FEBRILE SEIZURES
Brief Summary
A febrile seizure is a convulsion in a child caused by a spike in body temperature, often from an infection. They occur in young children with normal development without a history of neurologic symptoms.
Frequency
It is one of the most prevalent neurological conditions in the pediatric age range. According to reports, 1 out of every 25 children would encounter at least one FS throughout their childhood.
Inheritance
Febrile seizure is inherited in an autosomal dominant pattern.
History of Disease
While identified by the ancient Greeks, febrile seizures were not recognized as a distinct syndrome separate from epilepsy until this century. In 1980, a National Institutes of Health consensus conference identified a febrile seizure as an event usually occurring between three months and five years of age in infancy or childhood, associated with fever, but without evidence of intracranial infection or a defined cause.
Scheffer and Berkovic (1997) recorded that 23 individuals had seizure disorders starting in childhood in a large multigenerational Australian family (range, 0.4-9 years; mean, 1.6 years). There were a number of seizure types for the patients, but all had generalized tonic-clonic seizures. With or without the associated fever, seizures can occur. Other forms of seizures, including absence, myoclonic and atonic, have occurred in at least 6 individuals. In the first or second decade, many were offset by seizures.
Pathogenesis
Achondroplasia is caused by a mutation in the FGF3 gene in chromosome 4 at 4p 16.3. This mutation causes a decreased production of fibroblast growth factor receptor 3 which is crucial in the conversion of cartilage into bone which is vital in the proper development of a person. This mutation is inherited in an autosomal dominant manner. More than 80 percent of people with achondroplasia have parents with normal characteristics and are born with achondroplasia due to a recent (de novo) gene modification (mutation).
Pathogenesis
In well-known epilepsy genes that encode sodium channel subunits, SCN1A and SCN2A, two risk variants lie, so these findings are not entirely unexpected. Notably, the greatest incidence of febrile seizures was associated with variants in another gene, ANO3. How this gene, which encodes a transmembrane protein that belongs to a family of chloride channels, may be linked to the susceptibility of seizures is little understood. Febrile seizure genetic risk is heterogeneous and includes rare as well as standard variants.
Symptoms
1
usually, a child having a febrile seizure shakes all over
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sometimes, the child may get very stiff or twitch in just one area of the body
3
the child may vomit or bite their tongue
4
sometimes, children do not breathe and may begin to turn blue
5
having a febrile seizure may have a fever higher than 100.4 F (38.0 C)
6
lose consciousness
7
shake or jerk arms and legs
Social Concerns
Children with febrile seizures are not related to problem behavior or executive functioning but may be at risk of developing delayed language.
Treatment
The aim of treatment is to manage the underlying cause. The following measures help keep the child safe during a seizure:
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Do not hold down the child or try to stop the seizure movements.
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Do not leave the child alone.
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Lay the child on the ground in a safe area. Clear the area of furniture or other sharp objects.
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Slide a blanket under the child if the floor is hard.
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Move the child only if they are in a dangerous location.
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Loosen tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
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If the child vomits or if saliva and mucus build up in the mouth, turn the child to the side or on the stomach. This is also important if it looks like the tongue is getting in the way of breathing.
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Do not force anything into the child's mouth to prevent biting the tongue. This increases the risk for injury.
Clinical Trials
Title:
Antipyretics for Preventing Recurrences of Febrile Seizures
Intervention:
Drug: Diclofenac, Paracetamol, Ibuprofen
Phase:
Phase 4
Procedure:
(A) Active Comparator: 1 drug_diclofenac 15 mg/kg suppository once
If temperature is >38 degrees Celsius, use diclofenacl suppository 1.5 mg/kg after 8 hours.If temperature is still <38 degrees Celsius, use acetaminophen mixture 15 mg/kg up to four times a day, or ibuprofen mixture 10 mg/kg up to four times a day, or placebo mixture up to four times a day as long as temperature < 38 degree Celsius.
(B) Placebo Comparator: 2 drug_Placebo suppository once
Immediately if temperature > 38 degree Celsius, diclofenac suppository 1,5 mg/kg once or placebo suppository After eight hours, if temperature still < 38 degree Celsius, acetaminophen mixture 15 mg/kg up to four times a day, or ibuprofen mixture 10 mg/kg up to four times a day, or placebo mixture up to four times a day as long as temperature < 38 degree Celsius.
(C) Active Comparator: 3 drug_acetaminophen mixture 15 mg/kg up to four times a day
Immediately if temperature > 38 degree Celsius, diclofenac suppository 1,5 mg/kg once or placebo suppository After eight hours, if temperature still < 38 degree Celsius, acetaminophen mixture 15 mg/kg up to four times a day, or ibuprofen mixture 10 mg/kg up to four times a day, or placebo mixture up to four times a day as long as temperature < 38 degree Celsius.
(D) Active Comparator: 4 drug_ibuprofen mixture 10 mg/kg up to four times a day
Immediately if temperature > 38 degree Celsius, diclofenac suppository 1,5 mg/kg once or placebo suppository After eight hours, if temperature still < 38 degree Celsius, acetaminophen mixture 15 mg/kg up to four times a day, or ibuprofen mixture 10 mg/kg up to four times a day, or placebo mixture up to four times a day as long as temperature < 38 degree Celsius.
(E) Placebo Comparator: 5 drug_oral placebo mixture up to four times a day
Immediately if temperature > 38 degree Celsius, diclofenac suppository 1,5 mg/kg once or placebo suppository After eight hours, if temperature still < 38 degree Celsius, acetaminophen mixture 15 mg/kg up to four times a day, or ibuprofen mixture 10 mg/kg up to four times a day, or placebo mixture up to four times a day as long as temperature < 38 degree Celsius.
Goal:
The researchers wanted to find out if the early use of antipyretics is capable in preventing recurrences of febrile seizures. When a child has had his/her first febrile seizure, the parents were instructed to give him/her antipyretic medication every time when the child had a new episode of fever during two years.
Further details at:
This study is referred to as NCT00568217 in the Information from the National Library of Medicine website. You may also go to this link to learn more about the details of the clinical trial.
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