Fever seizure (step) in children, what to do?

What is a febrile seizure (step)?

Quoting from the official website of the Indonesian Pediatrician Association (IDAI), a step is a seizure that occurs when there is an increase in body temperature. Usually above 38 degrees Celsius, which is caused by a process outside the brain.

This condition occurs in children aged 6 months to 5 years, with symptoms of fever that precede seizures. Symptoms of the step are:

The child is unconscious during a seizure. After a seizure, consciousness usually returns
Stiffness of the feet or hands
The feet or hands are tense and move erratically
Eyes glaring or flickering

Based on the symptoms that arise, the duration of the seizure and the type of seizure, there are two types of steps.

First, simple febrile seizures that last less than 15 minutes, do not recur within 24 hours, seizures occur throughout the body.

Second, complex febrile seizures that last more than 15 minutes, can recur within 24 hours, seizures occur in one part of the body.

What causes febrile seizures (step)?

There is no definite cause for this febrile seizure condition. However, quoting from Kids Health, several cases show that this condition has something to do with the virus and the way the developing child's brain reacts to high fever.

A sudden increase in temperature caused by inflammation or an infectious disease in children is also the cause. It is suspected that genetic factors also play a role in the incidence of febrile seizures.

This is due to differences in the seizure threshold in children. The reason is, there are children who have seizures when the body temperature is 38 degrees Celsius, there are also those who just have seizures when the temperature is above 40 degrees Celsius.

In very rare cases, stepping can occur as a side effect of immunization.

Can febrile seizures recur?

In some cases, the step condition in children can be repeated. The possibility of recurrent seizures, especially in the first year, and the risk factors that influence it are as follows:

Family history of febrile seizures
Age less than 12 months
Low temperature during seizures
The speed of seizures after fever

If the factors above are found, then the chance that the step will repeat itself is about 80 percent. Meanwhile, if no risk factors are found, the possibility of recurrence is 10-15 percent.

Are febrile seizures dangerous?

To date, there are no reports of child deaths caused by step. Disability as a complication has also never been reported.

Motor, mental and intellectual development in children who are born normal, generally remain normal even though they have experienced this condition.

The febrile seizure usually goes away on its own by the time the child is 5 years old. The incidence of epilepsy occurs in less than 5 percent of children with stepping and generally these children have other risk factors, such as:

Any obvious developmental or intellectual disabilities prior to the first step
Complex steps
History of epilepsy in parents or siblings

Each of the risk factors above increases the chance of developing epilepsy by 4-6 percent. If all are found, the chances of epilepsy increase to 10-49 percent.

Not all seizures accompanied by fever are steps.

If the seizure occurs beyond the age range of 6 months to 5 years, or after the seizure the child remains unconscious, the doctor will perform several tests to determine other causes of the seizure, such as meningitis, encephalitis, or epilepsy.

How to handle steps?

Step is a condition that is generally harmless, so parents don't have to worry too much if a seizure occurs.

Here are things you can do when your child has a seizure:

Stay calm and don't panic.
Move the child to a safe place, away from dangerous items such as glassware, sharp objects, or power sources.
Loosen tight clothing, especially around the neck.
Take the child's temperature at the time of seizure, observe how long the seizure was and what happens during the seizure for the doctor's data at the time of examination.
Tilt the child to let out food or drink from the mouth so that they don't choke.
Avoid putting anything in the child's mouth.
Avoid forcefully holding the child's feet or hands during a seizure, as this can lead to fractures.
Stay with the child during the seizure.

If you have had seizures before, the doctor usually provides the parents with a diazepam drug that is inserted through the buttocks. Give if the child is still having seizures and not given when the seizures have stopped.

How to prevent steps?

The principle of preventing febrile seizures is to reduce the fever when the child has a fever by administering fever relievers, such as paracetamol.

Choose a liquid medicine dosage form (syrup) that is suitable and easy for children to consume. For babies who are not able to take orally (taken orally or swallowed) can be given enema preparations or use rectally (rectally).

Give the child a warm compress, on the forehead, armpits, or folds of the elbows. Give the child plenty of water to lower the temperature.

It is recommended that parents have a thermometer at home so that they can measure the child's temperature and can provide precautions as already mentioned.

When to see a doctor

Parents need to take their little one to the doctor if they experience this, quoting from the NHS:

The child has a febrile seizure for the first time.
The seizure lasts more than 5 minutes and there is no sign of stopping.
The child has seizures with other serious illnesses, such as meningitis.
The child has difficulty breathing.

When you see the signs above, immediately take your little one to the doctor. The medical officer will diagnose the step based on the conditions that occur at that time.

The doctor may do a blood test or urine test if the step is accompanied by other serious illnesses.

Observation for the diagnosis of this condition is carried out in the hospital when the child has complex febrile seizures. Especially if your little one is under 12 months (1 year).

Several tests will be carried out. The first is an electroencephalogram (EEG) to measure the electrical activity of a child's brain. If there is an unusual pattern, you may have epilepsy.

Second, the lumbar puncture procedure or lumbar puncture. This is the collection of spinal fluid and brain (cerebrospinal).

Cerebrospinal (CSF) is a clear fluid that surrounds and protects the brain and spinal cord. A lumbar puncture procedure can be used to determine if a child has an infection of the brain or nervous system.