Seizures and Fever (cont.)
What Are the Exams and Tests for Febrile Seizures?
In evaluating a child with a febrile seizure, the physician is concerned about stopping the current seizure activity and then finding the causes of the seizures and the fever.
- Once seizure activity has stopped and the child’s condition is stabilized, attention turns toward determining the cause of the seizure. The doctor will want to know this type of information:
- Previous seizures without a fever (if so, then it is more likely the child has an underlying seizure disorder, such as epilepsy, rather than a febrile seizure)
- Family history of seizures, febrile or otherwise
- Presence of any known nervous system disorders in the child, such as delay in development or severe head injury
- Any medications the child has been taking, including the possibility of poisoning
- The doctor will conduct a careful physical examination to detect any nervous system disorders.
- The physician will also try to determine the cause of the fever. In particular, meningitis may be a possibility, especially in a child with any of the following characteristics:
- Younger than 12 months
- Appears particularly ill
- Stiffness of the neck (for example, difficulty flexing chin toward the chest)
- Unusually long period of drowsiness after the seizure
- Experiencing complex febrile seizure (often prolonged or repeated seizures)
- Other tests, such as blood and urine tests, and X-rays, such as a chest x-ray, may be used in diagnosing the cause of fever. Advanced studies such as head CT scan, MRI scan, and EEG (electroencephalogram, brain wave tracing)may be used as the patient's clinical examination permits.
What Are the Home Remedies for Febrile Seizure?
These aspects of home care need to be considered:
- Care of the child during the seizure: During a seizure, only a limited amount of intervention should be undertaken. The main objective is to protect the child’s airway so that breathing is maintained. Protection from other injury is important.
- Remove objects, such as food and pacifiers, from the mouth.
- Place the child on his or her side or abdomen.
- Clear the mouth with a suction bulb (if available) if there is vomiting.
- Perform a jaw thrust or chin lift maneuver if there is noisy or labored breathing.
- Do not try to restrain the child or try to stop seizure movements.
- Do not force anything into the child's mouth. Don't try to hold the tongue. (It is not necessary to try to prevent the tongue from being swallowed.)
- Control of the fever: Because the seizure is being caused by fever, measures should be taken to lower the body temperature.
- Remove clothing.
- Apply cool washcloths to the face and neck.
- Sponge the rest of the body with cool water (do not immerse a seizing child in the bathtub).
- Give medication to lower the fever (acetaminophen suppositories in the rectum, if available). Oral medications should not be given until the child is awake.
- Consider the cause of the fever: This is probably best left up to the doctor's medical evaluation.
Medically Reviewed by a Doctor on 11/11/2016
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Thomas Rebbecchi, MD, FAAEM
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