What are Febrile Seizures?
Febrile seizures are convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body. Less commonly, the child becomes rigid or has twitches in only a portion of the body, such as an arm or a leg, or on the right or the left side only. Most febrile seizures last a minute or two, although some can be as brief as a few seconds while others last for more than 15 minutes.
The majority of children with febrile seizures have rectal temperatures greater than 102 degrees Fahrenheit. Most febrile seizures occur during the first day of a child’s fever. Children prone to febrile seizures are not considered to have epilepsy, since epilepsy is characterized by recurrent seizures that are not triggered by fever.
Causes of Febrile Seizures
A febrile seizure can be very frightening for any parent or caregiver. Most of the time, a febrile seizure does not cause any harm and the child usually does not have a more serious long-term health problem.
Febrile seizures occur most often in otherwise healthy children between ages 9 months and 5 years. Toddlers are most commonly affected. Febrile seizures often run in families.
Most febrile seizures occur in the first 24 hours of an illness, and may not occur when the fever is highest. Ear infections, a cold or viral illness may trigger a febrile seizure.
Symptoms of Febrile Seizures
Febrile seizure symptoms can range from mild staring to more severe shaking or tightening of the muscles.
A child having a febrile seizure may:
- Have a fever higher than 100.4 F (38.0 C)
- Lose consciousness
- Shake or jerk arms and legs
Febrile seizures are classified as simple or complex:
- Simple febrile seizures. This more common type lasts from a few seconds to 15 minutes. Simple febrile seizures do not recur within a 24-hour period and are generalized, 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.
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.
What do I do if my child has a Febrile Seizure?
If your child has a febrile seizure, act immediately to prevent injury.
- Place her on the floor or bed away from any hard or sharp objects.
- Turn her head to the side so that any saliva or vomit can drain from her mouth.
- Do not put anything into her mouth; she will not swallow her tongue.
- Call your child’s doctor.
- If the seizure does not stop after 5 minutes, call 911 or your local emergency number.
Are Febrile Seizures harmful?
Although they can be frightening to parents, the vast majority of febrile seizures are harmless. During a seizure, there is a small chance that the child may be injured by falling or may choke from food or saliva in the mouth. Using proper first aid for seizures can help avoid these hazards (see section entitled “What should be done for a child having a febrile seizure?”).
There is no evidence that febrile seizures cause brain damage. Large studies have found that children with febrile seizures have normal school achievement and perform as well on intellectual tests as their siblings who don’t have seizures. Even in the rare instances of very prolonged seizures (more than 1 hour), most children recover completely.
Between 95 and 98 percent of children who have experienced febrile seizures do not go on to develop epilepsy. However, although the absolute risk remains very small, certain children who have febrile seizures face an increased risk of developing epilepsy. These children include those who have febrile seizures that are lengthy, that affect only part of the body, or that recur within 24 hours, and children with cerebral palsy, delayed development, or other neurological abnormalities. Among children who don’t have any of these risk factors, only one in 100 develops epilepsy after a febrile seizure.
Complications of Febrile Seizures
Febrile seizures have been linked to an increased risk of epilepsy (see below), as well as other problems.
Recent research findings may indicate a link between febrile seizures and sudden unexplained death in childhood (SUDC), possibly due to the connection between febrile seizures and epilepsy.
However, this link hasn’t been proven and SUDC is incredibly rare, affecting around one in 100,000 children which is equivalent to a 0.001% chance.
In addition, one of the biggest studies of its kind looked at more than 1.5 million children with a history of febrile seizures and found no evidence of an increased risk of death in later childhood or adulthood.
Treatment of Febrile Seizures
During the seizure, take the following measures to keep the child safe:
- Do not restrain the child or try to stop the seizure movements.
- Lay the child on the ground in a safe area. Clear the area of furniture or other sharp objects.
- Slide a blanket under the child if the floor is hard.
- Move the child only if they are in a dangerous location.
- Loosen tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
- If the child vomits or if saliva and mucus build up in the mouth, turn the child to the side or on the stomach. This is also important if it looks like the tongue is getting in the way of breathing.
- Do not force anything into the child’s mouth to prevent biting the tongue. This increases the risk of injury.
Focus your attention on bringing the fever down:
- Insert an acetaminophen suppository (if you have some) into the child’s rectum.
- Do not give anything by mouth.
- Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol can make the fever worse.
- After the seizure is over and your child is awake, give the normal dose of ibuprofen or acetaminophen.
After the seizure, the most important step is to identify the cause of the fever.
Meningitis can cause a few cases of febrile seizures. It should always be considered, especially in children younger than 1 year old, or in children who still look ill when the fever comes down.
