Febrile Seizures in Child

Fever is a phenomenon that often happen in humans and can also happen in every
range of age, whether its baby, children, teenager, adult, or elder. Actually, fever is not kind of
disease but it can become symptom of several diseases. According to Ismoedijanto (2000),
fever is a condition when our body temperature is increasing until more than 38C. this
increasing body temperature happens as a result of movement of set-point in hypothalamus.
Hypothalamus is an organ that has a role as thermostat, it means control temperature changes
in our body. The fluctuation of our body temperature is still in normal condition, if the range
of its fluctuation is around 1C from the normal body temperature. If the fluctuation is bigger
than 1C, then the fluctuation is considered by a pathologic reaction of body, such as when
we suffering from fever (Dinarello & Porat. 2011).
Fever in children sometimes lead to seizure phenomenon that often called febrile
seizure or fever seizure. Febrile seizure is a condition that the body of someone is having
seizure and accompanied by fever (increasing of body temperature until exceed 38C). this
febrile seizure is a phenomenon that often happens in children especially in toddler (age of 6
months 5 years). Around 2-5 % of children in the ever have febrile seizure (AAP. 2011).
Febrile seizure in children is divided by two kind of seizures. The first one is simple febrile
seizure and the second one is complex febrile seizure. Simple febrile seizure is defined by a
seizure that happen and accompanied by fever (increasing of body temperature exceed 38C)
and this seizure duration is just 15 minutes or less. This kind of seizure is general seizure and
usually there is no following seizures in the next 24 hours. the next kind of febrile seizure is
complex febrile seizure. This seizure is defined as seizure that happens when the body
temperature is increasing exceed 38C (fever) and happens more than 15 minutes. This
seizure is usually focal seizure (attacks certain part of body) and there are following seizures
in the next 24 hours. the percentage of febrile seizure is classified as simple febrile seizure is
75% and the other 25% is classified as complex febrile seizure (Enger & Shelhass. 2014).
Febrile seizure can happen from several causes. The main causes is bacterial and viral
infections. Most commonly caused febrile seizure is upper respiratory infection, otitis media,
and viral infections (Tejani. 2016). Children is stage when the body is susceptible to be
infected by any infectious agent, whether its bacteria, virus, fungi, etc. this is because
children is not capable to keep their hygiene and health. They often have high curiosity to try
and know new things and this can increasing the risk of children being infected by any
infectious agent. Thats why febrile seizure is often happens in children. Their body is
responding toward infection by inducing PMN and macrophage to produce cytokines such
Interleukin (IL), TNF (Tumor Necrosis Factor), and some interferons (Ismoedijanto. 2000).
Those matters will work on hypothalamus ,which is organ that control and maintain
temperature inside whole body, so the increasing of body temperature will occurs. the
increasing of body temperature will affect many organs, including brain. The hot temperature
will heat the extra cranial and will disturbing ion channel that sensitive by temperature
change. This condition will lead to excess firing of neurotransmitter or ion that can make
muscle become over twitching or we called it seizure. In the other hand, cytokines that have
been produced as inflammatory reaction can become factor that make seizure happens.
Cytokines such as IL-1 will induce increasing of neural excitability that may lead to muscle
over twitching or seizures (Dube, Brewster, & Baram. 2009).
 Febrile seizure sometimes make parents worried about their children conditions, but
actually febrile seizure is not dangerous condition. So if febrile seizure case happens, things
that we should do are stay calm and dont be panic, keep on attention to every single change
that happen when seizure occurs. febrile seizure usually occurs only once in a lifetime but it
still have chance to happens again in the future. The probability of febrile seizure happen
again in the future is 1/3 if the seizure is happen when children is one year on age or more.
The probability is increasing if febrile seizure is happen when children is at the age less than
one year (Hitchings. 2014).

References:
Ismoedijanto. 2000. Demam Pada Anak. Sari Pediatri. Vol.2. No.2 [online]. Accessed
from: <http://saripediatri.idai.or.id/pdfile/2-2-6.pdf> [Accessed at 28 March 2017]
Dinarello CA & Porat R. 2011. Fever And Hyperthermia. Harrisons Principle of
Internal Medicine. Ed. 18E. Ch. 16 [online]. Accessed from:
<http://accessmedicine.mhmedical.com/content.aspx?bookid=331&sectionid=40726725>
[Accessed at 28 March 2017]
AAP. 2011. Clinical Practice GuidelineFebrile Seizures: Guideline for the
Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure. Pediatrics Vol.127.
No. 2 [online]. Accessed from:
<http://pediatrics.aappublications.org/content/pediatrics/127/2/389.full.pdf> [Accessed at 28
March 2017]

Shellhass R & Engel J. 2014. Febrile Seizures [online]. Accessed from:

<http://cmim.org/pdf2014/funcion.php?f=articulos_201408MEDLINKFebrileseizures.pdf>
[Accessed at 28 March 2017]
Tejani NR. 2016. Febrile Seizures [online]. Accessed from:
<http://emedicine.medscape.com/article/801500-overview> [Accessed at 28 March 2017]
Ismoedijanto. 2000. Demam Pada Anak. Sari Pediatri. Vol.2. No.2 [online]. Accessed
from: <http://saripediatri.idai.or.id/pdfile/2-2-6.pdf> [Accessed at 28 March 2017]
Dube CM, Brewster AL, & Baram TZ. 2009. Febrile Seizures: Mechanisms and
Relationship to Epilepsy. Brain & Develepmont [online]. Accessed from:
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698702/pdf/nihms110551.pdf> [Accessed
at 28 March 2017]
Hitchings S. 2014. Febrile Convulsions Information for Parents and Carers. Oxford
University Hospitals [online]. Accessed from: <http://www.ouh.nhs.uk/patient-
guide/leaflets/files/11491Pconvulsions.pdf> [Accessed at 28 March 2017]