persists. Gradually return to normal skin color and normal level consciousness.

Some children recover fairly quickly, while others recover for a long time. During the attack, parents completely lose their sense of time, and therefore a short attack can be regarded as a very long one.

Risk group

Of course, not every child suffers from such a problem. Febrile seizures are associated with individual features nervous system of the baby - in this case, he has an increased sensitivity threshold. In addition, some children may experience seizures at a temperature of 39 degrees, while for others, 38 is enough. At the same time, most children do not suffer from such convulsions at all.

In babies with a high threshold of sensitivity, febrile convulsions can be observed once, several times, and can be with each case of an increase in body temperature.

To date, doctors do not have reliable data on which children are more likely to experience such seizures. However, in most cases, febrile seizures affect premature babies, babies with pathologies of the central nervous system, children who have spinal hernias, as well as babies who have had a difficult or rapid birth.

First aid for febrile seizures

At home, care for febrile seizures should take into account two points:

1. Prevention of entry of vomit, food, saliva into the respiratory tract.
2. Prevention of traumatic injuries during a seizure.

To solve these problems, it is necessary to put the child on a stable, flat surface away from dangerous objects. At the same time, his body should be in the so-called rescue position, that is, the child should be placed on his side, and his face should be turned down. This will eliminate the possibility of liquid entering the respiratory tract. It is not recommended to take other actions on your own.

Before the doctor arrives, it is necessary to remember the duration of the attack and its manifestations - it is this information that will help specialists understand what kind of help the child needs. It is very important to pay attention to the presence of consciousness, posture, position of the head, limbs, eyes. It should be borne in mind that the doctor may ask eyewitnesses to show the movements and posture of the child.

What can not be done during an attack?

During such an attack, in no case should you put any objects into your mouth or take out your tongue. Contrary to the popular myth, it is impossible to swallow the tongue, while any manipulations with the oral cavity can lead to traumatic injuries to the teeth, jaws, and tongue. In addition, there is a risk that the wreckage introduced into oral cavity object or broken teeth will enter the respiratory tract, and this poses a real threat to life.

You should not try to hold the child by force, since this in no way affects the course of the attack and does not bring any benefit to the patient. In addition, artificial respiration is not recommended in this case. Until full recovery of consciousness, in no case should you give water to drink or medications because there is a risk that they will be inhaled.

Diagnosis of febrile seizures

A child who has had a febrile seizure at least once should definitely be shown to a pediatric neurologist. The physician must rule out neurological causes such seizures, including various forms epilepsy.

In this case, it is necessary to conduct the following types of research:

• biochemical and general analysis of blood and urine;
• analysis of cerebrospinal fluid - this is done to exclude meningitis or encephalitis;
• electroencephalogram;
• nuclear magnetic resonance or computed tomography.

Treatment of febrile seizures

If a child has a febrile seizure, it is imperative to call an ambulance. Before the doctors arrive, you should give the baby first aid:

1. If you are alone, you need to call for help.
2. Immediately put the baby on a hard surface and turn his head to the side.
3. Monitor the rhythm of the child's breathing. If he is tense and not breathing, then immediately after the end of the convulsions, artificial respiration should be started.
4. Ventilate the room and undress the child. The air temperature in the room should not be higher than 20 degrees.
5. You can apply physical methods to reduce the high temperature.
6. Give the child an antipyretic - suppositories with paracetamol are ideal.
7. Until the convulsions stop, in no case should you leave the child alone or try to force him to swallow the medicine.

In the event that febrile convulsions last no more than fifteen minutes and recur quite rarely, no other treatment is required. If such seizures are repeated quite often or are of a prolonged nature, an intravenous injection of anticonvulsants may be required - such an injection will be given by doctors from the ambulance team.

It must be remembered that febrile convulsions and high body temperature can be observed with quite dangerous diseases- neuroinfections. Fortunately, such diseases are rare, and their diagnosis does not cause any particular difficulties. If in doubt, the doctor may perform a lumbar puncture to remove some cerebrospinal fluid. This method allows you to make the correct diagnosis in doubtful cases.

Preventive measures and consequences of febrile seizures

Prophylaxis is required only if febrile seizures recur very often or last too long. In any case, the decision regarding preventive treatment accepted exclusively by a neurologist.

Although febrile seizures are very dramatic in themselves, they rarely cause any serious damage to the central nervous system. Such a threat arises only if such attacks are repeated frequently and are of a long-term nature, but in any case, damage to the nervous system is rarely serious enough.

It should be noted that in children who have suffered such convulsions, there is a risk of developing epilepsy, but it is minimal and amounts to only about 2%.

Thus, despite the fact that febrile convulsions have quite terrible symptoms, they do not pose a serious danger to the life and health of the child. The main thing in this situation is to master the methods of first aid. This is what will allow you to wait for the doctors without compromising the health of the baby. To exclude the presence of serious problems, you need to contact a neurologist - the doctor will prescribe necessary examinations and be able to make a correct diagnosis.