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Febrile Seizures (Convulsions Caused by Fever)

Your child has reacted strongly to a fever by having a seizure. This information explains what to do if your child has a febrile seizure.

What are febrile seizures?

A child with seizures may have any of the following: stiffening of the limbs or the body, short, sudden jerking movements of the muscles that cannot be controlled and rolling back of the eyes into the head. A seizure almost always involves loss of consciousness, during which time the child is not responsive. When these seizures are caused by a fever, they are called febrile seizures. Most febrile seizures last for only a couple of minutes.

What to do if your child is having a febrile seizure

If your child is having a seizure, stay calm and take the following steps:

  1. Keep your child away from sources of danger. Remove nearby objects that are sharp or hard.

  2. Do not hold your child down or try to stop his movements. If you can, roll your child gently on his side or roll his head to the side so that any fluids can drain out of his mouth.

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  4. Try to put something soft like a folded jacket under your child's head. Remove any tight clothing, especially around your child's neck. Remove glasses so they do not break.

  5. Do NOT try to put anything in your child's mouth. This could cause choking or broken teeth.

  6. Your child's doctor will want to know how long the seizure lasts. If you can, look at a clock or your watch to see when the seizure starts and ends.

  7. If the seizure lasts less than 3 minutes, take your child to the doctor or clinic right away. If the doctor's office is not open, take your child to a hospital emergency department.

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  9. If the seizure lasts more than 3 minutes, call an ambulance right away.

  10. If your child has a seizure and does not have a fever, or if your child is unwell, then you need to see a doctor regardless of how long the seizure lasts.        

What to expect after the seizure

Sometimes children are confused or drowsy after a seizure and need to sleep for a while. Do not wait until your child has returned to normal to seek medical attention. Do not give your child any water, food, or medicine until the seizure is over and he is fully alert.

What to expect at the doctor's office or hospital

The doctor will ask you to describe the seizure carefully, including how long it lasted and how your child looked and moved. It may help the doctor to know if the shaking could be stopped with gentle holding of the shaking body part, or if the jerking movements persisted.

The doctor will examine your child. If the cause of the fever is known, and your child is not confused or unconscious, the doctor will not usually ask for any laboratory tests. However, if she suspects something else is wrong, she may order some tests. These will help to rule out any other possible causes of seizures.

If your child had a typical febrile seizure, he probably will not need to stay in the hospital. However, if your child has had an atypical febrile seizure (lasting for more than 15 minutes, more than one seizure in a 24 hour period, or if he is not back to himself and alert a few hours after the seizure) then the doctor may order tests and keep the child in the emergency room or in the hospital until the child is safe to return home.

Treating your child's fever

Fever may be caused by almost any childhood illness or infection. Often, febrile seizures happen just as your child's temperature starts to rise. You might not even know yet that your child has a fever. Treating your child's fever with medicine will not necessarily prevent a seizure or shorten the time it lasts, but it can help to make your child more comfortable.

Do not try to give fever medicine while your child is having a seizure. Wait until the seizure is over. Do not put your child in the bathtub.

Measuring your child's temperature

If your child feels warm, check his temperature with a thermometer. A normal temperature is 37.5°C (99.5°F) when taken by mouth, or 38°C (100.4°F) when taken rectally.

Medicine

Give your child acetaminophen (Tylenol®, Tempra, Panadol®) or ibuprofen (Advil®, Motrin®, Brufen) for fever. Read the instructions on the medicine bottle carefully to find out how much medicine to give and how often to give it. If you are not sure, check with your doctor or pharmacist. Do not give your child ASA (acetylsalicylic acid or Aspirin) unless a doctor tells you to.

Clothing

Keep your child lightly dressed. Remove heavy bedclothes.

Febrile seizures are common

Between 2-5% of children (meaning between two to five out of 100 children) will have at least one febrile seizure between the ages of six months and five years. There is a strong genetic component to febrile seizures. Parents of a child with febrile seizures often had febrile seizures too, and siblings are also more likely to have them.

Febrile seizures do not cause brain damage

A child's appearance during a febrile seizure can be quite frightening for parents. However, brief seizures do not damage the brain or cause permanent changes in the brain. Most febrile seizures last only a few minutes, although they probably seem to go on much longer. Even if your child has a long febrile seizure, the risk of brain damage is low.

Medicines to prevent febrile seizures

There are anti-seizure medicines (anticonvulsants or anti-epileptic drugs) that can prevent febrile seizures. These medicines do have side effects, and children who have febrile seizures do not usually need to take them. However, there might be special circumstances when your child's doctor thinks that an anti-seizure medicine is needed.

If your child often has febrile seizures, the doctor may give a short-acting anti-seizure medicine. The doctor will explain how to care for your child and when you need to seek medical attention.

You do not need to give your child special treatment

All children get sick sometimes, especially young children. Your child happens to react to fever in a drastic manner. Treat and protect your child the same way as any other normal, healthy child. Remember, fevers and seizures can start suddenly. If your child is under five years of age, make sure you stay close by when he is taking a bath. Do not leave your child alone in the bathtub.

Risk of another febrile seizure

Children who have a febrile seizure are at risk for having another febrile seizure. This occurs in about 30 to 35 percent of cases. A febrile seizure will not necessarily occur every time the child has a fever. Most recurrences happen within one year of the initial seizure and almost all occur within two years. A child is more likely to have recurrent febrile seizures if he is younger than 15 months when he has the first seizure and if he has a parent or sibling who has had febrile seizures or epilepsy.

Febrile seizures usually go away on their own when the child is older

Febrile seizures do not necessarily mean that your child will have epilepsy later in life. Fewer than five in 100 children who have febrile seizures develop epilepsy. Epilepsy is a condition marked by repeated seizures without fever.

Key points

  • Febrile seizures are episodes of uncontrollable jerking movements and loss of consciousness caused by fever. They are common in children between the ages of six months and five years.
  • During a febrile seizure, keep your child safe and do not try to put anything in his mouth. Try to roll him onto his side or roll his head to one side.
  • Take your child to the doctor after a febrile seizure. If the seizure lasts longer than three minutes, call an ambulance.
  • Treating your child's fever with medicine will not necessarily prevent seizures.
  • If you have concerns or questions, please talk to your child's doctor.

Elly Berger, BA, MD, FRCPC, FAAP, MHPE

5/4/2013
 




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