Febrile fits

Naturally, fever is treated as a friend than a disease since it shows off the disease entry in the initial period itself and helps the body to fight infections by stimulating the natural defence mechanism. Although fever supports and stimulates our body, it can also cause complications like fits and even death in uncontrolled and untreated cases. So, one should be more cautious while treating fever, especially in infants.

Fear of getting fever is common in everyone, but it will be extremely dreadful for parents whose children suffer from febrile fits. Anyone will suffer from drowsiness, delirium and disorientation (i.e. dullness, blabbering and losing control) during the course of high fever. In the case of patients who have a more sensitive brain, high fever, in its course, can cause fluttering, i.e., seizure/fits – Febrile fits - due to the abnormal reaction of the brain. Febrile fits are named after the incidences and nature of the complaints.

'Katradhu Tamizh' Ram's next Diwali in Suburbs Rajini Still In A Dilemma! அஜீத் பேட்டி? ராம் இயக்கத்தில் சேரன்? கமல் பாராட்டிய டைட்டில்்

Incidences - Febrile fits are more common in infants and children than adults. Thus, this disease can be considered the intolerable nature or intensified suffering of the tender brain against high fever. Incidences seem to be more common in toddlers whose age is less than two years. Also, it is found to be more common in boys than girls. The reason is unknown. It also seems to be more common with children who have cerebral palsy, delayed milestones and other neurological abnormalities. More commonly, it occurs when temperature shoots up above 102 F.

Causes – Commonly, febrile fits get triggered due to sustained high temperature or due to the shooting up of temperature all of a sudden. This steep rise of temperature usually causes increased catabolism, dehydration, circulatory shock, etc., to cause an unfavourable circumstance for brain function. The brain reacts according to the intensity / severity as drowsiness or delirium or convulsions. So, febrile fits need not be related with epilepsy and should be treated just as a suffering for the time being. But one should be aware that if this condition is left untreated, epilepsy can get rooted here.

Symptoms - usually vary from child to child. It can occur anywhere in the body any time without warning. It presents symptoms generally as twitching (focal or generalised).

• Blinking / twitching of eyelids and other parts

• Deviation of mouth angle with movements

• Stiff face / painful facial expression

• Drooling and frothy saliva with severe gasping

• Rigidity and spasms in the parts involved - commonly arms flexed and legs extended or stretched

• Rythmic jerky movements in parts with alternate tightness (spasm) and relaxation
  In severe cases, violent attack follows without any relaxation causing status epilepticus which can endanger life

• Coma or loss of consciousness after suffering

Diagnostic techniques – No one can deny the importance of diagnosis and laboratory investigations for the assessment of prognosis and treatment. Even though fever is a trigger or causative factor for the suffering and the source for the fever has been treated, it is better to evaluate the disease and rule out complications from every angle with examinations and investigations starting from pulse, respiratory rate, etc.

• Routine blood tests and urine tests (to rule out any infection, anaemia, low or high sugar levels, metabolic disorders, poisoning, hormonal imbalance, etc.)

• X-ray of skull (in AP view and lateral view) / CT / MRI scan (to identify any bleeding spots / clots / brain tumours / cysts)

• Electroencephalography (EEG) – to find out abnormal brain functions

• Neurological analysis (to analyse muscle coordination, movements, reflexes)

• Spinal tap and analysis of cerebrospinal fluid in case of suspicion of meningitis

Prevention and management – Prevention is always better than cure. So, the first and foremost thing to do is to avoid getting fever by following hygienic measures and proper treatment. In case of recurrent fever, it is better to analyse and eliminate the root cause (for example - tonsillitis). Secondly, treat the fever immediately to arrest it at the earliest i.e., care should be taken in all means that the temperature should not be allowed to rise above 101 F. In case of high fever, the child should be given complete bed rest and sponge bath often to bring the body temperature below 101 F. To combat dehydration, fluid intake should be enhanced sufficiently. If necessary, child can be hospitalised.

In case of fits - Parents need to stay calm, observe carefully and take care of their child from getting injured. They should inform the doctor about the starting nature of seizure, duration, conscious level of the child, suffering side, parts, suffering nature, incontinence of urine or stool, etc., to proceed for proper treatment immediately. They should be aware that since febrile fits are mostly harmless and stays only for that time with good prognosis, they need not worry about the child's life or future.

Caring for children during seizure

• Protect the child from any injury by supporting and cushioning during seizure

• Try to remove all objects / furniture away from the child during jerks

• Loosen the dresses and keep good aeration

• Do not try to stop or hold the sufferer as you cannot stop it or make it go off all of a sudden - allow the seizure to run its natural course

• Do not give anything in the hand to the child during a seizure - it will harm the child

• Do not give anything through the mouth - even water or medicines as they cannot swallow at the time.

• Also avoid putting any objects in the mouth to avoid tongue biting or choking

• Extend the head (stretching backwards) so that breathing will be easier for the child

• Roll over the child to lie on the side so that frothy saliva can drool out (avoiding choking / avoiding entering into lungs causing bronchitis or pneumonia)

Complications – Mostly there won’t be any complication at all with febrile fits i.e. when treated properly and cared for well thereafter to prevent future recurrences. Only when it is left untreated or maltreated, epilepsy can strike roots and reflect in all facets of life with continuous suffering, i.e., in education, employment, quality of life, etc. The anti-convulsant drugs used for treatment will cause most of the complication than the disease itself. So it is better to avoid unnecessary medications. Using anti-epileptic medicines unnecessarily for a prolonged period will cause

• Dullness and poor concentration (children cannot cope with study as before)
  Kidney and liver can suffer damage

• Finally lack of care / treatment can lead one to emergency situation i.e., violent continuous seizure (Status epilepticus) / death

General treatment – Usually when child is brought to the doctor, the child will be fine and there won’t be any complaints at all except fever (since most of the febrile fits have a short span and disappear before the doctor can be called). In general, anti-pyretics, antibiotics and anti-convulsants / tranquillers will be prescribed immediately for treating fever and convulsions. Here, the doctor will explain about febrile fits and its harmless nature to the parents to cool them down. Then he will go on to analyse the complaint with all sorts of investigation to choose the right management.

Parents will come with plenty of questions, i.e., whether continuous treatment is required or not? If yes, how long the treatment should be continued? How effective would the treatment be? If he can promise cure... Actually, doctors cannot answer these questions logically or scientifically because of the unidentified, ultimate cause of suffering other than fever, but anyhow modern approach can boldly commit good prognosis or cure with systemic management. Normally, tranquillers will be prescribed during the suffering period or on a continuous basis, depending upon the intensity of suffering and lab results. Sometimes anti-convulsants are prescribed according to the recurrent nature of the complaint. If the seizure seems to stop after 2+ years, one can be considered as relieved or cured and treatment can be stopped.

Homeopathy approach - Children usually outgrow febrile fits. Also febrile fits commonly will not affect intellectual thoughts or activities. So, parents need not worry about the child’s future. Sedative medicines often prescribed will suppress febrile fits and also the mind / thoughts of the child. Homeopathy always claims that it is always wise to treat the condition than to suppress it with tranquiller or anti-convulsants, i.e., for seizure or treatment should not stop brainy activities.

To cool the brain and to make it strong or provide with good insulation, Homeopathy provides medicines on the basis of constitution and temperament of the child. Homeopathy treatment can strengthen the child’s brain naturally to withstand unfavourable circumstances like high fever, etc. Homeopathy can tune off the disease by treating the patient as a whole with individualisation. In Homeopathy also one needs to undergo treatment and follow-up for at least for 1-2 years, but Homeopathy treatment will not lead to drowsiness but will be like a very peaceful refreshment of the brain.

Homeopathic medicines commonly used in cases of febrile fits are Aconite, Aethusa, Agaricus, Apis mel, Ars alb, Belladonna, Calc carb, Capsicum, Causticum, Cicuta, Cina, Cuprum met, Gelsemium, Kali carb, Lachesis, Lycopodium, Natrum mur, Nux vom, Oenanthe crocata, Opium, Rhus tox, Zinc sulp, etc. These medicines should be taken under the advice and diagnosis of a Qualified Homeopath.