Febrile Seizures

What Are They?

Febrile seizures occur in children. They are caused by a fever of at least 102° Fahrenheit or by a sudden rise in body temperature. These seizures usually happen at the beginning of an illness, soon after the fever appears. Febrile seizures affect about 3% of children. They are most common between ages 6 months and 5 years.

What is a seizure? The brain's nerve cells (neurons) communicate with each other by giving off tiny electric signals. When someone has a seizure (convulsion), the way the brain's nerve cells give off signals suddenly changes, causing different muscles in the body to twitch or jerk uncontrollably.

About one in three children who have had a febrile seizure will have another one within one year, but most children eventually grow out of this condition. The risk of having another seizure is greater in children with a family history of febrile seizures, and in children who had their first seizure when they were younger than 12 months old. Children who have delays in normal development are also more likely to have febrile seizures.

Symptoms

Signs of a febrile seizure may include:

• Jerky, twitching movements of the arms and legs
• Stiffness
• Rolling eyes
• Passing out (loss of consciousness)
• Not responding to voices or touch

Diagnosis

In most cases, a doctor can diagnose febrile seizures based on a description of the episode. However, the doctor may want to see your child to look for the cause of the fever. In particular, the doctor will want to make sure your child does not have any signs of a serious infection of the brain (encephalitis) or of the membranes that cover the brain and spinal cord (meningitis).

Expected Duration

Febrile seizures usually last only a few minutes. If they last longer than this, call your doctor right away.

Prevention

There is no way to prevent the first febrile seizure. In children who already have had one febrile seizure, some medications may help to prevent more seizures. However, the potential side effects of these drugs may be worse than the benefits. The American Academy of Pediatrics does not recommend using these medications except in special circumstances. Instead, it recommends that parents of children at risk of febrile seizures be taught how best to manage a fever (to avoid febrile seizures) and what to do if a child does has a seizure.

Treatment

You cannot stop a seizure once it starts, but you can do the following to protect your child:

• Try to stay calm.
• Place the child on his or her side or stomach on a safe, flat surface, such as the floor. Keep the child away from furniture or objects that may cause injury.
• Tilt your child's head to the side to prevent choking.
• Do not restrain your child or put anything between his or her teeth.
• Observe your child carefully so you can describe the events to your doctor.
• Keep track of the time. If the seizure lasts longer than about five minutes, call your doctor.

After a seizure, call your doctor to arrange an appointment so your child can be examined.

Treatment involves reducing the fever and treating whatever is causing the fever. Hospitalization usually is not necessary, unless the condition causing the fever requires it.

Prognosis

The outlook is excellent. Febrile seizures generally are not harmful and do not cause long-term problems. Children with cerebral palsy, developmental delays or certain neurological problems are slightly more likely than other children to develop epilepsy (repeated seizures that are not related to fevers) after febrile seizures. Children who have repeated febrile seizures, and who had their first seizure when they were younger than 12 months old, are at an increased risk of developing epilepsy. However, the risk is still very low.

Additional Info

American Academy of Pediatrics (AAP)

141 Northwest Point Blvd.

Elk Grove Village, IL 60007-1098

Phone: (847) 434-4000

Fax: (847) 434-8000

E-Mail: kidsdocs@aap.org

http://www.aap.org/

Epilepsy Foundation

4351 Garden City Drive

Landover, MD 20785-7223

Toll-Free: (800) 332-1000

http://www.efa.org/

National Institute of Neurological Disorders and Stroke

P.O. Box 5801

Bethesda, MD 20824

Phone: (301) 496-5751

Toll-Free: (800) 352-9424

TTY: (301) 468-5981

http://www.ninds.nih.gov/