What are the symptoms of high fever convulsions? Listen..

Patient's question:

What are the symptoms of high fever convulsions? I heard that children with high fever convulsions cannot receive vaccinations at the age of 4! Meningococcal meningitis and the like? I don't know if it's true!!! Thank you

Doctor's answer:

Any sudden high fever in young children can cause febrile seizures, with an incidence rate of approximately 2-8%. It is the most common cause of seizures in children, accounting for about 30% of all pediatric seizures. Febrile seizures are more common in children aged 6 months to 3 years because their brains are not fully developed during this stage, and they have poor inhibitory control. Even weak stimuli can trigger strong and widespread excitation in the brain, leading to abnormal neuronal discharge and seizures.
In addition to age factors, genetic factors also contribute to the development of febrile seizures. Approximately 40-58% of close relatives of affected children have a history of febrile seizures or epilepsy.
Typical febrile seizures (simple febrile seizures) have the following characteristics:
⑴ More common in children aged 6 months to 3 years, occasionally seen in children aged 4-5 years, and rare in those over 6 years old.
⑵ The child usually has good general health.
⑶ Seizures often occur at the onset of fever when the temperature rises sharply to ≥39°C, commonly seen in acute viral upper respiratory infections.
⑷ Seizures are generalized, occur infrequently (most children have only one seizure during a single fever), last for a short duration (seconds to 10 minutes), and recover quickly without abnormal neurological symptoms. Simple febrile seizures have a good prognosis and generally do not affect intelligence, learning, or behavior. About 30-50% of children may have subsequent febrile seizures during fever, but these usually stop occurring after they start school.
A febrile seizure is classified as complex if it meets any of the following criteria:
⑴ Onset before 6 months of age or after 6 years of age.
⑵ Duration exceeds 15 minutes.
⑶ Multiple seizures during a single febrile illness.
⑷ Focal seizures instead of generalized seizures.
⑸ Temporary paralysis or other neurological abnormalities after the seizure.
⑹ Initial onset during high fever (≥39°C), followed by moderate or low-grade fever with subsequent seizures.
⑺ Abnormal EEG findings persisting for one week after fever subsides.
⑻ Positive family history of epilepsy; some scholars advocate classifying this type as "febrile-induced epilepsy."
Febrile seizures may progress to epilepsy, with risk factors including:
⑴ Pre-existing neurological developmental abnormalities.
⑵ Family history of epilepsy.
⑶ The first seizure is complex in nature.
If only one risk factor is present, the risk of developing epilepsy is 1-2%. With 2-3 risk factors, the risk increases to 10%. If the first seizure involves 2-3 complex features (focal seizures, duration of 15 minutes or more, or recurrence within 24 hours, followed by neurological abnormalities), the risk of epilepsy progression rises to 20%.
There is no specific medication for complex febrile seizures, but prophylactic treatment can be used for children with frequent recurrences. There are two approaches:
⑴ No medication is taken regularly, but anticonvulsant drugs (e.g., diazepam enema) are used at the onset of fever to reduce recurrence.
⑵ Long-term medication (under medical supervision), such as oral phenobarbital or sodium valproate, for several weeks to 1-2 years. This method should be used cautiously due to the need for long-term use and potential side effects.
It is recommended to seek medical attention at a local hospital for diagnosis and treatment.
During a seizure, parents should:
⑴ Remain calm to prevent injuries from falls due to convulsions.
⑵ If the seizure is brief, it may stop before you can take action.
⑶ If the seizure is prolonged or recurrent, seek immediate medical attention for anticonvulsant medication and oxygen therapy.
⑷ After the seizure stops, clear any vomit from the airway to maintain respiratory.
How to prevent seizures:
⑴ Take measures to avoid upper respiratory infections as much as possible.
⑵ Use antipyretic drugs (e.g., anacin nasal drops) at the onset of infection.
⑶ Medication can be used to prevent recurrence in complex febrile seizures.
⑷ Preventing recurrence of complex febrile seizures is particularly important, as each seizure episode may cause brain cell hypoxia, affecting the child's long-term prognosis.