PYRETIC SWIMMING IN CHILDREN
Fever spasms are a fairly common and relatively harmless phenomenon. About 5% of the pediatric population may develop feverish convulsions. Typically occurs in children aged 6 months to 5 years with an average age of about 18 months. It is more common in boys than in girls. It usually occurs in healthy children who develop fever usually above 39 C.
Feverish convulsions are convulsions in children aged 6 months to 5 years who have fever with a rectal temperature above 38 ° C with no evidence of intracranial infection or neurological disease.
– Simple fever spasms:
An episode of generalized convulsions at all 4 extremes and duration of less than 15 minutes.
– Complicated fever spasms:
An episode of generalized spasms lasting more than 15 minutes or multiple episodes of spasms within a 24-hour period or spasms on only one side of the body.
Convulsions occur in children who develop a fever, it does not have to occur as soon as a fever episode begins. They may occur before we realize that the child has a fever.
Typically the child has spasms where he or she loses consciousness, has eyes usually open, eyes focused forward or sideways, body muscles become rigid and then convulsions occur at all four extremities. The skin becomes pale and sometimes blue.
Fever spasms are due to the combination of low tolerance of the central nervous system (CNS) for spasms with an exogenous agent that is fever.
The reasons for the CNS’s low tolerance for convulsions appear to be genetic.Statistically 24% of children have a family history of fever and 4% have a family history of epilepsy. The hypothalamus, which is the center of the brain where body temperature is regulated, seems to play a central role as well as some related canals such as: SCN1A, SCN9A, GPR98, GABRG2.
Fever that causes feverish convulsions most often appears to be due to certain infections such as some gastroenteritis (Shigella, Rotavirus) and some upper respiratory infections such as HHV6 and HHV7.
- We control the temperature of the child.
- We strip the child down to lower his body temperature.
- We administer antipyretic from the rectum.
- We never put anything in a child’s mouth.
- If the child has lost consciousness we lie down on the side.
- If the doctor has prescribed diazepam (Diazepam, Stesolid) we give it rectally if the seizures do not stop within 10 minutes.
Contact the hospital directly if:
- It is the first episode of fever spasms for the child.
- If the child is under 12 months.
- If convulsions occur after a few days the child is ill.
- If the child has more than one episode of convulsions within a 24-hour period.
- If convulsions last more than 10 minutes.
- If the child has seizures only on one side of the body.
- If the child does not recover after a few minutes.
- If the child has seizures in one part of the body after convulsions.