What is a febrile seizure?
A febrile seizure is a convulsion in a child triggered by a fever. Such convulsions occur without any underlying brain or spinal cord infection or other neurologic cause. Febrile seizures occur in children. They are caused by a fever of at least 102 degrees Fahrenheit or by a sudden rise in body temperature. These seizures usually happen at the beginning of an illness, soon after the fever appears. In young children, a rapidly rising body temperature can cause a seizure or a
convulsion. This is called a fever seizure or febrile seizure. It typically affects children between the ages of 6 months and 5 years and lasts just a few minutes. But it can seem like an eternity to frightened parents.
About 3-5% of otherwise healthy children between the ages of 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. There is a tendency for febrile seizures to run in families. Most febrile seizures are triggered by a rapid rise of body temperature over 102.2°F. Most occur well within the first 24 hours of an illness, not necessarily when the fever is highest. The seizure is often the first sign of a fever.
The first febrile seizure is one of life's most frightening moments for parents. Most parents are afraid that their child will die or have brain damage. Thankfully, simple febrile seizures are harmless. There is no evidence that simple febrile seizures cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties. Most febrile seizures are triggered by fevers from viral upper respiratory infections, ear infections, or roseola. Meningitis causes less than 0.1% of febrile seizures but should ALWAYS be considered, especially in children less than one year old or those who still look ill when the fever comes down. The risk of febrile seizures also increases after common childhood immunizations. Febrile seizures are a rare side effect of immunization, but it may occur the day of the diphtheria, tetanus and acellular pertussis (DTaP) vaccination or eight to 14 days after a measles-mumps-rubella (MMR) vaccination. Febrile seizures are caused by the fever that can accompany the vaccination - not by the vaccination itself.
A simple febrile seizure stops by itself within a few seconds to 10 minutes, usually followed by a brief period of drowsiness or confusion. Anticonvulsant medicines are generally not needed. A complex febrile seizure is one that lasts longer than 15 minutes, occurs in an isolated part of the body, or recurs during the same illness. About a third of children who have had a febrile seizure will have another one with a subsequent fever. Of those who do, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime. If there is a family history, if the first seizure happened before 12 months of age, or if the seizure happened with a fever below 102, a child is more likely to fall in the group that has more than one febrile seizure.
A febrile seizure may be as mild as the child's eyes rolling or limbs stiffening. Quite often a fever triggers a full-blown convulsion that involves the whole body. Febrile seizures may begin with the sudden sustained contraction of muscles on both sides of a child's body -- usually the muscles of the face, trunk, arms, and legs. A haunting, involuntary cry or moan often emerges from the child, from the force of the muscle contraction. The contraction continues for seemingly endless seconds, or tens of seconds. The child will fall, if standing, and may pass urine. He may vomit. He may bite his tongue. The child will not be breathing, and may begin to turn blue. Finally, the sustained contraction is broken by repeated brief moments of relaxation -- the child's body begins to jerk rhythmically. The child is unresponsive to the parent's screams.
A febrile seizure may be diagnosed by the health care provider when a grand mal seizure occurs in a child with a fever and no prior history of seizure disorders (epilepsy). In infants and young children, it is important to rule out other causes for a first-time seizure, especially meningitis. In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, a full seizure workup including an EEG, head CT, and lumbar puncture (spinal tap) is not warranted.
It's not necessary to lower your child's fever to stop a febrile seizure. So don't try to give your child fever medications during a seizure. For the same reason, you don't need to place your child in a cooling tub of water. It's much more practical - and comfortable - for your child to remain lying on the carpet or a bed. Most febrile seizures stop on their own within five minutes. If your child has a febrile seizure that lasts more than five minutes - or if your child has two or more seizures - call for emergency medical attention. In rare cases, the seizure may continue until your child arrives at the emergency room. If this happens, a doctor may order medication that's administered either through your child's rectum or intravenously to stop the seizure. If the seizure is prolonged or accompanied by a serious infection or if the source of the infection can't be determined, your doctor may want your child to stay in the hospital for further observation. But a hospital stay isn't routinely necessary for simple febrile seizures.
Most of the time, a febrile seizure occurs the first day of an illness. Often, a febrile seizure occurs before parents realize that their child is ill. However, 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. 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. You can also control fever by making sure your child drinks plenty of fluids and not bundling him or her up too tightly at night. Just don't give aspirin to children. Aspirin may trigger a rare but potentially fatal disorder known as Reye's syndrome.
It's also possible to prevent febrile seizures with prescription medications. Anticonvulsant medications such as phenobarbital, valproic acid (Depakene) and divalproex sodium (Depakote) are effective in preventing febrile seizures when taken daily. Oral or rectal diazepam (Valium, Diastat) also can reduce the risk of febrile seizures if taken at the time of a fever. But these medications all have drawbacks. They carry a definite risk of serious side effects in young children. Doctors rarely prescribe these prevention medications because most febrile seizures are harmless and most children outgrow them without any problems.
More information on epilepsy (seizures)
What is epilepsy? - Epilepsy is a general term that includes various types of seizures. Epilepsy is characterized by unprovoked, recurring seizures that disrupt the nervous system.
What are seizures? - Seizures (or convulsions) are temporary alterations in brain functions due to abnormal electrical activity of a group of brain cells that present with apparent clinical symptoms and findings.
What types of seizures are there? - The two main categories of seizures include partial seizures and generalized seizures. A partial seizure can evolve to a generalized seizure.
What types of epilepsy are there? - There are several types of epilepsy. Epilepsy can be divided into two broad categories: idiopathic epilepsy and symptomatic epilepsy.
What're the common types of epilepsy? - The most common types of epilepsy are absence epilepsy, temporal lobe epilepsy, frontal lobe epilepsy, occipital lobe epilepsy, and parietal lobe epilepsy.
What causes epilepsy? - Epilepsy may be caused by a number of unrelated conditions, including damage resulting from high fever, stroke, toxicity, or electrolyte imbalances.
What causes children epilepsy? - There are many possible causes of epilepsy in children. Seizures in infants and children may be due to birth defects, difficulties during delivery, or poisoning.
What factors will trigger epilepsy? - The triggers of epilepsy include inadequate sleep, food allergies, alcohol and smoking, flashing lights, developmental anomalies, and brain tumours.
What're the symptoms of epilepsy? - There are many forms of epilepsy, each with its own characteristic symptoms. The basic symptom of epilepsy is a brief and abnormal phase of behavior.
How is epilepsy diagnosed? - Making an accurate diagnosis is vital in planning the correct treatment to control seizures. Taking a medical history can help rule out non-epilepsy conditions.
What're the treatments for epilepsy? - For most people with epilepsy, treatment can reduce or prevent seizures and allow many patients to remain free of seizures for the rest of their lives.
What epilepsy medications are available? - Epilepsy is often treated with medication, neurocybernetic prostheses. Medications available for the treatment of seizures include phenytoin, carbamazepine, divalproex.
What epilepsy surgeries are available? - Surgical techniques to remove injured brain tissue may be appropriate for many patients with epilepsy. The most common surgery for epilepsy is temporal lobectomy.
What is vagus nerve stimulation? - Vagus nerve stimulation is a recently developed form of seizure control which uses an implanted electrical device.
What epilepsy diet is suggested? - It is believe that a restricted caloric intake while on a balanced diet can lead to measurable seizure reduction among all age groups.
How to prevent epilepsy? - Effective actions for the prevention of epilepsy include adequate pre-natal and post-natal care, safe delivery, control of fever in children, control of parasitic diseases.
Epilepsy in children - Epilepsy is a common childhood disorder. The prospect of control by means of anti-epileptic drugs is good in most children with epilepsy.
Pregnancy and epilepsy - Women with epilepsy who become pregnant have a higher risk for complications than women who don't have epilepsy.
Difference between seizures and epilepsy - Seizures are a symptom of epilepsy. Epilepsy is the underlying tendency of the brain to produce a sudden burst of electrical energy.
What's a grand mal seizure? - A grand mal seizure is a seizure involving the entire body, usually characterized by muscle rigidity, violent rhythmic muscle contractions, and loss of consciousness.
What's absence seizure (petit mal seizure)? - Absence seizure e - also known as petit mal seizure - is a type of seizure that most often occurs in children.
What is a febrile seizure? - A febrile seizure is a convulsion in a child triggered by a fever. A febrile seizure may be as mild as the child's eyes rolling or limbs stiffening.
What are epileptic seizures? - An epileptic seizure, often referred to as a fit, occurs when there is an abnormal discharge of neurones in the brain.
What is status epilepticus? - Status epilepticus is a continuous seizure state. Status epilepticus is most often caused by not taking anticonvulsant medication as prescribed.
What causes seizures? - Seizures may be caused by many conditions, diseases, injuries, and other factors. Injuries that may cause seizures include choking, head injury.