Prevention and treatment of febrile convulsion in children

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Febrile convulsion is the most common cause of seizures in children, 2/3 for young children in febrile convulsion, 5~6% children had seizure

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Febrile convulsion is the most common cause of seizures in children, 2/3 for young children in febrile convulsion, 5~6% children had seizures of epilepsy and overheating, is a common disease of the nervous system, the prevalence rate of about 5~6%. Does the child heat convulsion change into epilepsy? Does febrile seizures affect children's intelligence? How to deal with children with seizures? How to prevent the occurrence of febrile convulsion in children? This lecture will answer these questions in detail.

1, first to talk about what is high fever convulsion?

Due to the differences of clinical characteristics, prevention and treatment and prognosis, febrile convulsion can be divided into two types: simple and complex.

Simple febrile convulsion features: 1) age: the age of onset was 6 months ~3 years, 6~7 years younger than last relapse; 2) heating at 38.5 DEG C, after heat convulsions, febrile diseases often start in the upper respiratory tract infection, the first peak in the temperature rise at the TiC; 3) seizures occurred in the first 24 hours of fever, seizure type clonic or variant or light attack of generalized seizures; 4) the duration of seizures convulsions most 2~3 minutes, few may be slightly longer; 5) attack soon after waking, without infection and brain injury in the central nervous system. 6: EEG): convulsions soon after normal interictal 80%~90% was normal; 7) anticonvulsants do not need; most prognosis is very good, especially the normal interictal EEG.

The clinical features of febrile convulsion is typical: 1) is age dependent, which appears at a certain age, to a certain age is lost, will no longer attack; 2) attack is not cause fever, fever will not attack; 3) the neurological examination was normal, the prognosis is good, does not affect the intelligence 4); have a certain genetic predisposition.

Febrile seizures, which do not meet the above characteristics of febrile convulsion, are considered as complex febrile seizures.

2, children with febrile convulsions will be transformed into epilepsy?

The above mentioned how to distinguish between simple type and complex type of febrile seizures, meaning that the distinction between the two is to consider the relationship between febrile convulsion and epilepsy: in the past in favor of febrile convulsion and poor prognosis, but in recent years, many researchers believe that the prognosis is good, according to reports of febrile seizures after epilepsy incidence: simple type 2~3%, and complex type 15~20%.

Occurrence of febrile seizures after epilepsy risk factors include: 1) febrile convulsion occurred more than 5 times or 24 hours repeatedly attack; 2) seizures lasting more than 20 minutes; 3) at the onset temperature lower than 38.5 DEG C, has been in existence before the onset of abnormal nervous system; 4) with perinatal abnormalities (birth injury, asphyxia), positive family history of convulsion; 5) thermal seizures after 1 weeks of EEG is abnormal.

Among them 4 (), 5) is particularly important.

3, febrile seizures on children's intelligence influence?

It has been mentioned that pure febrile seizures do not affect the development of intelligence, but if repeated attacks or longer duration of seizures can cause brain damage, which may have an impact on intelligence. Clinical brain injury after febrile convulsion is indicated: 1) serious and frequent thermal seizure history; 2) after the cessation of febrile convulsion occurred symptoms of nerve spirit, such as Todd pseudoparalysis, sensory disturbance, visual impairment, aphasia; 3) interictal abnormal EEG; 4) heat seizures have mental disorder or non thermal seizure etc..

4, children appear convulsion should be how to deal with?

In addition to fever and treatment of primary disease, seizures by 0.2~0.5mg/kg diazepam intravenous injection, intravenous injection can not as intramuscular injection of luminal sodium 5~8mg/kg.

At home, parents once found children lead to seizures, should be immediately sent to nearby hospitals and good protection, avoid to bite your tongue or tongue fall caused by asphyxia.

5, how to prevent children with febrile seizures?

The prevention methods of children with febrile convulsion seizures, fever is taken in time in the drug fever, such as Bloven (Merrill Lynch), acetaminophen (Tylenol) and antipyretic drugs commonly used in children. The requirement is that in the early stage of fever, once the body temperature rises to 38 degrees C. At the same time should be timely to the hospital, and to the doctor that had had a history of febrile convulsions. According to the specific circumstances of the doctor will decide whether to give drugs to prevent seizures.

The vast majority of good prognosis of children with febrile convulsion, without drug prevention, but the risk factors of epilepsy in children includes repeatedly the authors, may consider fever and short-term use of stability, or long-term use of Rumina or valproate. Specifically, the most recurrent history of febrile convulsion children, only diazepam oral or intramuscular injection to luminal sodium can, in the heat of the head is 24 hours every 4 hours with diazepam 1 times, effective and reliable, but the drawback is that the drug appeared after the spirit wilt and sleepiness may hinder the primary diagnosis cause fever. In particular, oral phenobarbital can not well prevent febrile seizures, this is because at least like oral phenobarbital for several weeks to reach effective and stable blood concentration.

The risk factors of epilepsy for complex febrile convulsion in children: 1) and febrile convulsion occurred more than 5 times or 24 hours repeatedly attack; 2) seizure lasts over 20 minutes; 3) heat convulsion after 1 weeks of abnormal EEG. It may need long-term medication to prevent recurrent febrile convulsions, under 2 years of age should be the first choice in luminal, over the age of 2 is the first treatment for valproate, generally about 1 and a half years.

 

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