By Mayo Clinic Staff
Symptoms
Definition
A febrile seizure is a convulsion in a child that may be caused by a spike in body temperature, often from an infection. Your child's having a febrile seizure can be alarming, and the few minutes it lasts can seem like an eternity.
Febrile seizures represent a unique response of a child's brain to fever, usually the first day of a fever. Fortunately, they're usually harmless and typically don't indicate an ongoing problem. You can help by keeping your child safe during a febrile seizure and by comforting him or her afterward.
Call
your doctor to have your child evaluated as soon as possible after a febrile
seizure.
Symptoms
Febrile seizure symptoms can range from
mild — staring — to more severe shaking or tightening of the muscles.
A
child having a febrile seizure may:
· Have a fever
higher than 100.4 F (38.0 C)
· Lose
consciousness
· Shake or jerk
arms and legs
Febrile
seizures are classified as simple or complex:
· Simple febrile seizures. This more common type lasts from a few seconds to 15
minutes. Simple febrile seizures do not recur within a 24-hour period and are
generalized, not specific to one part of the body.
· Complex febrile seizures. This type lasts longer than 15 minutes, occurs more
than once within 24 hours or is confined to one side of your child's body.
Febrile
seizures most often occur within 24 hours of the onset of a fever and can be
the first sign that a child is ill.
When
to see a doctor
See
your child's doctor as soon as possible after your child's first febrile
seizure, even if it lasts only a few seconds. Call an ambulance to take your
child to the emergency room if the seizure lasts longer than 10 minutes or is
accompanied by:
· Vomiting
· A stiff neck
· Breathing
problems
· Extreme
sleepiness
A high body temperature causes most febrile
seizures.
Infection
Usually the fevers that
trigger febrile seizures are caused by a viral infection, less commonly by a
bacterial infection. Viral infections such as the flu and roseola, which often
are accompanied by high fever, appear to be most associated with febrile
seizure.
Post-immunization
seizures
Infection
Usually the fevers that
trigger febrile seizures are caused by a viral infection, less commonly by a
bacterial infection. Viral infections such as the flu and roseola, which often
are accompanied by high fever, appear to be most associated with febrile
seizure.
The risk of
febrile seizures may increase after some childhood immunizations, such as the
diphtheria, tetanus and pertussis or measles-mumps-rubella vaccinations. A
child can develop a low-grade fever after a vaccination. The fever, not the
vaccination, causes the seizure.
Risk factors
Factors that increase the risk of having a febrile
seizure include:
· Young age. Most febrile seizures occur in children between 6
months and 5 years of age. It's unusual for children younger than 6 months to
have a febrile seizure, and it's rare for these seizures to occur after 3 years
of age.
· Family history. Some children inherit a family's tendency to have
seizures with a fever. Additionally, researchers have linked several genes to a
susceptibility to febrile seizures.
Complications
Most febrile seizures produce no lasting
effects. Simple febrile seizures don't cause brain damage, mental retardation
or learning disabilities, and they don't mean your child has a more serious
underlying disorder.
Febrile
seizures don't indicate epilepsy, a tendency to have recurrent seizures caused
by abnormal electrical signals in the brain.
Recurrent febrile
seizures
The most common complication is the
possibility of more febrile seizures. The risk of recurrence is higher if:
· Your child's
first seizure resulted from a low fever.
· The period
between the start of the fever and the seizure was short.
· An immediate
family member has a history of febrile seizures.
· Your child was
younger than 15 months at the time of the first febrile seizure.
Preparing for your
appointment
You're likely to start by seeing your
child's family doctor or pediatrician. You may then be referred to a doctor who
specializes in disorders of the brain and nervous system (neurologist).
Here's
some information to help you get ready for your appointment.
What you can do
· Write down everything you remember about your child's seizure, including signs or
symptoms that occurred before the seizure, such as a fever.
· List medications, vitamins and supplements your child takes.
· Write down questions to ask your doctor.
For febrile seizures, some basic questions
to ask your doctor include:
· What's the most
likely cause of my child's seizure?
· What tests does
my child need? Do these tests require special preparation?
· Is this likely to
happen again?
· Does my child
need treatment?
· Will giving my
child fever-reducing medications during an illness help prevent febrile
seizures?
· What should I do
the next time my child has a fever?
· What can I do to
help my child during a febrile seizure?
· My child has
another health condition. How can we manage them together?
· Are there
brochures or other printed material I can take? What websites do you recommend?
Don't
hesitate to ask other questions, as well.
What to expect from
your doctor
Your doctor is likely to ask you a number
of questions, such as:
· Did your child
have a fever or illness before having this seizure?
· Can you describe
your child's seizure? What were the signs and symptoms? How long did the
seizure last?
· Has this happened
before?
· Does anyone in
your family have a history of febrile seizures or seizure disorders?
· Has your child
been exposed to illnesses?
· Does your child
have a history of head trauma or a neurological disease?
What you can do in
the meantime
If your child has another febrile seizure:
· Don't restrain
your child, but do place him or her on a safe surface, such as the floor.
· Place your child
on his or her side, keeping the face to the side and the lower arm extended
under the head, to prevent your child from inhaling vomit if vomiting occurs.
· If your child had
anything in his or her mouth when the seizure began, remove it to prevent
choking. Don't put anything in your child's mouth during a seizure.
· Seek emergency
care for a seizure that lasts longer than 10 minutes.
Tests and diagnosis
Identifying the cause of your child's fever
is the first step after a febrile seizure.
Simple febrile
seizures
To determine the cause of infection, your
doctor may recommend:
· A blood test
· A urine test
· A spinal tap
(lumbar puncture), to find out if your child has a central nervous system
infection, such as meningitis
Complex febrile
seizures
For complex febrile seizures, your doctor
also may recommend an electroencephalogram (EEG), a test that measures brain
activity.
If
the seizure involved just one side of the child's body, your doctor may also
recommend an MRI to check your child's brain.
Treatments and
drugs
Most febrile seizures stop on their own
within a couple of minutes. If your child has a febrile seizure that lasts more
than 10 minutes — or if your child has repeated seizures — call for emergency
medical attention.
More-serious
episodes
If the seizure lasts longer than 15
minutes, a doctor may order medication to stop the seizure.
If
the seizure is prolonged or accompanied by a serious infection or if the source
of the infection can't be determined, then your doctor may want your child to
stay in the hospital for further observation.
But
a hospital stay isn't usually necessary for simple febrile seizures.
Lifestyle and home
remedies
If your child has a febrile seizure, stay
calm and follow these steps:
· Place your child
on his or her side on a surface where he or she won't fall.
· Stay close to
watch and comfort your child.
· Remove hard or
sharp objects near your child.
· Loosen tight or
restrictive clothing.
· Don't restrain
your child or interfere with your child's movements.
· Don't put
anything in your child's mouth.
· Time the seizure.
Most
febrile seizures occur in the first few hours of a fever, during the initial
rise in body temperature.
Giving
your child medications
Giving your child infants' or children's acetaminophen
(Tylenol, others) or ibuprofen (Advil, Motrin, others) at the beginning of
fever may make your child more comfortable, but it won't prevent a seizure.
Use
caution when giving aspirin to children or teenagers. Though aspirin is
approved for use in children older than age 3, children and teenagers
recovering from chickenpox or flu-like symptoms should never take aspirin.
This
is because aspirin has been linked to Reye's syndrome, a rare but potentially
life-threatening condition, in such children.
Prescription prevention medications
Rarely, prescription anticonvulsant medications are used to
try to prevent febrile seizures. However, these medications can have serious
side effects that may outweigh any possible benefit.
Oral diazepam (Valium), lorazepam intensol, clonazepam
(Klonopin) or rectal diazepam (Diastat) may be prescribed for children who are
prone to febrile seizures.
These medications are typically used to treat seizures that
last longer than 10 minutes or if the child has more than one seizure within 24
hours. They are not typically used to prevent febrile seizures.
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