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No parent wants to have a sick child, but a child who has a seizure while ill is downright frightening for any parent. Seizures that are accompanied by a fever are called “febrile seizures,” and occur in 2 to 5% of the population. Thankfully, most of the time these seizures do not lead to long-term problems. Here’s what you need to know.

Febrile seizures are seizures accompanied by a fever at or greater than 100.4. Usually, the seizure occurs at the onset of the fever. How high the fever is not as important as how quickly it rises. Febrile seizures occur in children between the ages of 6 and 60 months, so they make up the most common type of seizures in young children. The most common age of a febrile seizure is between the ages of 12 and 18 months.

A child having a seizure may look pale, or the lips may have a bluish discoloration. He or she may stare off or the eyes may roll back, as the child becomes unresponsive. The arms and legs may become stiff and twitch or jerk rhythmically. Breathing may become shallow and the heart rate will increase. Febrile seizures usually only last a few minutes, but occasionally last much longer. Typically a child has only one seizure in a 24-hour period. If they have more than one seizure, or if the seizure lasts longer than 15 minutes, this is considered a complex febrile seizure, which may require hospitalization and further workup by a neurologist.

If your child has a febrile seizure, the most important thing to do is make sure he is safe. Place him on a flat surface such as the floor or a bed away from objects that may cause him harm. Turn his head to the side so if he vomits, he will not choke. Do not stick anything into your child’s mouth during the seizure, and be assured that he will not swallow his tongue. If the seizure lasts more than 5 minutes, call 911.

It is important for your child to be evaluated by a pediatrician after the seizure to look for a cause of the fever. For children under a year of age, they may need a spinal tap to look at the fluid surrounding the brain in order to make sure they don’t have meningitis. Older children would have more specific findings of meningitis, such as headache, altered mental status, and a stiff neck. They would only need a spinal tap if these findings are present along with the fever and seizure. For most children, febrile seizures are not associated with neurologic infections or other findings, and will need no further work up other than a good physical exam.

Febrile seizures tend to run in families. For children under a year of age, they have a 50% chance of having another seizure. Older children have a 30% chance. There is no way to prevent febrile seizures. Even if you give your child fever reducers such as acetaminophen or ibuprofen, they are still at risk. Most children will not need to be on a preventive anti-seizure medication.

Febrile seizures are scary for parents to witness, but be assured that they do not cause long-term brain damage. Also, there is no association with developing a seizure disorder or epilepsy later in life. Thankfully, most children with febrile seizures tend to outgrow them after the age of 5.

Takeaways

  • Febrile seizures are caused by a fever.
  • They are the most common cause of fever in infants.
  • Most are not emergencies.
  • Keep you baby safe during a seizure.
  • If the seizure lasts longer than 5 minutes, call 911.

References

  1. American Academy of Pediatrics. Clinical Practice Guidelines—Febrile Seizures.
  2. American Academy of Pediatrics. Febrile Seizures.

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