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Febrile Seizure

Updated : February 1, 2024





Background

Febrile seizures are seizures caused by a rapid increase in body temperature, with a fever higher than 38 C or 100.4 F, without any underlying seizure-provoking causes or disorders, such as central nervous system infections, electrolyte imbalances, drug withdrawal, trauma, genetic susceptibility, or known epilepsy.

Simple and complicated febrile seizures are the two types of febrile seizures.

Epidemiology

A general definition of a febrile seizure in children ranges from 6 months to 60 months (5 years). However, the actual age range varies significantly throughout the medical literature.

Up to 4% of children in this age range get febrile seizures, which are quite prevalent. Some children only experience one febrile seizure, while others experience several episodes throughout early childhood.

Anatomy

Pathophysiology

A febrile seizure is the immature brain’s age-dependent response to a fever. The development of the brain results in an increase in neuronal excitability, which puts the child at risk for febrile seizures. As a result, febrile seizures primarily affect young children under the age of 3 since their seizure threshold is low.

The precise pathophysiology of febrile seizures is unknown. 10% to 20% of first-degree relatives of individuals with febrile seizures also experience febrile seizures, indicating a genetic predisposition. There is no known inheritance pattern in particular.

Etiology

When a child has a temperature of more than 38 C (100.4 F) and no other seizure-inducing etiologies, they have febrile seizures. Since every child’s threshold convulsive temperature differs, the maximum fever intended to trigger febrile seizures is specific to each individual. Frequent febrile seizures frequently happen when the patient’s temperature increases, even if the severity of the fever is ultimately the most important cause.

A febrile seizure may be a child’s initial disease indicator, with the discovery of a temperature higher than 38 degrees coming later. Although no one cause of fever is more likely to result in febrile seizures, viral infections rather than bacterial are more frequently linked to febrile seizures. HHV-6 is frequently linked to febrile seizures in the United States and Europe.

The influenza A virus has frequently been linked in Asian nations to febrile seizures. Any sufficiently high temperature may bring on a febrile seizure. Postnatal corticosteroid therapy significantly increases the risk of febrile seizures in premature children. Alcohol and nicotine use during pregnancy is associated with a marginally higher incidence of febrile seizures.

Stress during pregnancy or the first few months of life can train the developing brain in ways that increase neuronal excitability and reduce the seizure threshold. Other risk factors include exposure to road noise and air pollution near the residence.

Genetics

Prognostic Factors

About 30% of children with febrile seizures in the past continue to have an elevated risk of having another febrile seizure. A second febrile seizure during the first year is 50% more likely in children under 12 months at the time of the first one. Within a year, this risk drops to 30%.

A family history of febrile seizures, low temperature at the time of the seizure, and a shorter time between the fever and the seizure may also point to a higher likelihood of subsequent febrile seizures, in addition to the young age at the time of the first seizure. The risk of febrile seizures recurring, however, is not always increased by characteristics linked to complicated febrile seizures.

Children with uncomplicated febrile seizures are around 1% to 2% more likely than the general population to develop epilepsy in the future. The risk of epilepsy increases (5–10%) in children with complicated febrile seizures, poor neurodevelopment, or family history. There is no evidence that febrile seizures are associated with intellect deficits or learning difficulties.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

During a febrile seizure: To ensure the safety of the child who has febrile seizures, the first step is laying the child on a flat, soft surface, which can prevent choking on other fluids, including saliva, and protect from any risk during the seizure. Also, it is essential not to keep any sharp or other objects nearer that can harm the child. 

Protect the Airway: To keep the airway clear for the child and make them not choke, place, or lay the child on their side by placing their head in which face should be downward. Not to insert anything, including medications, in their mouth during the seizure as it is harmful where there are chances that the child can bite their tongue. 

Monitoring and observing the seizure duration: When a child experiences a seizure, it is recommended to note the time and duration from the occurrence of the seizure, any unusual behaviours, and type of movements. As we know, simple febrile seizures usually last for less than five minutes, and if the seizures last for more than five minutes or longer, they can be considered complex seizures. 

After the Seizure: The focus should be on reducing the fever of the child, which will prevent another seizure from reoccurring. Antipyretic medication is usually recommended with an appropriate dose, such as acetaminophen or ibuprofen. Tepid bathing could also help in reducing the temperature of the body, but cold water needs to be avoided. 

Medical evaluation: After the seizure, it is recommended to call your doctor to seek medical attention, which requires a complete evaluation to rule out any underlying causes. The healthcare expert will assess the child’s health by determining the cause of the fever and recommending any further tests that are required. 

Antipyretic Medications: In children with a known history of febrile seizures, antipyretic medications are used to lower temperature or fever at the first sign, which can also be a part of treatment for children who are having recurrent febrile seizures. Medical attention seeking will help further on how to follow with these medications. 

Preventive Measures: We need to have some preventive measures to manage the symptoms associated with febrile seizures because no one can tell when this seizure occurs. Preventive measures include reducing the temperature of the body using antipyretic medications, keeping the child hydrated, and wearing a lightweight dress is recommended. Monitoring of underlying diseases or infections that can cause fever should also be done. 

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Lifestyle modification for febrile seizures

Management of Fever: It is recommended for the family or parents to monitor their child’s health, especially their body temperature, during any time when he falls sick. Digital thermometers can help to check their temperature. To make sure that their fever is under control, administration of antipyretic agents to reduce the temperature, making sure that the child is hydrated in case of fever to prevent dehydration, which is associated with worsening of seizures. 

Infection control: There are high chances that many febrile seizures are known to occur and be triggered by an infection. It is mandatory to take steps to prevent and control infections, and it is recommended to follow and practice hygiene, like washing hands and avoiding children from being infected or affected by any sick individuals whenever possible. Vaccinations and immunization of the child are essential to take care of against diseases. 

Dressing and Environment: Make sure to loosen the clothes of the child during the seizure or to keep your child in lightweight and breathable clothes which help them breathe more efficiently and regulate the temperature of the body during hot weather and in case of fever. Comfortable room temperature is preferred, which is neither hot nor cold. 

Regular Sleep Cycle: Children need to get adequate sleep to maintain their sleep cycle, which could avoid stress and prevent seizures from reoccurring. 

Trigger identification and management: Keep a note of the child’s health and their external environment when a febrile seizure occurs or is going to occur, which can alert us from having those objects to which the child is exposed the next time, which can trigger a seizure. 

Managing acute signs of febrile seizures: In children with a known history of febrile seizures, which are prolonged or frequent, antipyretic medications are recommended to use when the first sign is fever, which is only a preventive measure that is followed when a doctor is giving instructions. 

Communication and Education: Community education on febrile seizures is essential, which can help individuals know what and what not to do during an event of a febrile seizure and how to manage and control fever. Need to share the child’s history of medical illness with the healthcare provider. 

Consultation: Follow-up should be regular to keep the child’s health on track and receive guidance on how to manage febrile seizures if at all occur, in which healthcare experts provide appropriate preventive measures or medical help.  

Use of Antipyretic Medications in febrile seizures

Drugs such as acetaminophen or ibuprofen are used only to reduce or lower the body temperature or fever and give relief from febrile seizures in children who have recurrent history of seizures. These medications are not for terminating seizures while they occur but only help to lower the temperature, which will help prevent seizures from reoccurring while there is a fever. 

acetaminophen: It is also known as paracetamol, which is a non-opioid analgesic with antipyretic properties used in the management of pain and fever. It is safe and used against febrile seizures in children, only to relieve fever by reducing the temperature that is associated with febrile seizures. 

ibuprofen: It is an NSAID with antipyretic properties, which is used to treat pain and fever. In the management of febrile seizures, this is used as an antipyretic, which is effective in children to lower body temperature or fever. 

Efficacy of Anticonvulsant therapy in febrile seizures

When a febrile seizure occurs for less than five-minute duration, no medication is needed as it is a simple febrile seizure that is known to self-terminate, except antipyretics are used to reduce body temperature.

If febrile seizures last longer than five-minute duration, which falls into the category of complex seizures, then pharmacological treatment with anticonvulsants is prescribed. 

First-line therapy with benzodiazepines such as midazolam (buccal) and diazepam (IV or Rectal) is recommended to control or terminate seizures that are prolonged. Caretakers are usually trained on how to administer these medications in case of an emergency. 

Second-line therapy with barbiturates and other anticonvulsants is recommended in the prevention of simple febrile seizure recurrence, such as phenobarbital (IV), Phenytoin (IV), and levetiracetam (IV). 

Third-line therapy in the prevention of refractory seizures includes propofol, which is an intravenous sedative-hypnotic agent in hospital settings, and barbiturate thiopentone (IV), which is required in induction and ventilation. Barbiturate primidone helps in reducing the recurrence of simple febrile seizures.  

For Intermittent prophylaxis, clobazam, which is a benzodiazepine, is a drug of choice that reduces the recurrence.

For continuous prophylaxis, antiepileptic sodium valproate is used, which can help decrease excessive electrical activity that takes place in the brain, ultimately leading to a reduction in recurrence. 

midazolam: midazolam is a benzodiazepine that is short-acting and whose onset is rapid following an injection. It is used to produce sedation or drowsiness and is used in the emergency management of seizures, especially febrile seizures with a duration of more than five minutes. 

diazepam: it is a benzodiazepine that is used in the management of specific types of seizures, such as febrile seizures. Oral diazepam is used in intermittent prophylaxis, but rectal diazepam is used in children with prolonged febrile seizures. 

phenobarbital: The barbiturate class included phenobarbital, which is used in the management of seizures and is particularly effective for febrile seizures. It is the drug of choice in young children with uncomplicated febrile seizures, which are recurrent. 

phenytoin: it is a hydantoin derivative included as a first-generation anticonvulsant drug used in the management of recurrent febrile seizures. 

levetiracetam: It is a novel antiepileptic drug that is effective in the prevention of recurrent febrile seizures given orally. 

propofol: it is an intravenous anesthetic compound used in monitored anesthesia care or used as an induction agent for general anesthesia. It does have anticonvulsant properties, which inhibit epileptic discharges in EEG and prevent seizures in clinical settings. 

primidone: it is an antiepileptic drug and first-generation barbiturate, which is used in the prevention of febrile seizures, which are recurrent by reducing abnormal brain electrical activity. 

clobazam: It is a benzodiazepine that is used as an adjunctive in the prevention of recurrent febrile seizures. 

sodium valproate: It is an antiepileptic medication used daily in the effective management of febrile seizures, which are recurrent in children. 

Phases in managing febrile seizures

PRE-SEIZURE PHASE 

Community Education: Educating the community, which includes caregivers and parents, about febrile seizures and their management is most important. Educating about the associated signs of febrile seizures, such as fever, and how to manage it with any one antipyretic medications (acetaminophen and ibuprofen) if prescribed. 

Managing Fever: In case of a child experiencing simple febrile seizures, parents or caregivers should be prepared on how to manage it correctly. Keeping a digital thermometer on hand to observe or monitor the body temperature of the child, if required, administration of any one antipyretic medication that is already prescribed to keep a check for fever. 

Trigger Identification: Awareness about potential triggers and their association with febrile seizures in children and how to prevent or minimize their child’s exposure to these trigger factors should be educated to parents and caregivers. 

Communication: Parents and caregivers are required to share their child’s medical history, including seizures, with the persons who are responsible for their child’s care, such as daycare providers, teachers, and family members. 

DURING THE SEIZURE 

Safety: During a febrile seizure, the first thing to do is to keep the child safe by laying the child on their side with the head facing down on a flat, soft surface to prevent choking on fluids, including saliva, and minimize the harm. 

Do Not Restrain. Trying to restrain from movements or holding the child down is not a recommended way of stopping the seizures as it may cause harm to the child. 

Seizure Duration: It is instructed to observe and note the time in which the seizure started and the duration from how long it took place. Suppose seizures are for less than five minutes in duration. In that case, it is a simple febrile seizure, which is self-terminated and does not require medication except antipyretics to control fever if required. In complex cases where seizures last long, that is, more than five-minute duration, medical intervention is needed where anticonvulsants are prescribed for controlling febrile seizures. 

Stay Calm: It is instructed to remain calm while witnessing a seizure, though it is frightening because, in most cases, febrile seizures are brief, and they resolve on their own without causing injury. 

POST-SEIZURE CARE 

  • Post-seizure care needs to be taken for the child by reassuring and focussing on comforting the child. 
  • Administration of antipyretic agents to reduce the body temperature or to check fever as prescribed by the doctor. 
  • Seeking medical intervention or evaluation for the root cause of fever and determination of the same using necessary tests or treatments. 
  • While seeking medical help, sharing the duration of the seizure and the child’s medical history is recommended. 
  • Preventive measures that are necessary for the management of febrile seizures need to be discussed with the doctor, including the management of fever with antipyretic medications or other measures to reduce the future potential risk of febrile seizures that are recurrent and prolonged. 
  • In hospital settings for recurrent or prolonged seizures, close medical intervention is undertaken with the help of anticonvulsants. 

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052913/

https://www.ncbi.nlm.nih.gov/books/NBK448123/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210946/

Febrile Seizure

Updated : February 1, 2024




Febrile seizures are seizures caused by a rapid increase in body temperature, with a fever higher than 38 C or 100.4 F, without any underlying seizure-provoking causes or disorders, such as central nervous system infections, electrolyte imbalances, drug withdrawal, trauma, genetic susceptibility, or known epilepsy.

Simple and complicated febrile seizures are the two types of febrile seizures.

A general definition of a febrile seizure in children ranges from 6 months to 60 months (5 years). However, the actual age range varies significantly throughout the medical literature.

Up to 4% of children in this age range get febrile seizures, which are quite prevalent. Some children only experience one febrile seizure, while others experience several episodes throughout early childhood.

A febrile seizure is the immature brain’s age-dependent response to a fever. The development of the brain results in an increase in neuronal excitability, which puts the child at risk for febrile seizures. As a result, febrile seizures primarily affect young children under the age of 3 since their seizure threshold is low.

The precise pathophysiology of febrile seizures is unknown. 10% to 20% of first-degree relatives of individuals with febrile seizures also experience febrile seizures, indicating a genetic predisposition. There is no known inheritance pattern in particular.

When a child has a temperature of more than 38 C (100.4 F) and no other seizure-inducing etiologies, they have febrile seizures. Since every child’s threshold convulsive temperature differs, the maximum fever intended to trigger febrile seizures is specific to each individual. Frequent febrile seizures frequently happen when the patient’s temperature increases, even if the severity of the fever is ultimately the most important cause.

A febrile seizure may be a child’s initial disease indicator, with the discovery of a temperature higher than 38 degrees coming later. Although no one cause of fever is more likely to result in febrile seizures, viral infections rather than bacterial are more frequently linked to febrile seizures. HHV-6 is frequently linked to febrile seizures in the United States and Europe.

The influenza A virus has frequently been linked in Asian nations to febrile seizures. Any sufficiently high temperature may bring on a febrile seizure. Postnatal corticosteroid therapy significantly increases the risk of febrile seizures in premature children. Alcohol and nicotine use during pregnancy is associated with a marginally higher incidence of febrile seizures.

Stress during pregnancy or the first few months of life can train the developing brain in ways that increase neuronal excitability and reduce the seizure threshold. Other risk factors include exposure to road noise and air pollution near the residence.

About 30% of children with febrile seizures in the past continue to have an elevated risk of having another febrile seizure. A second febrile seizure during the first year is 50% more likely in children under 12 months at the time of the first one. Within a year, this risk drops to 30%.

A family history of febrile seizures, low temperature at the time of the seizure, and a shorter time between the fever and the seizure may also point to a higher likelihood of subsequent febrile seizures, in addition to the young age at the time of the first seizure. The risk of febrile seizures recurring, however, is not always increased by characteristics linked to complicated febrile seizures.

Children with uncomplicated febrile seizures are around 1% to 2% more likely than the general population to develop epilepsy in the future. The risk of epilepsy increases (5–10%) in children with complicated febrile seizures, poor neurodevelopment, or family history. There is no evidence that febrile seizures are associated with intellect deficits or learning difficulties.

During a febrile seizure: To ensure the safety of the child who has febrile seizures, the first step is laying the child on a flat, soft surface, which can prevent choking on other fluids, including saliva, and protect from any risk during the seizure. Also, it is essential not to keep any sharp or other objects nearer that can harm the child. 

Protect the Airway: To keep the airway clear for the child and make them not choke, place, or lay the child on their side by placing their head in which face should be downward. Not to insert anything, including medications, in their mouth during the seizure as it is harmful where there are chances that the child can bite their tongue. 

Monitoring and observing the seizure duration: When a child experiences a seizure, it is recommended to note the time and duration from the occurrence of the seizure, any unusual behaviours, and type of movements. As we know, simple febrile seizures usually last for less than five minutes, and if the seizures last for more than five minutes or longer, they can be considered complex seizures. 

After the Seizure: The focus should be on reducing the fever of the child, which will prevent another seizure from reoccurring. Antipyretic medication is usually recommended with an appropriate dose, such as acetaminophen or ibuprofen. Tepid bathing could also help in reducing the temperature of the body, but cold water needs to be avoided. 

Medical evaluation: After the seizure, it is recommended to call your doctor to seek medical attention, which requires a complete evaluation to rule out any underlying causes. The healthcare expert will assess the child’s health by determining the cause of the fever and recommending any further tests that are required. 

Antipyretic Medications: In children with a known history of febrile seizures, antipyretic medications are used to lower temperature or fever at the first sign, which can also be a part of treatment for children who are having recurrent febrile seizures. Medical attention seeking will help further on how to follow with these medications. 

Preventive Measures: We need to have some preventive measures to manage the symptoms associated with febrile seizures because no one can tell when this seizure occurs. Preventive measures include reducing the temperature of the body using antipyretic medications, keeping the child hydrated, and wearing a lightweight dress is recommended. Monitoring of underlying diseases or infections that can cause fever should also be done. 

Management of Fever: It is recommended for the family or parents to monitor their child’s health, especially their body temperature, during any time when he falls sick. Digital thermometers can help to check their temperature. To make sure that their fever is under control, administration of antipyretic agents to reduce the temperature, making sure that the child is hydrated in case of fever to prevent dehydration, which is associated with worsening of seizures. 

Infection control: There are high chances that many febrile seizures are known to occur and be triggered by an infection. It is mandatory to take steps to prevent and control infections, and it is recommended to follow and practice hygiene, like washing hands and avoiding children from being infected or affected by any sick individuals whenever possible. Vaccinations and immunization of the child are essential to take care of against diseases. 

Dressing and Environment: Make sure to loosen the clothes of the child during the seizure or to keep your child in lightweight and breathable clothes which help them breathe more efficiently and regulate the temperature of the body during hot weather and in case of fever. Comfortable room temperature is preferred, which is neither hot nor cold. 

Regular Sleep Cycle: Children need to get adequate sleep to maintain their sleep cycle, which could avoid stress and prevent seizures from reoccurring. 

Trigger identification and management: Keep a note of the child’s health and their external environment when a febrile seizure occurs or is going to occur, which can alert us from having those objects to which the child is exposed the next time, which can trigger a seizure. 

Managing acute signs of febrile seizures: In children with a known history of febrile seizures, which are prolonged or frequent, antipyretic medications are recommended to use when the first sign is fever, which is only a preventive measure that is followed when a doctor is giving instructions. 

Communication and Education: Community education on febrile seizures is essential, which can help individuals know what and what not to do during an event of a febrile seizure and how to manage and control fever. Need to share the child’s history of medical illness with the healthcare provider. 

Consultation: Follow-up should be regular to keep the child’s health on track and receive guidance on how to manage febrile seizures if at all occur, in which healthcare experts provide appropriate preventive measures or medical help.  

Drugs such as acetaminophen or ibuprofen are used only to reduce or lower the body temperature or fever and give relief from febrile seizures in children who have recurrent history of seizures. These medications are not for terminating seizures while they occur but only help to lower the temperature, which will help prevent seizures from reoccurring while there is a fever. 

acetaminophen: It is also known as paracetamol, which is a non-opioid analgesic with antipyretic properties used in the management of pain and fever. It is safe and used against febrile seizures in children, only to relieve fever by reducing the temperature that is associated with febrile seizures. 

ibuprofen: It is an NSAID with antipyretic properties, which is used to treat pain and fever. In the management of febrile seizures, this is used as an antipyretic, which is effective in children to lower body temperature or fever. 

When a febrile seizure occurs for less than five-minute duration, no medication is needed as it is a simple febrile seizure that is known to self-terminate, except antipyretics are used to reduce body temperature.

If febrile seizures last longer than five-minute duration, which falls into the category of complex seizures, then pharmacological treatment with anticonvulsants is prescribed. 

First-line therapy with benzodiazepines such as midazolam (buccal) and diazepam (IV or Rectal) is recommended to control or terminate seizures that are prolonged. Caretakers are usually trained on how to administer these medications in case of an emergency. 

Second-line therapy with barbiturates and other anticonvulsants is recommended in the prevention of simple febrile seizure recurrence, such as phenobarbital (IV), Phenytoin (IV), and levetiracetam (IV). 

Third-line therapy in the prevention of refractory seizures includes propofol, which is an intravenous sedative-hypnotic agent in hospital settings, and barbiturate thiopentone (IV), which is required in induction and ventilation. Barbiturate primidone helps in reducing the recurrence of simple febrile seizures.  

For Intermittent prophylaxis, clobazam, which is a benzodiazepine, is a drug of choice that reduces the recurrence.

For continuous prophylaxis, antiepileptic sodium valproate is used, which can help decrease excessive electrical activity that takes place in the brain, ultimately leading to a reduction in recurrence. 

midazolam: midazolam is a benzodiazepine that is short-acting and whose onset is rapid following an injection. It is used to produce sedation or drowsiness and is used in the emergency management of seizures, especially febrile seizures with a duration of more than five minutes. 

diazepam: it is a benzodiazepine that is used in the management of specific types of seizures, such as febrile seizures. Oral diazepam is used in intermittent prophylaxis, but rectal diazepam is used in children with prolonged febrile seizures. 

phenobarbital: The barbiturate class included phenobarbital, which is used in the management of seizures and is particularly effective for febrile seizures. It is the drug of choice in young children with uncomplicated febrile seizures, which are recurrent. 

phenytoin: it is a hydantoin derivative included as a first-generation anticonvulsant drug used in the management of recurrent febrile seizures. 

levetiracetam: It is a novel antiepileptic drug that is effective in the prevention of recurrent febrile seizures given orally. 

propofol: it is an intravenous anesthetic compound used in monitored anesthesia care or used as an induction agent for general anesthesia. It does have anticonvulsant properties, which inhibit epileptic discharges in EEG and prevent seizures in clinical settings. 

primidone: it is an antiepileptic drug and first-generation barbiturate, which is used in the prevention of febrile seizures, which are recurrent by reducing abnormal brain electrical activity. 

clobazam: It is a benzodiazepine that is used as an adjunctive in the prevention of recurrent febrile seizures. 

sodium valproate: It is an antiepileptic medication used daily in the effective management of febrile seizures, which are recurrent in children. 

PRE-SEIZURE PHASE 

Community Education: Educating the community, which includes caregivers and parents, about febrile seizures and their management is most important. Educating about the associated signs of febrile seizures, such as fever, and how to manage it with any one antipyretic medications (acetaminophen and ibuprofen) if prescribed. 

Managing Fever: In case of a child experiencing simple febrile seizures, parents or caregivers should be prepared on how to manage it correctly. Keeping a digital thermometer on hand to observe or monitor the body temperature of the child, if required, administration of any one antipyretic medication that is already prescribed to keep a check for fever. 

Trigger Identification: Awareness about potential triggers and their association with febrile seizures in children and how to prevent or minimize their child’s exposure to these trigger factors should be educated to parents and caregivers. 

Communication: Parents and caregivers are required to share their child’s medical history, including seizures, with the persons who are responsible for their child’s care, such as daycare providers, teachers, and family members. 

DURING THE SEIZURE 

Safety: During a febrile seizure, the first thing to do is to keep the child safe by laying the child on their side with the head facing down on a flat, soft surface to prevent choking on fluids, including saliva, and minimize the harm. 

Do Not Restrain. Trying to restrain from movements or holding the child down is not a recommended way of stopping the seizures as it may cause harm to the child. 

Seizure Duration: It is instructed to observe and note the time in which the seizure started and the duration from how long it took place. Suppose seizures are for less than five minutes in duration. In that case, it is a simple febrile seizure, which is self-terminated and does not require medication except antipyretics to control fever if required. In complex cases where seizures last long, that is, more than five-minute duration, medical intervention is needed where anticonvulsants are prescribed for controlling febrile seizures. 

Stay Calm: It is instructed to remain calm while witnessing a seizure, though it is frightening because, in most cases, febrile seizures are brief, and they resolve on their own without causing injury. 

POST-SEIZURE CARE 

  • Post-seizure care needs to be taken for the child by reassuring and focussing on comforting the child. 
  • Administration of antipyretic agents to reduce the body temperature or to check fever as prescribed by the doctor. 
  • Seeking medical intervention or evaluation for the root cause of fever and determination of the same using necessary tests or treatments. 
  • While seeking medical help, sharing the duration of the seizure and the child’s medical history is recommended. 
  • Preventive measures that are necessary for the management of febrile seizures need to be discussed with the doctor, including the management of fever with antipyretic medications or other measures to reduce the future potential risk of febrile seizures that are recurrent and prolonged. 
  • In hospital settings for recurrent or prolonged seizures, close medical intervention is undertaken with the help of anticonvulsants. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052913/

https://www.ncbi.nlm.nih.gov/books/NBK448123/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210946/