Febrile Seizure – Diagnosis and Treatment

Diagnosis

Identifying Febrile Convulsions

When a child with typical development has a single, short seizure linked to fever, doctors usually rely on the medical and developmental history to determine the cause.

If the child is up to date with vaccinations and has no immune system concerns, extra tests are not needed. However, if a child has not had all recommended shots or has weakened immunity, doctors might check for serious infections.

Common tests include:

  • Blood work
  • Urine analysis
  • Spinal tap to look for brain or spinal cord infection

These steps help doctors rule out other health issues.

Checking for Complicated Febrile Convulsions

If the febrile seizure is long, occurs more than once in a short period, or has unusual features, doctors order further testing. They may use an electroencephalogram (EEG) to evaluate brain activity for abnormal patterns.

Doctors might perform an MRI if the child’s head is larger than expected, the neurological exam is not normal, or there are signs of increased pressure in the skull.

These evaluations help doctors find out if there are other causes behind the seizure and provide important information for future care.

Treatment

Handling Severe Situations

For seizures lasting more than five minutes, doctors prescribe a fast-acting medication to help stop the episode. Sometimes a medicine from the benzodiazepine class quickly calms the brain’s activity.

If a child has a long seizure, is very young (under 6 months), or has a seizure when there is a serious infection or the cause of the fever is not clear, the doctor may decide to keep the child in the hospital for closer observation.

This ensures the child is safe and doctors can treat any complicated medical problems right away.

Doctors may also recommend acetaminophen or other antipyretics to lower fever, mainly to help the child feel better. In most cases, hospital care and heavy medications are not necessary unless seizures are severe or unusual.

Getting Ready for Your Child’s Visit

Steps to Take Before the Appointment

1. Make a Record: Write down what happened before, during, and after your child’s seizure. Include details about any fever, any illness, and the exact symptoms you saw. Note how long the seizure lasted and anything unusual your child did before or after.

2. List All Medications: Make a complete list of everything your child takes. This includes medicines, vitamins, and supplements. This helps the doctor check for possible interactions or causes.

3. Prepare Your Questions: Having your questions ready helps you use your time well. Some useful questions are:

  • What could have caused the seizure?
  • Does my child need any tests?
  • What should I do if this happens again?
  • Will medicine to bring down a fever help prevent future seizures?
  • Can vaccinations or immunizations make febrile seizures more likely?

Write any other concerns you have, especially about vaccines or immunizations. You can also bring information about your child’s vaccination history to help the doctor.

Questions Your Doctor Might Ask

Doctors may need details to diagnose or rule out other conditions. Be ready to answer:

  • What was your child doing before the seizure?
  • Did your child have a fever or get any immunizations before it happened?
  • Can you describe the seizure? How long did it last?
  • Has your child or anyone in the family had seizures before?
  • Was your child sick or exposed to someone ill?
  • Has your child had any blows to the head or trouble with the nervous system?

If possible, keep a table or list like the one below to help you track important information:

Detail Your Notes
Fever (Yes/No)  
Duration of Seizure  
Previous Seizures  
Vaccination Dates  
Other Health Issues  

How to Help While Waiting for the Visit

If your child has another seizure before the appointment:

  • Stay calm and gently move your child to the floor if needed.
  • Lay them on their side with the face down and lower arm under the head. This position keeps the airway clear if vomiting occurs.
  • Remove anything from your child’s mouth if the seizure starts, but never put anything into their mouth during a seizure.
  • Don’t try to hold them down.
  • If the seizure lasts over five minutes, call for emergency medical help right away.

You can also note the dates of recent vaccinations, as this information helps your doctor understand the timing of the seizure in relation to recent immunizations. The doctor may use recent guidelines from places like the CDC when discussing vaccines and seizure risks.


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