familial febrile seizures 2

Familial Febrile Seizures: An Overview

Febrile seizures can run in families, and research suggests that there may be a genetic component to this condition. Studies have shown that children who have a family history of febrile seizures are more likely to experience recurrent febrile seizures themselves.

• Family History: If a child's parents, brothers or sisters, or other close relatives have had febrile seizures, the child is at a higher risk of developing this condition. In fact, research suggests that there may be a slight tendency for febrile seizures to run in families [2].
• Recurrent Febrile Seizures: Children with a family history of febrile seizures are more likely to experience recurrent febrile seizures themselves. A study found that first-degree family history was significantly associated with recurrent febrile seizures, with an odds ratio of 2.1 [15].

It's essential for parents and caregivers to be aware of this potential risk factor if they have a family history of febrile seizures. If you're concerned about your child's risk of developing febrile seizures or have questions about their symptoms, consult with a healthcare professional.

References: [2] - Children aged 3 months to 5 or 6 years may have seizures when they have a high fever. These are called febrile seizures (pronounced FEB-rile) and occur in 2% to 5% of all children (2 to 5 out of 100 children). There is a slight tendency for them to run in families. [15] - Results: Recurrent febrile seizures was the only phenotypic feature significantly associated with first-degree family history of febrile seizures (OR 2.1, 95% CI 1.15 to 3.88).

Common Signs and Symptoms of Familial Febrile Seizures

Familial febrile seizures, also known as recurrent febrile seizures, can exhibit similar signs and symptoms to those experienced by children with simple febrile seizures. Some common indicators include:

• Uncontrollable shaking (convulsions): Children may experience convulsive movements of the arms and legs, which can be a sign of an impending seizure.
• Short-term loss of consciousness: In some cases, children may lose consciousness for a brief period, usually lasting only a few seconds to minutes.
• Eye rolling: Some children may exhibit eye rolling or other abnormal eye movements as a precursor to a seizure.
• Moaning or vocalization: Children may make unusual sounds or moan before or during a seizure.
• Vomiting or urination: In some cases, children may experience vomiting or urination (incontinence) during or after a seizure.

These symptoms can vary in severity and duration, but they are often indicative of an impending febrile seizure. It's essential to note that not all children with familial febrile seizures will exhibit these signs and symptoms, and some may have more severe or prolonged episodes.

References:

• [3] - According to the provided context, some of the most common symptoms include uncontrollable shaking (convulsions) and a short-term loss of consciousness.
• [5] - A simple febrile seizure can stop by itself within a few seconds to 10 minutes, but it's essential to monitor for signs of more severe episodes.
• [6] - During a febrile seizure, the child's body usually becomes stiff, they lose consciousness, and their arms and legs twitch.

Based on the provided context, here are the diagnostic tests for familial febrile seizures (also known as Generalized Epilepsy with Febrile Seizures Plus, GEFS+):

• Clinical diagnosis: GEFS+ is diagnosed clinically through the seizure type, EEG pattern, and family history [7].
• Molecular genetic testing: Molecular genetic testing can confirm the diagnosis of GEFS+, but it's not always necessary for diagnosis [7].
• Electroencephalography (EEG): An EEG may be done if febrile seizures have focal features or are recurrent to assess the risk of seizure recurrence [6, 9].
• Brain scans: A CT scan (computerized tomography) or other brain scans may be ordered to rule out other conditions that could cause seizures [9].

It's worth noting that routine diagnostic testing, such as laboratory tests, neuroimaging, or electroencephalography, is not recommended for simple febrile seizures unless indicated by the child's medical history and physical exam [1, 13].

Treatment Options for Familial Febrile Seizures

Familial febrile seizures, also known as Generalized Epilepsy with Febrile Seizures Plus (GEFS+), are a type of epilepsy syndrome characterized by recurrent febrile seizures. While there is no cure for GEFS+, various treatment options can help manage the condition.

• Antiepileptic medications: These medications can be used to prevent or reduce the frequency and severity of febrile seizures. However, their use should be carefully considered due to potential adverse effects [7].
• Fever management: Treatment of fever is essential in preventing febrile seizures. Antipyretic medications such as acetaminophen or ibuprofen can help manage fever [8].
• Prophylactic drug management: Some studies suggest that prophylactic use of antiepileptic drugs during subsequent fever episodes may be effective in reducing the recurrence of febrile seizures [14].

Important Considerations

It is essential to note that continuous or intermittent antiepileptic medications are not recommended after a first febrile seizure due to potential adverse effects [7]. Additionally, giving an antipyretic at the beginning of a febrile illness has not been shown to prevent a febrile seizure [13].

References

[7] DK Smith · 2019 · Cited by 172 — Continuous or intermittent antiepileptic medications are not recommended after a first febrile seizure because of potential adverse effects. [8] Sep 13, 2023 — Fever treatment – After the seizure has stopped, treatment for the fever is started, usually by giving oral or rectal antipyretics. [14] Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2021; 6(6):CD003031.

The differential diagnosis for familial febrile seizures involves considering various conditions that may present similarly to febrile seizures. Some of these conditions include:

• Acute bacterial meningitis: This is a serious infection that can cause fever, headache, and stiff neck, which may be mistaken for febrile seizures [8].
• Viral meningitis: Similar to acute bacterial meningitis, viral meningitis can cause fever, headache, and stiff neck, but it is typically less severe than bacterial meningitis.
• Viral encephalitis: This condition involves inflammation of the brain caused by a viral infection, which may present with fever, seizures, and altered mental status.

It's essential to note that these conditions require prompt medical attention and can be life-threatening if not treated promptly. A healthcare professional should consider these differential diagnoses when evaluating a child with febrile seizures, especially if there are any signs of severe illness or concern for underlying infection [5].

In addition to these conditions, genetic epilepsy with febrile seizures plus (GEFS+) is also considered in the differential diagnosis for familial febrile seizures. GEFS+ is a familial syndrome characterized by the presence of febrile seizures in an individual with a family history of seizures/epilepsy [11].