{"id":130,"date":"2018-08-29T05:11:48","date_gmt":"2018-08-29T05:11:48","guid":{"rendered":"https:\/\/www.venkateshwarhospitals.com\/blog\/?p=130"},"modified":"2025-11-11T08:45:42","modified_gmt":"2025-11-11T08:45:42","slug":"frightening-but-benign-neurological-behaviors-in-children-during-fever","status":"publish","type":"post","link":"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/","title":{"rendered":"Frightening but Benign Neurological Behaviors in Children during Fever"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Abnormal behavior in children with fever is very frightening to the parents, challenging to treating doctors and can be life threatening to the child. The majority of these abnormal behaviors are benign. But because parents are so worried that such kids are exposed to unnecessary investigations and over treatment. In a hurry, while rushing them to the hospital, they are prone to accidents.<\/span><\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#Understanding_Fever_and_Behavior_Changes_in_Children\" >Understanding Fever and Behavior Changes in Children<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#Common_Neurological_Behaviors_during_Fever\" >Common Neurological Behaviors during Fever<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#1_Febrile_Seizures_in_Children\" >1. Febrile Seizures in Children<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#2_Febrile_Delirium\" >2. Febrile Delirium<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#3_Febrile_Syncope\" >3. Febrile Syncope<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#4_Febrile_Myoclonia\" >4. Febrile Myoclonia<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"#\" data-href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/frightening-but-benign-neurological-behaviors-in-children-during-fever\/#When_to_Suspect_CNS_Infection\" >When to Suspect CNS Infection<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Understanding_Fever_and_Behavior_Changes_in_Children\"><\/span><b>Understanding Fever and Behavior Changes in Children<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Fever is the commonest cause of headache in childhood, but since small children cannot explain, they are irritable, do not eat, continuously crying and their sleep is disturbed. Parents are worried. But what they need to do is to give antipyretics and plenty of oral fluids. Paracetamol is safe and few doses can be given even without prescription. The dose is 10mg to 15 mg \/kg\/dose, 3 to 4 times in 24 hours.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Common_Neurological_Behaviors_during_Fever\"><\/span><b>Common Neurological Behaviors during Fever<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Common abnormal neurological behaviors during fever in children are febrile seizures, febrile syncope, febrile myoclonus and febrile delirium. Vomiting is a common association with fever and these children are invariably given anti emetics. One of the common toxicities of antiemetic is encephalopathy. Such children are agitated, restless, disoriented, hallucinated and irrelevant in their talk. Such problems are more common in combination drugs like paracetamol and domperidone, where parents are not aware of the contents. These drugs can also cause extrapyramidal symptoms. Such symptoms can be scary to parents. A single parental dose of diazepam or diphenhydramine can relieve these symptoms.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"1_Febrile_Seizures_in_Children\"><\/span><b>1. Febrile Seizures in Children<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">\u00a0The incidence of febrile seizure in India is around 3% in children younger than 5 years of age. The common age group is 6 months to 5 years. The cause of fever is not CNS infection and is usually viral upper respiratory tract infection. The majority (85%) are typical and are generalized, usually once in a febrile episode and last less than 15 min. treatment is antipyretics and plenty of fluids. EEG and neuro imaging are not required. Short term preventive treatment with clobazam 5mg up to 10 kg weight, 7.5mg up to 15 kg weight and 10 mg up to 20 kg weight per day for 3 days, starting at onset of fever can be given to worried parents.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"2_Febrile_Delirium\"><\/span><b>2. Febrile Delirium<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Delirium is seen at peak of fever, child is agitated, restless, disoriented and talks irrelevant. There can be marked tachycardia with sweating. Once the fever comes down, the child becomes normal. The only treatment advised is to lower the temperature with cold sponging and antipyretics. Avoid giving feeds during that time.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"3_Febrile_Syncope\"><\/span><b>3. Febrile Syncope<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In febrile syncope, the child becomes unresponsive, pale and limp. This is due to vasodilatation and pooling of blood at peripheries leading to decreased intracranial blood flow. Nothing to panic. Put the child on a flat hard surface. Give cold liquids to drink and antipyretics to lower the fever.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"4_Febrile_Myoclonia\"><\/span><b>4. Febrile Myoclonia<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Some children start jerking their whole body for hours together and do not respond to benzodiazepines and other anticonvulsants. These are known as febrile myoclonia and are supposed to be due to the release of cytokines during fever. These cytokines stimulate hypothalamus causing myoclonus.<\/span><\/p>\n<p><b>Also Read &#8211;<\/b> <a href=\"https:\/\/www.venkateshwarhospitals.com\/blog\/tips-for-choosing-the-best-hospital-for-child-care\/\"><span style=\"font-weight: 400;\">Tips For Choosing The Best Hospital For Child Care<\/span><\/a><\/p>\n<h2><span class=\"ez-toc-section\" id=\"When_to_Suspect_CNS_Infection\"><\/span><b>When to Suspect CNS Infection<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">CNS infection should always be kept in mind when a child presents with abnormal neurological behavior and fever.\u00a0 In meningitis, the child will be sick looking and may have neck rigidity. Observation in the majority of the case will resolve the issue and few may require CSF analysis to exclude CNS infection.<\/span><\/p>\n<p style=\"text-align: justify;\">liquids to drink and antipyretics to lower the fever.<\/p>\n<p style=\"text-align: justify;\">Some children start jerking their whole body for hours together and do not respond to benzodiazepines and other anticonvulsants. These are known as febrile myoclonia and are supposed to be due to the release of cytokines during fever. These cytokines stimulate hypothalamus causing myoclonus.<\/p>\n<p style=\"text-align: justify;\">CNS infection should always be kept in mind when a child presents with abnormal neurological behavior and fever. \u00a0In meningitis, child will be sick looking and may have neck rigidity. Observation in majority of the case will resolve the issue and few may require CSF analysis to exclude CNS infection.<\/p>\n<p>&nbsp;<\/p>\n<blockquote class=\"graf graf--blockquote\">\n<p><strong>Medically Reviewed by<\/strong>\u200a\u2014\u200a <a href=\"https:\/\/www.venkateshwarhospitals.com\/doctor-profile\/dr-brig-k-s-rana\">Dr. (Brig) K. S. Rana<\/a> (Principal Director \u2013 <a href=\"https:\/\/www.venkateshwarhospitals.com\/paediatrics-and-neonatology.php\">Pediatric Neurology<\/a>)<\/p>\n<\/blockquote>\n","protected":false},"excerpt":{"rendered":"<p>Abnormal behavior in children with fever is very frightening to the parents, challenging to treating doctors and can be life threatening to the child. The majority of these abnormal behaviors are benign. But because parents are so worried that such kids are exposed to unnecessary investigations and over treatment. In a hurry, while rushing them&#8230;<\/p>\n","protected":false},"author":1,"featured_media":132,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[29,30,27,28],"class_list":["post-130","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurology","tag-child-neurologist","tag-dr-k-s-rana","tag-neurologist","tag-neurology"],"_links":{"self":[{"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/posts\/130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/comments?post=130"}],"version-history":[{"count":3,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/posts\/130\/revisions"}],"predecessor-version":[{"id":1227,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/posts\/130\/revisions\/1227"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/media\/132"}],"wp:attachment":[{"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/media?parent=130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/categories?post=130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.venkateshwarhospitals.com\/blog\/wp-json\/wp\/v2\/tags?post=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}