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Posted by Dr. Monica Wonnacott | March 25, 2016

Febrile Seizures: Is Your Child At Risk?

A febrile seizure is a seizure that happens when a child has a fever. Febrile seizures happen in 3-5% of children, and usually occur between the ages of 6 months to 6 years. Children who have had 1 febrile seizure have a 20-30% risk of having another. Most febrile seizures happen as a result of viruses (like what causes a common cold).

How do I know if my child is having a febrile seizure?

Febrile seizures cause involuntary twitching, shaking, or stiffening of the body. It usually involves the whole body (not a partial seizure that causes just a part of the body, like an arm to shake). During the seizure, the child’s eyes will often roll back, or to the side, and the child is unresponsive to you calling. Your child’s breathing may be unusual, and the skin can change color (darker or paler). While the seizure will seem like it goes on forever when it is happening, febrile seizures are typically very short, less than a minute. Rarely, they can last more than 15 mins. Usually the child recovers fairly quickly (a few mins) after the seizure.

What to do when it happens.

  1. Get your child into a safe position. Lay him down on the floor so he doesn’t fall or hit his head on anything hard or sharp.
  2. Position your child’s head to the side, so he doesn’t choke on any saliva or potential vomit.
  3. Look at the time. Two minutes can feel like an hour when your child is seizing. It is important you know how long it lasts.
  4. Record it. Everyone has a phone on them nowadays. Record the seizure. It helps tremendously for your pediatrician to be able to see what happened.
  5. Call your child’s name and put your hand on your child to see if you can stop it. In a true febrile seizure, your child will not respond to your calling and the shaking will not stop with your touch. These two simple moves help distinguish seizures from other causes of shaking.
  6. Seek medical care if it is the first time. This will help confirm the diagnosis and may help determine the cause of the fever.

The long-term consequences.

This is the good news. While it will scare you to death to watch your small child have a febrile seizure, there are almost no long-term consequences in an otherwise healthy child. Febrile seizures are not life threatening and do not cause brain damage or nervous system problems. Most kids “outgrow” them as they get to be school-aged.

Can I prevent them?

Did you know that everyone has a seizure threshold? For most people, the value is so high (maybe 105-108 degrees) that you can’t naturally get there, even if you’re sick. For whatever reason, some small children have what seems to be a lower threshold. In those children, it seems logical to prevent the seizure, by preventing the fever from getting too high. As a general rule, most docs will tell you to treat fevers in kids with febrile seizures more aggressively (Tylenol, Motrin, cool baths, etc.). With that said, there was a study in 2009 in the Archives of Pediatrics and Adolescent Medicine that revealed no difference in recurrence rates of febrile seizures in those treated with fevers from those not treated. As for me, even though I know it may not make a difference, if it were my kid, I’d probably still treat the fevers. As a parent, if there is anything I can do to help prevent it, I’m all over it. If nothing else, it will help my kid feel better (from whatever is causing the fever in the first place).