A febrile seizure is a convulsion in a child caused by a spike in body temperature, often from an infection. They occur in young children with normal development without a history of neurologic symptoms. It can be frightening when your child has a febrile seizure, and the few minutes it lasts can seem like an eternity. Fortunately, they're usually harmless and typically don't indicate a serious health problem.
You can help by keeping your child safe during a febrile seizure and by offering comfort afterward. Call your doctor to have your child evaluated as soon as possible after a febrile seizure.
Usually, a child having a febrile seizure shakes all over and loses consciousness. Sometimes, the child may get very stiff or twitch in just one area of the body.
A child having a febrile seizure may:
Febrile seizures are classified as simple or complex:
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.
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 five minutes or is accompanied by:
Usually, a higher than normal body temperature causes febrile seizures. Even a low-grade fever can trigger a febrile seizure.
The fevers that trigger febrile seizures are usually caused by a viral infection, and less commonly by a bacterial infection. Influenza and the virus that causes roseola, which often are accompanied by high fevers, appear to be most frequently associated with febrile seizures.
The risk of febrile seizures may increase after some childhood immunizations. These include 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.
Factors that increase the risk of having a febrile seizure include:
Most febrile seizures produce no lasting effects. Simple febrile seizures don't cause brain damage, intellectual disability or learning disabilities, and they don't mean your child has a more serious underlying disorder.
Febrile seizures are provoked seizures and don't indicate epilepsy. Epilepsy is a condition characterized by recurrent unprovoked seizures caused by abnormal electrical signals in the brain.
The most common complication is the possibility of more febrile seizures. The risk of recurrence is higher if:
Most febrile seizures occur in the first few hours of a fever, during the initial rise in body temperature.
Giving your child infants' or children's acetaminophen (Children's Non-Aspirin Tylenol, others) or ibuprofen (Infants' Motrin, Children's Motrin, others) at the beginning of a 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.
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.
Rectal diazepam (Diastat) or nasal midazolam might be prescribed to be used as needed for children who are prone to long febrile seizures. These medications are typically used to treat seizures that last longer than five minutes or if the child has more than one seizure within 24 hours. They are not typically used to prevent febrile seizures.
Febrile seizures occur in children with normal development. Your doctor will carefully review your child's medical history and developmental history to exclude other risk factors for epilepsy. In normally developing children, identifying the cause of your child's fever is the first step after a febrile seizure.
Children who are current with their vaccinations who have a first simple febrile seizure don't need testing. Your doctor can diagnose the febrile seizure based on history.
In children with delayed immunization or a compromised immune system, your doctor may recommend tests to look for severe infections:
To diagnose the cause of a complex febrile seizure, your doctor may also recommend an electroencephalogram (EEG), a test that measures brain activity.
Your doctor may also recommend an MRI to check your child's brain if your child has:
Most febrile seizures stop on their own within a couple of minutes. If your child has a febrile seizure, stay calm and follow these steps:
If your child has a febrile seizure that lasts more than five minutes — or if your child has repeated seizures — call for emergency medical attention.
A doctor may order medication to stop a seizure that lasts longer than five minutes.
Your child's doctor may hospitalize the child for observation if:
But a hospital stay isn't usually necessary for simple febrile seizures.
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.
For febrile seizures, some basic questions to ask your doctor include:
Don't hesitate to ask other questions, as well.
Your doctor is likely to ask you a number of questions, such as:
If your child has another febrile seizure: