Definition:

Febrile seizure is associated

with high fever
(38.9 C – 40.0 C). Seizures show
an active tonic-clonic
pattern, which lasts for 15-20
seconds.
It usually occur due to the
sudden spike of
temperature.
It happen most often when a
child develops a fever at
night, when a parent is not
aware of it.
 Febrile seizure are divided into 2 types:

 Simple febrile seizures which are generalized,

last <15 minutes and do not recur within 24
hours. Complication injuries…

 Complex febrile seizures recur more than in 24

hours or are focal. This may indicate a more
serious disease process, such as meningitis,
abscess, or encephalitis.
Pathophysiology:
 Febrile seizures occur in young children at a time in
their development when the seizure threshold is low.
This is a time when a young children are susceptible
to frequent childhood infections such as upper
respiratory inf ection, otitis media, viral syndrome,
and they respond with comparably higher
temperature. Animal studies suggest a possible role
of endogenous pyrogens such as interleukin 1beta,
that by increasing neuronal excitability, may link
fever and seizure activity.
Diagnostic evaluation:

 Physical examination with special attention

to neurologic status.
 Cerebrospinal fluid examination
 Complete blood count and urinalysis
 Cultures of nasopharynx , blood, or urine as
appropriate to determine cause of fever.
 Blood sugar, calcium and electrolyte levels.
 EEG
 EEG, with or without video monitoring,
locates epileptic focus, spread, intensity,
and duration, helps classify seizure type.
 CT scanning or MRI identifies lesion that
may cause of seizure.
 Single photon emission CT scanning
(SPECT) or positron emission tomography
(PET) identifies seizure foci.
Therapeutic Management:
 Teach parents that, after
the seizure subsides,
they should sponge the
child with tepid water to
reduce the fever quickly.
 Advice them not to put
the child in the bathtub,
however, because it
would be easy for the
child to slip underwater
should a second seizure
occur.
 Applying alcohol or cold water is not
advisable.

 Parents should not attempt to give oral

medications such as acetaminophen, because
the child will be in a drowsy, stare after the
seizure and might aspirate the medicine.
 Advise parents to put a cool washcloth on the
child’s forehead, axillary, and groin areas and
transport the child, lightly clothed, to a health
care facility for immediate education.
 Do not try to restrain your child or try to stop
the seizure movements.

 Focus your attention on bringing the fever

down.
 Teach the parents to loose any tight clothing,
especially around the neck. If possible, open
or remove clothes from the waist up.

 Do not force anything into the baby’s mouth

to prevent him from biting the tongue, as this
increases the risk of injury.
 Nursing Management:
 Increase the child’s fluid
intake to prevent
dehydration.

Rationale:
Fever increases the child’s
fluid requirements by
increasing the metabolic
rate.
 Expose the skin to the air
by leaving the child
lightly dressed in an
absorbent material.

Rationale:
Loss of heat from the skin
by radiation in the main
temperature regulating
mechanism available to
the infant or small child.
 Administer antipyretic drugs.

Rationale:

Although effective in reducing fever,

antipyretic drugs may obscure the clinical
picture and cause numerous side effects
including diaphoresis, skin eruptions,
nausea, vomiting, hematologic changes
and fever.
Medication:
 Antipyretic drugs should be used in patients
who appear uncomfortable secondary to the
fever. Antipyretics do not appear to prevent
recurrence of febrile seizures.

 Acetaminophen (tylenol)
 Reduces fever by acting directly on hypothalamic
heat-regulating centers, which increases
dissipation of body heat via vasodilation and
sweating.
 Some children who have repeated episodes of
multiple febrile seizures are treated with
Phenobarbital or Dekote (Valproate)
 Other medications can be given at the time of a
febrile seizure. Diastat (diazepam) gel or liquid
diazepam can be given by rectum.
 Klonopin (clonazepam) wafers can be placed on
the tongue or a tablet form of diazepam or
lorazepam can be crushed and put between the
cheek of the gum.