Patient's question:
Daughter had a seizure due to a cold and fever. After the seizure, her temperature was 37.5. At nine and a half months, one day when it was very cold outside, she had a seizure for over a minute after suddenly going into the hallway. At ten and a half months, due to high internal heat, she wet her pants at night and had a seizure after a slight fever. The next day, after finishing urinating, she had another seizure. Her temperature after the second seizure was 37.4. Both the EEG and CT scans were normal. Calcium levels were normal but slightly low; other tests were normal. Is it epilepsy? There is no family history of epilepsy.Doctor's answer:
Hello: The condition you are experiencing is a symptom of pediatric high fever convulsions! Convulsions are sudden, involuntary contractions of the entire or partial skeletal muscle groups, often accompanied by impaired consciousness. This is a temporary disruption of nervous system function, characterized by abnormal discharges of nerve cells, mostly caused by excessive central nervous system impulses, or may be due to a decrease in the threshold of peripheral nerve muscle stimulation, such as hypocalcemia in the blood. The incidence of pediatric convulsions is 10 to 15 times that of adults, and high fever convulsions are one of the main causes of pediatric convulsions. Statistics show that 2% to 3% of children under the age of 5 have experienced high fever convulsions.High fever convulsions often recur. After the first convulsion, approximately 25% to 40% (average 33%) of children may experience convulsion recurrence during subsequent febrile illnesses. Among children with high fever convulsions, one-third have a second convulsion, and half of those have a third episode. The total recurrence rate is 9% or higher.
Therefore, predicting whether a recurrence will occur is very important for assessing the prognosis of high fever convulsions. The prediction of recurrence is mainly based on the age of onset. Children with the first episode before the age of one have the highest recurrence rate, with approximately half of the cases experiencing recurrence. Additionally, if the high fever convulsions are complex and the child has a family history of epilepsy, the likelihood of recurrence is higher. Recurrences usually occur within two years of the initial high fever convulsion.