Definisi

A febrile seizure is a convulsion in a child that may be caused by a spike in body temperature,
often from an infection. Your child's having a febrile seizure can be alarming, and the few
minutes it lasts can seem like an eternity.
Febrile seizures represent a unique response of a child's brain to fever, usually the first day of a
fever. Fortunately, they're usually harmless and typically don't indicate an ongoing problem. You
can help by keeping your child safe during a febrile seizure and by comforting him or her
afterward.
Febrile seizures fact sheet. National Institute of Neurological Disorders and Stroke.
http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm. Accessed Nov.
3, 2014.

Patofisiologi
Febrile seizures occur in young children at a time in their development when the seizure
threshold is low. This is a time when young children are susceptible to frequent childhood
infections such as upper respiratory infection, otitis media, viral syndrome, and they respond
with comparably higher temperatures. Animal studies suggest a possible role of endogenous
pyrogens, such as interleukin 1beta, that, by increasing neuronal excitability, may link fever and
seizure activity.[3] Preliminary studies in children appear to support the hypothesis that the
cytokine network is activated and may have a role in the pathogenesis of febrile seizures, but the
precise clinical and pathological significance of these observations is not yet clear.[4, 5]
Febrile seizures are divided into 2 types: simple febrile seizures (which are generalized, last < 15
min and do not recur within 24 h) and complex febrile seizures (which are prolonged, recur more
than once in 24 h, or are focal).[6]Complex febrile seizures may indicate a more serious disease
process, such asmeningitis, abscess, or encephalitis. Febrile status epilepticus, a severe type of
complex febrile seizure, is defined as single seizure or series of seizures without interim recovery
lasting at least 30 minutes.
Viral illnesses are the predominant cause of febrile seizures. Recent literature documented the
presence of human herpes simplex virus 6 (HHSV-6) as the etiologic agent in roseola in about
20% of a group of patients presenting with their first febrile seizures. Shigella gastroenteritis also
has been associated with febrile seizures. One study suggests a relationship between recurrent
febrile seizures and influenza A.[7, 8]
Febrile seizures tend to occur in families. In a child with febrile seizure, the risk of febrile
seizure is 10% for the sibling and almost 50% for the sibling if a parent has febrile seizures as
well. Although clear evidence exists for a genetic basis of febrile seizures, the mode of
inheritance is unclear.[9]

While polygenic inheritance is likely, a small number of families are identified with an
autosomal dominant pattern of inheritance of febrile seizures, leading to the description of a
"febrile seizure susceptibility trait" with an autosomal dominant pattern of inheritance with
reduced penetrance. Although the exact molecular mechanisms of febrile seizures are yet to be
understood, underlying mutations have been found in genes encoding the sodium channel and the
gamma amino-butyric acid A receptor
1. Iwasaki N, Nakayama J, Hamano K, Matsui A, Arinami T. Molecular genetics of febrile
seizures. Epilepsia. 2002. 43 Suppl 9:32-5. [Medline].
2. Hirose S, Mohney RP, Okada M, Kaneko S, Mitsudome A. The genetics of febrile
seizures and related epilepsy syndromes. Brain Dev. 2003 Aug. 25(5):304-12. [Medline].
3. Nakayama J, Arinami T. Molecular genetics of febrile seizures. Epilepsy Res. 2006 Aug.
70 Suppl 1:S190-8. [Medline].

Etilogi
The important viral or bacterial infection causes of FSs were recent upper respiratory
infection42.3% (95% CI: 37.2%47.4%), gastroenteritis21.5% (95% CI: 13.6%29.4%), otitis
media infections15.2% (95% CI: 9.8%20.7%), pneumonia8.7% (95% CI: 5.4%11.9%), urinary
infections3.2% (95% CI: 1.3%5.0%), rosella 2.0% (95% CI: 0.02%3.8%), and other
infections12.8% (9.8%15.8%). The pooled prevalence rate of childhood febrile seizure
compared to other childhood seizures in Iran was 47.9 %(95% CI 12.329.5%)
Forest plots of recurrent FS for random effects metaanalyses
Prevalence of simple and complex febrile seizure were 69.3% (95% CI: 19.631.0) and 28.3%
(95% CI: 59.5 79.0), respectively. Generalized seizures are classified into a number of
categories depending on their behavioral effects. Toniccolonic seizures the prevalence rate
among other types of generalized seizures was 78.9% (95%CI: 68.8%89.2%).
(Squares represent effect estimates of individual studies with their 95% confidence intervals of
prevalence FS with size of squares proportional to the weight assigned to the study in the meta
analysis. The diamond represents the overall result and 95% confidence interval of the random
effects metaanalysis).

Diagnosa,rational,dan intervention
Nursing Care Plan for Febrile Seizures

I. Increased body temperature related to the presence of pyrogens that disrupt the thermostat, the
average increase in metabolism and disease dehydration.
Goal: Normal body temperature.
Outcomes: temperature 36.5 C - 37.5 C and the clients are free from fever.
Interventions and Rational:
1. Observation of vital signs every four hours.
R /: Vital signs are increased, is a manifestation of the occurrence of seizures and complications.
2. Provide a description of the family regarding the provision compress.
R /: Cold compresses can reduce body temperature.
3. Give light clothing that can absorb sweat.
R /: Facilitate the release of heat into the air.
4. Encourage clients to drink.
R /: Prevent dehydration.
5. Engage in collaboration with the medical team for giving antipyretics and antibiotics.
R /: Antipyretics to reduce body temperature and antibiotics for the treatment of infections.
II. Risk for ineffective airway clearance related to neuromuscular damage and obstruction
trakeobroncial.
Goal: maintain effective breathing pattern with a clean airway and prevented from aspiration.
Outcomes:
Normal respiration: 15-30 x per minute and no muscle retraction.
Interventions and Rational:
1. Place the patient in a comfortable position (semi-Fowler).
R /: Freeing airway to prevent asphyxiation.
2. Loosen clothing, especially on the neck, chest and abdomen.
R /: Make it easy breathing and comfort.
3. Give spatel in mouth
R /: Preventing trauma to the tongue.
4. Section if necessary.
R /: Eliminate secretions and prevent aspiration and cleaning the airway of secretions.

5. Give 02 In accordance with the requirement.

R /: Overcoming hypoxia.
III. Knowledge Deficit: families with respect to misinterpretation and lack of information.
Goal: Verbally client can reveal that stimulation may increase seizures
Outcomes:
Clients can take medication on a regular basis.
Interventions and Rational
1. Assess pathology and prognosis of the condition of the client.
R /: to demonstrate and determine the action to be performed.
2. Assess treatment that has been done.
R /: Preventing conflicts of drug effects.
3. Provide nutritious food.
R /: Restoring general condition and condition as well as preventing a decrease in body weight.
4. Discuss the effects of drugs.
R /: Knowing the signs of allergic reaction and know the development of the client's condition.
5. Explain how to prevent infection.
R /: Improve knowledge of the client and prevent complications.
6. Immediately lower the heat in the event of a seizure.
R /: Heat can cause repeated seizures.
7. Teach the family to give anti-seizure drugs and anti-pyretic in accordance with the rules of the
medical team.
R /: Preventing drug misuse.
IV. Risk for injury or trauma related to weakness, changes in consciousness.
Goal: Verbally clients can find out the factors that allow the trauma.
Outcomes:
Clients are free from trauma when a seizure occurs.
Interventions and Rational
1. Explain the factors predisposing to seizures.
R /: Preventing false perceptions and increase client cooperative attitude.

2. Keep clients from trauma by providing a safety on the side of the bed.
R /: Safety handy while preventing trauma (fall) when the seizure occurred.

3. Keep the client in the event of an aura.

R /: Knowing early impending seizures and prevent trauma.
4. Stay with the client during the phase of seizures.
R /: To prevent complications as early as possible.
V. Impaired self-concept (low self esteem) related to epilepsy and wrong perceptions and
uncontrolled.
Goal: Verbally clients do not experience a mis interpretation and low self-esteem does not
happen
Outcomes:
Clients and families can know correctly about prognosis, treatment regimen and treatment of
seizures.
Interventions and Rational
1. Provide a description of the disease, treatment and prevention method.
R /: Improving cooperation and prevent misinterpretation.
2. Explain how to avoid the risk factors.
R /: Knowing the risk factors for the client to avoid the cause of the seizures.
3. Answers questions and accommodate all clients and families.
R /: Meet the lack of information about febrile seizures.
1. NANDA. 2005. Nursing Diagnosis: Definition and Classification 2005-2006. NANDA
International. Philadelphia.
2. Betz, Cecily L dan Sowden, Linda L. 2002.Keperawatan Pediatrik, Edisi 3, EGC: Jakarta.