Definition Febrile seizures are generalised (whole body) convulsions that can occur in children with fever.
What is going on in the body? Febrile seizures occur in three to four percent (3% to 4%) of children who are younger than 5 years old. Fever lowers the seizure "threshold" in the brain. The whole brain can then "short circuit," resulting in a generalised motor seizure.
What are the signs and symptoms of the condition? This kind of seizure usually happens when there is a rapid rise in temperature. The average temperature at which these seizures occur is 40 degrees Celsius although some seizures may occur at a higher or lower temperature. During a seizure, the child becomes unconscious. The eyes roll upward. The arms and legs become stiff or jerk. Each febrile seizure usually lasts 1-10 minutes.
What can be done to prevent the condition? Fevers should be treated early, but that treatment may not be enough to prevent seizures. Thirty percent (30%) of children who have had one febrile seizure will have another one.
How is the condition diagnosed? It is important to make sure there is no underlying brain disorder or epilepsy. There are two kinds of febrile seizures: simple and complex. Simple febrile seizures are generalised, or involve the whole body, and last less than 15 minutes. Only 2% of these are caused by brain disorders or epilepsy. Complex seizures may affect only some parts of the body and last more than 15 minutes. These are more likely to be caused by a brain disorder or epilepsy.
What are the long-term effects of the condition? Children who have had a true febrile seizure have only a very mildly elevated risk of having epilepsy later on in life.
What are the risks to others? Febrile seizures are not contagious, though the underlying illness that caused the fever may be contagious. Speak with a doctor for more information.
What are the treatments for the condition? The goal of treatment is to reduce the fever using paracetamol or ibuprofen. Children should not be given aspirin in the setting of a fever unless prescribed by a doctor. aspirin given for viral illnesses increases the risk of Reye's syndrome.
When a child does have a fever, it is important to reduce the temperature and not to bundle the child in too many blankets. Bundling up with clothes and blankets may increase the temperature. Antiepileptic drugs are generally not used if there is no underlying disease, such as epilepsy.
If a seizure does occur, it is important to protect the child's airway. If he or she has anything in the mouth, clear it with a finger to prevent choking and place the child on his or her side or abdomen. During a seizure do not try to restrain the child or stop seizure movements. Protect the child's body and let the seizure run its course. The caregiver should contact the child's doctor for further advice. Seek emergency assistance if the seizure continues longer than 10 minutes or signs of choking and difficulty breathing occur.
What are the side effects of the treatments? The mainstay of treatment is paracetamol to reduce fever, which is usually well tolerated, though allergic reactions do occur (rare).
What happens after treatment for the condition? A true febrile seizure generally resolves without problems, other than the risk of repeat febrile seizures.
How is the condition monitored? The child should be watched for neurologic problems or epilepsy. Complex seizures should be evaluated with brain imaging studies such as a MRI or CT scan, and by electroencephalography (EEG), which records brain waves.
Author: Gerald C. McIntosh, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
