Generally, seizures resulting from fever rise due to non-central nervous system infections between 6 months and 6 years are called as external febrile convulsions generally. In our society, 2 to 5% of healthy children up to 5 years of age experience one or more feverish referrals. It is more common in boys than girls. The age at onset of seizures occurs in 90% of cases in the first three years, in 4% in 6 months, in 6% in 3 years of age. It is most frequently observed between 18-24 months. Seventeen months before and after 6 years of age require careful research.
Generally, upper respiratory viral infections, rarely fever due to gastroenteritis, cannot be limited, but this leads to a short-term loss of consciousness in the form of abnormal electrical disruption in the fully immature child’s brain, and in the form of contraction or softening in the whole body. Rarely, the seizure can be seen on the first seizure which lasts more than one hour. Or the seizure may be focal (on one side of the body). This suggests that the underlying cause is a more serious brain problem.
Seizures are divided into two groups as simple and complicated. 80-90% are of the simple type.
In simple febrile convulsions, fever is 39 degrees and above, less than 15 minutes, seizure is normal, the child’s neurological development is normal, there is a family history of febrile convulsions in the family, the seizure shape is seen in the whole body (generalized type) is understood.
In complicated type febrile convulsions, the seizure is provoked with low fever of 38 degrees and below, the neurological development of the child is abnormal, the seizure lasts more than 15 minutes, more than 24 seizures in 24 hours, the family history of epilepsy, the seizure shape in one side of the body (focal type ).
The risk of recurrence of seizures is generally 33% (25-50%), and the risk of recurrence is highest if the seizure started at the first year of life. If the family history is positive, the risk increases again by 50%. 50% of the seizures were repeated in the first 6 months, 75% in one year and 90% in two years.
Diagnosis; In order to exclude the possibility of meningitis in the first febrile transfer of 12 months, cerebrospinal fluid examination with lumbar puncture is recommended. Children between 12-18 months should be decided in the follow-up if there is no other focus of fire. Routine lumbar puncture is not recommended in children over 18 months of age. Transient irregularities in the EEG may be seen in the acute period after seizure. Complicated febrile convulsions are more likely to be present in the EEG. Imaging is not recommended in a simple febrile transfer.
complex type is controversial. Generally, febrile seizures are 90-95%
age-dependent and disappear after 6 years of age. In rare cases, there is
a possibility of non-fever transfer (epilepsy) at 5-10%
. In addition to this, it is recommended to use intermittent preventive therapy (rectal diazepam) or antiepileptic drugs for at least one year of continuous preventive treatment, depending on whether it is simple or complicated.
The family should be concerned about this issue. It should be explained that this is not a situation that would affect the intelligence of the child in the future, and it should be explained that this is a very good state-of-the-art condition.