Retired Professor of Paediatrics and Neonatal Medicine, Imperial College School of Medicine, University of London
What is a febrile seizure?
Children who are running a high fever may have a fit. This is called a febrile seizure. This usually happens during the first few hours of a fever. The child may have a strange look for a few moments, then stiffen, twitch, and roll his eyes. Following this he may not respond to what is being said to him for a short time. After the seizure, he quickly returns to normal. The seizure usually lasts less than 1 minute. Febrile seizures rarely happen more than once within a 24-hour period.
These seizures need to be differentiated from other kinds of seizures (ones that are not caused by fever) that usually last longer, can affect only one part of the body, and may occur repeatedly. Although febrile seizures may appear very scary, they do not cause brain damage, nervous system problems, paralysis, mental retardation, or death.
What must be done if the child has a febrile seizure?
Immediate action must be taken to prevent injury
The child must be placed on the floor or bed
The head must be turned to the side so that any saliva or vomit drains out rather then enter the windpipe and cause choking
Nothing should be put into the mouth
The paediatrician must be consulted immediately.
Do these seizures recur?
Febrile seizures tend to run in families. The risk of having seizures with other episodes of fever depends on the age of the child. Children younger than 1 year of age at the time of their first seizure have a 50% chance of having another febrile seizure. Children older than 1 year of age have only a 30% chance of having a second febrile seizure.
Do these children get epilepsy later?
Epilepsy is a term used for seizures that occur repeatedly. Epileptic seizures are not caused by fever. Children with a history of febrile seizures have only a slightly higher risk of developing epilepsy by age 7 than children who have not had febrile seizures.
How are febrile seizures treated?
The paediatrician will examine the child to make sure that it is indeed a febrile seizure and not due to a serious infection like meningitis, especially if the child is younger than 1 year of age.
It is most important to determine and treat the cause of the fever rather than the seizure. Cold sponging and medicines like acetaminophen, ibuprofen or nimesulide may be given to bring the fever down. Anti-fever drugs help lower the fever, but they do not prevent febrile seizures. The doctor may advise a spinal tap called lumbar puncture to exclude the possibility of meningitis. In general, medicines called anti-convulsants that are used to prevent future episodes are not recommended in cases of simple febrile seizures. However, this should be discussed with the paediatrician. In cases of prolonged or repeated seizures, the recommendation may be different.