When a child has a fever, their body can ache, they are restless and they just don’t feel well. While a fever is a part of our natural response to infection, the fever itself can lead to complications. One rare complication is a febrile seizure.
A febrile seizure is when your child (ages 6 months to 6 years of age) experiences convulsions that occur in the setting of a fever. As a father, Dr. Kiarash Sadrieh says he can’t imagine too many things more distressing than seeing his already-ill child suffer through a seizure; but as a pediatric neurologist at Children’s Hospital Los Angeles, he recognizes that febrile seizures are usually not life threatening. During a febrile seizure, a child may:
A seizure lasts only a minute or two, but can go on longer. Febrile seizures rarely require medication. The majority of the cases we see at Children’s Hospital Los Angeles do not require hospital admission.
If a child has any type of seizure, it is important to stay calm and follow these four steps, Sadrieh says:
Febrile seizures are divided into two categories:
The chances of epilepsy developing in a healthy, developmentally typical child who has a simple febrile seizure are estimated to be 2 to 4%, while the rate in the general population is about 1 to 2%. Although febrile seizures are scary, they are usually not associated with significant health problems. Short febrile seizures do not cause brain damage.
Treatment of febrile seizures is usually limited to fever-lowering agents such as acetaminophen or ibuprofen. These will not decrease the chance of having another febrile seizure, but will make your child more comfortable. Daily anti-seizure drugs are not recommended.
Even though your child will be evaluated on the day of their seizure, certain situations require further diagnostic testing.
If your child has a febrile seizure, make sure he or she sees your pediatrician or an emergency department physician as soon as possible. While simple febrile seizures are not harmful, a physician needs to make sure they are not a symptom of a more serious illness. Talk with your pediatrician to determine if a consultation with a pediatric neurology specialist is appropriate for your child.
The risk of recurrence varies with age. Below the age of 1, the risk is around 50%, while older children have a risk of about 20%. The overall risk of recurrence is about 30 to 35%. Other risk factors include certain genetic syndromes that can put a child at higher risk for febrile seizures or a family history of epilepsy.
Could siblings be affected and experience a seizure, too?
There is a genetic predisposition to febrile seizures, but the exact mode of inheritance is not known. About 10 to 20% of the time, children who have had a febrile seizure have a first degree relative, such as a sibling or parent, who has also had, or will have, one. Additionally, identical twins have a higher rate than fraternal twins.
Children’s Hospital Los Angeles