Febrile Seizures

Febrile seizures are not a type of epilepsy. Febrile seizures can occur when a child has a high fever, most commonly above 38.3˚C (101˚F), and usually on the first day of a rapid rise in body temperature.

The incidence of febrile seizures does not indicate a possibility of developing epilepsy. Less than 2 percent of children who experience febrile seizures will develop epilepsy later in life. Febrile seizures are classed as incidents rather than as a condition.

There are two types of febrile seizures:

1. Simple febrile seizures are more common and relatively harmless. They usually last less than 15 minutes and have no after effects. A neurological examination following a simple seizure will yield no abnormalities.

2. Complex febrile seizures may be more threatening. They can occur at body temperatures lower than 83.3˚C and can last longer than 15 minutes. Only one side of the body is affected during a complex febrile seizure and neurological reports may indicate abnormalities. In both cases, febrile seizures pose no threat of mental retardation, cerebral palsy, learning disabilities or death.

Who has febrile seizures?Expand Who has febrile seizures? Section

A febrile seizure is usually seen in children between six months and three years of age; however, they can occur up in children up to five years old. Overall, the incidence of febrile seizures is higher in males than in females.

Only 3 to 4 percent of children experience febrile seizures and only with a fever. With no family history of seizures, chances are very low for your child to have a febrile seizure.

Causes of Febrile SeizuresExpand Causes of Febrile Seizures Section

There are a number of possible causes of febrile seizures. A fundamental cause for all febrile seizures is a vulnerability of the brain to an oncoming seizure. Children have a higher susceptibility to seizure activity in the brain – a lower seizure threshold – because of their age and the immaturity of their body’s immune system. Complicated by a rapidly rising fever and possibly the general condition of health, a febrile seizure may occur.

Several other factors may increase the risk of febrile seizures:

  • a family history of seizures
  • chronic maternal ill health
  • parental fertility problems
  • breech birth
  • Caesarean birth
  • small birth weight
  • developmental delay
  • cerebral problems (may increase the incidence of febrile seizures)
  • smoking and drug intake including anti-epileptic drugs during pregnancy (can further increase the risk)

Precautions and TreatmentsExpand Precautions and Treatments Section

Certain precautions, including the use of medication, will reduce the chance of your child having febrile seizures.

Reducing the child’s body temperature will lower the seizure risk. To do this, cover the child’s exposed body with wet (not ice-cold) cloths since evaporating water lowers temperature. Fanning will speed up the cooling process.

After drying the child’s body, an analgesic is often prescribed to help stabilize the child’s body temperature. Such drugs should be kept to the minimum amount prescribed by the child’s physician.

Medications specific to febrile seizures, such as phenobarbital, offer another option. Phenobarbital is the most effective medication to prevent febrile seizures. Remember it takes several days to accumulate an effective level of the drug in the blood and in the brain. Taking phenobarbital daily to maintain a specific amount in the blood may reduce the occurrence of febrile seizures.

Phenobarbital is usually prescribed only after many febrile seizures have occurred because it may cause:

  • hyperactivity,
  • behavioural problems,
  • sleep disturbances,
  • hindered development of intelligence,
  • learning disabilities and
  • dependence.

Tips for ParentsExpand Tips for Parents Section

Although a seizure can be terrifying to a parent, stay calm and try to accurately assess the situation. A febrile seizure is usually mild and brief, often manifesting no more than a slight slumping and loss of consciousness or a rolling of the eyes back in the head. Sometimes there may be convulsive stiffening and jerking, but there is no need to panic.

General Guidelines

  1. Protect the child from sharp, hot or otherwise dangerous objects.
  2. Loosen tight clothing.
  3. Do not put anything in the child’s mouth.
  4. Do not restrict his/her movements.
  5. Roll the child on his/her side.
  6. Try to keep everyone relaxed.

A febrile seizure produces no lasting effects. Only 25 to 30 percent of children who experience one will ever have another. Only when a seizure occurs within the child’s first year and there is a family history of febrile seizures or epilepsy and if it was a complex seizure will the chances of another incident increase to 80 percent or more.

Otherwise, the chances of another incident are reduced to as low as 10 percent. Febrile seizures are rare. Recurrence is even rarer. Febrile seizures have no lasting effects. Children usually outgrow them after five years of age.