热性惊厥家长须知 Febrile Seizure - Mayo Clinic

Overview概述

A febrile seizure is a convulsion in a child that‘s caused by a fever. The fever is often from an infection. Febrile seizures occur in young, healthy children who have normal development and haven‘t had any neurological symptoms before.

热性惊厥是一种由发热引起的儿童惊厥。发热通常是由感染引起的。热性惊厥发生在发育正常，且既往没有任何神经系统症状的健康儿童。

It can be frightening when your child has a febrile seizure. Fortunately, febrile seizures are usually harmless, only last a few minutes, and typically don‘t indicate a serious health problem.

当你看到孩子热性惊厥发作时，感觉很可怕。幸运的是，热性惊厥通常是无害的，只持续几分钟，而且通常不意味着有严重的健康问题。

You can help by keeping your child safe during a febrile seizure and by offering comfort afterward. Call your doctor to have your child evaluated as soon as possible after a febrile seizure.

发作时你要保证孩子的安全，发作后要安抚孩子，并尽快打电话联系医生，评估孩子的情况。

Symptoms症状

Usually, a child having a febrile seizure shakes all over and loses consciousness. Sometimes, the child may get very stiff or twitch in just one area of the body.

通常，一个患有热性惊厥的孩子会全身颤抖，失去知觉。有时，孩子可能只是身体的一个部位变得非常僵硬或抽动。

A child having a febrile seizure may:

• Have a fever higher than 100.4 F (38.0 C)
• Lose consciousness
• Shake or jerk the arms and legs

有热性惊厥的儿童可能会：

• 发热，温度高于100.4华氏度（38.0摄氏度）
• 失去知觉
• 手臂和腿摇动或抽搐

Febrile seizures are classified as simple or complex:

• Simple febrile seizures. This most common type lasts from a few seconds to 15 minutes. Simple febrile seizures do not recur within a 24-hour period and are not specific to one part of the body.
• Complex febrile seizures. This type lasts longer than 15 minutes, occurs more than once within 24 hours or is confined to one side of your child‘s body.

热性惊厥发作分为单纯性和复杂性两种：

• 单纯性热性惊厥：这种常见的类型会持续几秒钟到15分钟。单纯性热性惊厥在24小时内不会复发，也不是局限于身体的某个部位。
• 复杂性热性惊厥：这种类型的发作持续时间超过15分钟，在24小时内不止一次发作，或者局限于孩子身体的一侧。

Febrile seizures most often occur within 24 hours of the onset of a fever and can be the first sign that a child is ill.

热性惊厥通常发生在发热出现后的24小时内，也可能是儿童生病的第一个迹象。

When to see a doctor什么时候去看医生

See your child‘s doctor as soon as possible after your child‘s first febrile seizure, even if it lasts only a few seconds. Call an ambulance to take your child to the emergency room if the seizure lasts longer than five minutes or is accompanied by:

在你孩子的第一次热性惊厥发作后，要尽快去看医生，即使它只持续几秒钟。如果惊厥持续超过5分钟或有以下情况，呼叫救护车将孩子送往急诊室：

• Vomiting
• A stiff neck
• Breathing problems
• Extreme sleepiness
• 呕吐
• 脖子僵硬
• 呼吸问题
• 极度嗜睡

Causes原因

Usually, a higher than normal body temperature causes febrile seizures. Even a low-grade fever can trigger a febrile seizure.

通常，体温高于正常会引起热性惊厥。即使是低热也会引发热性惊厥。

Infection 感染

The fevers that trigger febrile seizures are usually caused by a viral infection, and less commonly by a bacterial infection. The flu (influenza) virus and the virus that causes roseola, which often are accompanied by high fevers, appear to be most frequently associated with febrile seizures.

引发热性惊厥的发热通常是由病毒感染引起的，其次是细菌感染。流感病毒和引起幼儿急疹的病毒，经常导致高热，与热性惊厥密切相关。

Post-vaccination seizures疫苗接种后发作

The risk of febrile seizures may increase after some childhood vaccinations. These include the diphtheria, tetanus and pertussis vaccine and the measles-mumps-rubella vaccine. A child can develop a low-grade fever after a vaccination. The fever, not the vaccine, causes the seizure.

一些儿童接种疫苗后，热性惊厥的风险可能会增加。这些疫苗包括白喉、破伤风和百日咳疫苗以及麻疹-腮腺炎-风疹疫苗。儿童在接种疫苗后可能会出现低热。引起热性惊厥的是发热，而不是疫苗。

Risk factors 危险因素

Factors that increase the risk of having a febrile seizure include:

• Young age. Most febrile seizures occur in children between 6 months and 5 years of age, with the greatest risk between 12 and 18 months of age.
• Family history. Some children inherit a family‘s tendency to have seizures with a fever. Additionally, researchers have linked several genes to a susceptibility to febrile seizures.

增加热性惊厥发作风险的因素包括：

• 年龄小：大多数热性惊厥发生在6个月至5岁的儿童中，最大的风险发生在12至18个月的儿童之间。
• 家族史：有些孩子继承了家族热性惊厥的倾向。此外，研究人员还将一些基因与热性惊厥易感性联系起来。

Complications并发症

Most febrile seizures produce no lasting effects. Simple febrile seizures don‘t cause brain damage, intellectual disability or learning disabilities, and they don‘t mean your child has a more serious underlying disorder.

大多数热性惊厥不会产生持久的影响。单纯性热性惊厥不会导致脑损伤、智力障碍或学习障碍，也不意味着你的孩子有更严重的潜在疾病。

Febrile seizures are provoked seizures and don‘t indicate epilepsy. Epilepsy is a condition characterized by recurrent unprovoked seizures caused by abnormal electrical signals in the brain.

热性惊厥是被诱发的惊厥发作，并不意味着癫痫。癫痫是一种由大脑异常电信号引起的反复的，无诱因的惊厥发作。

Recurrent febrile seizures 复发性热性惊厥

The most common complication is the possibility of more febrile seizures. The risk of recurrence is higher if:

• Your child‘s first seizure resulted from a low-grade fever.
• The febrile seizure was the first sign of illness.
• An immediate family member has a history of febrile seizures.
• Your child was younger than 18 months at the time of the first febrile seizure.

最常见的并发症是可能出现多次热性惊厥。如果有以下情况，则复发的风险较高：

• 你的孩子的第一次惊厥发作是由于低热引起的。
• 热性惊厥是疾病的第一个症状。
• 直系亲属有热性惊厥发作史。
• 你的孩子在第一次热性惊厥发作时还不到18个月。

Prevention预防措施

Most febrile seizures occur in the first few hours of a fever, during the initial rise in body temperature.

大多数热性惊厥发作，发生在发热的最初几个小时内，在最初的体温升高期间。

Giving your child medications给孩子服用药物

Giving your child infants‘ or children‘s acetaminophen or ibuprofen at the beginning of a fever may make your child more comfortable, but it won‘t prevent a seizure.

在发热的时候给你的孩子用对乙酰酰氨基酚或布洛芬，可能会让孩子舒服些，但不能防止惊厥发作。

Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye‘s syndrome, a rare but potentially life-threatening condition, in such children.

在给儿童或青少年服用阿司匹林时要小心。虽然阿司匹林被批准用于3岁以上的儿童，但从水痘或流感样症状中恢复的儿童和青少年绝对不应该服用阿司匹林。这是因为阿司匹林与雷伊综合症有关，这是一种罕见但可能危及生命的疾病。

Prescription prevention medications预防性的处方药物

Rarely, prescription anticonvulsant medications are used to try to prevent febrile seizures. However, these medications can have serious side effects that may outweigh any possible benefit.

偶尔，需要处方的抗惊厥药物会用于预防热性惊厥。然而，这些药物可能会有严重的副作用，超过任何可能的好处。

Rectal diazepam or nasal midazolam might be prescribed to be used as needed for children who are prone to long febrile seizures. These medications are typically used to treat seizures that last longer than five minutes or if the child has more than one seizure within 24 hours. They are not typically used to prevent febrile seizures.

直肠地西泮（安定）或鼻用咪达唑仑可用于容易发生长时间热性惊厥的儿童。这些药物通常用于治疗持续时间超过5分钟的惊厥发作，或如果儿童在24小时内热性惊厥发作超过一次。它们不是常规用于预防热性惊厥。

Diagnosis诊断

Febrile seizures occur in children with normal development. Your doctor will carefully review your child‘s medical history and developmental history to exclude other risk factors for epilepsy. In normally developing children, identifying the cause of your child‘s fever is the first step after a febrile seizure.

热性惊厥发生在发育正常的儿童中。医生会仔细检查孩子的病史和发育史，以排除癫痫的其他危险因素。在正常发育的儿童中，确定孩子发热的原因是热性惊厥发作后的第一步。

Simple febrile seizures单纯性热性惊厥

Children who are current with their vaccinations who have a first simple febrile seizure don‘t need testing. Your doctor can diagnose the febrile seizure based on history.

目前正在接种疫苗的首次单纯性热性惊厥的儿童不需要检测。医生可以根据病史诊断为热性惊厥。

In children with a delayed vaccination schedule or a compromised immune system, your doctor may recommend tests to look for severe infections:

对于延迟疫苗接种计划或免疫系统受损的儿童，医生可能会建议以下检测，排除严重感染：

• A blood test
• A urine test
• A spinal tap (lumbar puncture), to find out if your child has a central nervous system infection, such as meningitis
• 血常规
• 尿常规
• 脊椎穿刺（腰椎穿刺），检查你的孩子是否有中枢神经系统感染，如脑膜炎

Complex febrile seizures复杂性热性惊厥

To diagnose the cause of a complex febrile seizure, your doctor may also recommend an electroencephalogram (EEG), a test that measures brain activity.

为了确定复杂性热性惊厥的原因，医生可能会建议脑电图（EEG）检查，这是一种测量大脑活动的测试。

Your doctor may also recommend an MRI to check your child‘s brain if your child has:

• An unusually large head
• An abnormal neurological evaluation
• Signs and symptoms of increased pressure in the skull
• A febrile seizure that lasted an unusually long time

如果孩子有以下情况，医生可能会建议脑部的核磁共振检查：

• 头异常的大
• 神经系统评估异常
• 颅内压力增加的迹象和症状
• 热性惊厥持续时间过长

Treatment治疗

Most febrile seizures stop on their own within a couple of minutes. If your child has a febrile seizure, stay calm and follow these steps:

大多数热性惊厥发作会在几分钟内自行停止。如果孩子出现热性惊厥，保持冷静并遵循以下步骤：

• Place your child on his or her side on a soft, flat surface where he or she won‘t fall.
• Start timing the seizure.
• Stay close to watch and comfort your child.
• Remove hard or sharp objects near your child.
• Loosen tight or restrictive clothing.
• Don‘t restrain your child or interfere with your child‘s movements.
• Don‘t put anything in your child‘s mouth.
• 把孩子放在一个不会摔倒的柔软平坦的表面上。
• 开始计时惊厥发作时间。
• 密切观察和安慰孩子。
• 清除孩子附近坚硬或尖锐的物体。
• 松开紧身或约束孩子的衣服。
• 不要约束孩子或干扰孩子的动作。
• 不要把任何东西放进孩子的嘴里。

Call for emergency medical attention if:

如果有以下情况，则要求紧急就医：

• Your child has a febrile seizure that lasts more than five minutes.
• Your child has repeated seizures.
• Your child‘s seizure lasted less than five minutes but your child isn‘t improving quickly.
• 热性惊厥发作持续时间超过5分钟。
• 反复发作。
• 惊厥发作持续不到五分钟，但孩子病情没有很快好转。

More-serious episodes更严重的情况

A doctor may order medication to stop a seizure that lasts longer than five minutes.

Your child‘s doctor may hospitalize the child for observation if:

持续时间超过5分钟，医生会下医嘱，用药来停止惊厥发作。

如果有以下情况，医生可能会让孩子住院观察：

• The seizure is prolonged
• The child is younger than 6 months old
• The seizure is accompanied by a serious infection
• The source of the infection can‘t be found
• 惊厥发作时间过长
• 孩子不到6个月
• 惊厥发作伴有严重的感染
• 无法确定感染源

But a hospital stay isn‘t usually necessary for simple febrile seizures.

但单纯性的热性惊厥，通常不需要住院。

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