Signs of a febrile seizure include:
- Repeated rhythmic jerking or stiffening of your child's arms and legs
- Eyes rolled back in your child's head
- Lack of consciousness
A febrile seizure usually is due to a rapid rise in your child's temperature, but the above signs don't necessarily reflect the height of the fever. Most febrile seizures are short, with the signs usually lasting 5 minutes or less. After the seizure, your child may cry or be quite sleepy.
A febrile seizure may be triggered by a rapidly developing fever, which could be caused by an infection in any part of your child's body. The fever is usually from a typical childhood illness, such as a middle ear infection. A less common but very serious cause of a seizure is an infection of a child's central nervous system (brain and spinal cord). One such infection is meningitis, a condition in which membranes surrounding the brain become infected. Another is encephalitis, an inflammation in the brain itself.
Young age is the strongest risk factor. Most febrile seizures occur between the ages of 6 months and 5 years, and the highest likelihood of febrile seizures is in children between the ages of 12 months and 18 months. Some children inherit a family's tendency to have seizures with a fever.
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When to seek medical advice |
Seek medical attention immediately if your child has a seizure, develops a stiff neck, becomes confused or delirious, is difficult to wake up or acts very sick. First-time febrile seizures should be evaluated by your doctor as soon as possible.
Your doctor will need to examine your child to determine the possible causes of the fever and seizure. Your doctor may order blood and urine tests to detect an infection.
If your doctor suspects a central nervous system infection, a spinal tap (lumbar puncture) may be necessary. In this procedure, approximately one-half teaspoon of spinal fluid is removed with a needle appropriately placed into the child's lower back. This test can reveal evidence of infection in the fluid that surrounds the brain and spinal cord.
Although they may greatly concern you as a parent, the vast majority of febrile seizures produce no lasting effects.
Febrile seizures are classified as simple or complex. Researchers currently believe that simple febrile seizures cause no higher incidence of subsequent epilepsy, cerebral palsy or mental retardation. A complex febrile seizure lasts longer than 15 minutes, occurs more than once within 24 hours or is confined to one side of the body. Complex febrile seizures may carry a somewhat higher risk of subsequent seizures.
If your child experiences a febrile seizure, you might wonder whether he or she has a more serious underlying disorder, such as epilepsy. However, epilepsy in children is defined as recurring seizures in the absence of fever. The odds that your child will develop epilepsy after a febrile seizure are small. Between 95 percent and 98 percent of children who have a simple febrile seizure will never develop epilepsy. However, children with epilepsy are more likely to have seizures when they have a fever, because fever lowers the seizure threshold.
The vast majority of febrile seizures stop on their own within 5 minutes. However, if the seizure lasts for more than 5 minutes — or if your child has two or more seizures — call for emergency medical attention.
If the seizure is still occurring when your child arrives at the emergency room, a doctor may order medication administered either through your child's rectum or intravenously to stop the seizure.
It's possible that the doctor will want your child to stay in the hospital briefly for further observation. But a hospital stay isn't always necessary.
If your child is susceptible to febrile seizures, it may be possible to prevent these seizures by taking quick action to control fever when your child has an illness.
Most of the time, a febrile seizure occurs during the first day of an illness. By giving your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) at the first indication of fever, you may reduce the chance of a febrile seizure. But don't give aspirin to children. Aspirin may trigger a rare but potentially fatal disorder known as Reye's syndrome. Also, don't bundle up your child too much at night, and make sure your child drinks plenty of fluids.
It also is possible to prevent febrile seizures by having your child take a prescription anticonvulsant medication until age 3 or 4. However, doctors rarely prescribe these medications because most febrile seizures are harmless and most children outgrow them without any problems.
Medications that prevent seizures have drawbacks. Anticonvulsant medications such as valproic acid (Depakene) and divalproex (Depakote) are effective in preventing febrile seizures, but they carry a significant risk of serious side effects in young children. Children who have frequent or prolonged febrile seizures might benefit from preventive treatment with oral or rectal diazepam (Valium, Diastat).
Although febrile seizures are usually harmless, these steps can help your child avoid injury during the seizure:
- Place your child on his or her side, somewhere where they won't fall.
- Stay close beside to watch and comfort your child.
- Remove any 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 attempt to put anything in your child's mouth.
Within 1 to 2 hours of a febrile seizure, many children are back on their feet, running around the doctor's office or playing safely at home. By staying calm, observing your child and knowing when to call the doctor, you're doing everything that's needed to take care of your child.
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April 15, 2002 —
