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        Fits accompanying fever is a recurring illness among children. Individual susceptibility to febrile fits depends on transmission of a specific trait.

        Mosquitoes bite all of us, only a few get malaria and some others filariasis. But on few others it has no effect at all!

        Excerpts from a wide-ranging interview with Dr K Pandian, pediatric neurologist and a visiting consultant at BM Hospital, Nanganallur.

        Q) What is febrile fits?

        A) Occurrence of convulsions with fever without any infection of the brain is termed febrile fits. Some children who experience a sudden rise in temperature tend to have convulsions. An otherwise normal child with minor respiratory infection or an insignificant illness, rolls the eyes, suddenly looks upwards, and becomes unresponsive.

        In some, this further advances to twitching of the lips and frothing from the mouth. The child may have either stiffening of all the limbs or twitching of the hands and legs. Usually this lasts for a few seconds or minutes and almost invariably self-limiting. In few instances this may get prolonged over 15 minutes.

        Q) When does it occur?

        A) Children have convulsions even with a slight increase in body temperature. Normally there are no episodes after the second day.

        But if there is a repeat attack, investigations have to be done to rule out other serious causes.

        Q) What is the age when it can occur?

        A) Febrile convulsions occur in children in the age group of 6 months to five years of age. Convulsions are more common in boys than girls, but chances of epilepsy must be ruled out.

        Q) Why does febrile fits occur?

        A) In some children, the threshold of the brain is low and does not resist a sudden rise is temperature which makes them susceptible to fits.

        Q) What are the types of fits?

        A) Usually a febrile fit is brief and generalised, that is, it affects both sides of the body and is self-limiting. The affected child usually regains sense after the episode. If it does not produce after affects like paralysis, unresponsiveness or weakness, then it can be termed as simple febrile fits.

        On the other hand, if it lasts more than few minutes or continues for 15-30 minutes affecting one side of the body, producing profound unresponsiveness, it is termed as complex febrile fits.

        Q) What is the natural course of illness?

        A) Usually it is self-limiting. By the time medical help is sought most of the fits subside.

        Q) Will there be repercussions later?

        A) Children who have febrile fits have strong tendency to have recurrence till around 6 years of age. The risk is high in smaller children with family history and in those with developmental or neurological problem.

        Q) Can febrile fits damage the brain?

        A) Brief seizures do not. But convulsions lasting 20 minutes and above can damage the brain. Some may develop damage to a particular area of the brain, which may lead to epilepsy later.

        Q) Why does it occur in only some? Is it hereditary?

        A) Individual susceptibility to febrile fits depends on transmission of specific trait. In most cases there is a history of similar febrile fits in the parent or the siblings.

        But a definite correlation is still not proven.

        Q) Can febrile fits be prevented?

        A) Yes. Temperature should never be allowed to shoot up for children vulnerable to fibrile fits. Medications like paracetamol in doses as prescribed by the doctor have to be followed.

        It is wrong to keep the child wrapped in blanket as this prevents heat loss. Sponging with water from head to foot helps to bring down temperature. Certain drugs like diazepam, clobazepam given orally along with paracetamol would largely reduce the incidence of fits.

        Q) Does it require long term medicine?

        A) This has to be decided by the doctor.