Being with a child having a febrile seizure can be an extremely frightening experience for a parent. The more you know about this relatively common childhood occurrence, the better you’ll be able to respond if and when it occurs, and the less frightening it will seem.
What is a febrile seizure?
A febrile seizure is a convulsion that occurs in a child who is between 6 months and 6 years old and has a body temperature greater than 100.4 degrees. Children 12-18 months are most commonly affected. Approximately 2 percent to 4 percent of children younger than 5 years old will experience a febrile seizure. They usually occur on the first day of illness and sometimes are the first indication that a child is sick.
Febrile seizures can be “simple” or “complex.”
During a simple febrile seizure, the child loses consciousness and usually has rhythmic twitching or convulsion of the arms and legs; sometimes they can just feel stiff. These are usually 1-2 minutes in duration but can last up to 15 minutes. After, the child may cry, be confused or sleepy.
Complex febrile seizures are less common. Like simple febrile seizures, these involve loss of consciousness and twitching of the arms and legs but can last longer than 15 minutes. Children often have temporary, significant arm and leg weakness following the convulsion.
Are febrile seizures dangerous?
Febrile seizures do not cause brain damage nor have any adverse effect on a child’s development or intelligence. It’s also not an indicator that a child has epilepsy.
What are the causes?
Viral infections such as a common cold (or “upper respiratory infection”) or bacterial infections, such as a urinary tract infection or ear infection, can cause fever, and that may lead to a febrile seizure.
There are familial tendencies to febrile seizures. If a child’s parent or siblings had a febrile seizure when young, he or she is more likely to have a febrile seizure than a child whose close relatives have never had one.
What should I do if my child experiences a febrile seizure?
Adults can help a child get through a febrile seizure safely. First, move the child to a soft surface such as a carpeted floor and, if possible, place them on their side (consider propping them from behind with pillows). Do not restrain the child or try to “stop” the convulsions. Do not put anything in the child’s mouth. Take note of the start and stop time of the convulsing. Make a mental note of what the motions look like. This information will be helpful to your child’s healthcare provider.
IMPORTANT: If the seizure lasts longer than five minutes, the child appears to have blue lips or has stopped breathing, call 911 or your local emergency number.
After the seizure, what should I do?
If the child is upset, console him or her and take the child’s temperature. Give a fever or pain reducer such as acetaminophen or ibuprofen, especially if he or she seems uncomfortable. Next, call your primary care provider’s office for advice. In some cases, your primary doctor or nurse practitioner will be happy to see your child in the clinic; other times they may recommend that you seek medical attention in a pediatric emergency room. If you have called an emergency response line, they will advise you regarding how to seek medical care safely: by car or in an ambulance.
What can we expect from our health care provider?
In general, a fully vaccinated child old than 12 months who experiences a one-time simple febrile seizure often doesn’t require blood studies, imaging, or a formal seizure evaluation by a neurologist. Children younger than 12 months or those who are under-vaccinated sometimes require blood tests, X-rays or other lab testing to determine what type of illness caused the seizure and rule out dangerous infections such as bacterial meningitis. Your health care provider will not routinely prescribe anti-seizure medications, as the potential side effects of these strong medications outweigh the benefits. Most children will not require an overnight stay in the hospital.
What can I do once I get home?
Approximately 30 percent of children who have had a febrile seizure will experience another within 1-2 years, but they will not have one every time they have a fever. You should continue to use medications to treat your child’s fever as you normally would and as directed by your provider. However, it is not recommended that parents give fever-reducing medications to a child who is not having fever because it does not appear to reduce the risk of a future febrile seizure.
Erin Martin, APRN, CNP, is a nurse practitioner in the emergency department at Children’s Minnesota.