Understanding Febrile Seizures

A febrile seizure is a convulsion which is triggered by a fever in a child. They can occur without a neurologic cause or an infection of the brain or spinal cord. Febrile seizures occur in about five percent of children between six months and five years of age and tend to run in families. They usually occur early in the illness and are believed to be caused by the rapid increase in body temperature rather than the height of the fever. Febrile seizures can be triggered by bacterial infections such as an ear infection, Strep throat, or by common viral infections like Roseola or an upper respiratory infection.

While a febrile seizure may be as mild as the child’s eyes rolling or limbs stiffening, it more commonly occurs as a full-blown convulsion involving the whole body. They usually start with a sudden contraction of muscles on both sides of a child’s body involving the muscles of the face, trunk, arms, and legs. The child may cry or moan as the contraction continues for several seconds. The child will then fall (if standing), and may pass urine. The contraction becomes a brief moment of relaxation, and then the child’s body begins to jerk rhythmically. During this time, the child will not respond to voices. This part of the seizure usually stops within a few minutes.

Steps to take during a seizure:

• Leave the child on the floor. You may want to slide a blanket under the child if the floor is hard.

Move him only if he is in a dangerous location.

• Remove objects that may injure him.
• Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
• If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach.
• Do NOT try to give anything by mouth.
• Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol may make the fever worse.

If the seizure lasts several minutes, call 911 to have an ambulance bring the child to the hospital. If the seizure ends quickly, drive the child to an emergency room when it is over.

Steps to take after the seizure is over:

• Once the child is awake, give the normal dose of ibuprofen or acetaminophen.
• The most important step is to identify the cause of the fever.
• After the first febrile seizure, the child should be examined by a health care provider as soon as possible. In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, the child will need minimal testing if any.
• Take the child to the doctor if repeated seizures occur during the same illness, or if this looks like a new type of seizure for the child.
• It is normal for children to sleep or be briefly drowsy or confused right after a seizure.

Additional Information

The first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage. However, simple febrile seizures are harmless. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties. A small number of children who have had a febrile seizure go on to develop epilepsy, but not because of the febrile seizure. Children who develop epilepsy have their first seizures during fevers. About a third of children who have had a febrile seizure will have additional febrile seizures. Of those who do have a second seizure, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime and most children outgrow febrile seizures by age 5.

Hopefully your child will never experience a febrile seizure, but if they do; remain calm, follow the above instructions, and ensure you get any questions answered by the physician who treats your child.

All the best,

Dr. Doug

Dr. James Douglas Campbell, MD, FAAP, MHA, LLC, is a pediatric health professional who advises Montessori Unlimited on the needs of our program as a whole, and provides consultation and technical assistance on child health issues.

Dr. Campbell received his Doctorate of Medicine from the University of Florida and a Masters of Health Administration from the University of North Florida College of Health. He is Board Certified with the American Board of Pediatrics and a Fellow of the American Academy of Pediatrics. He has been taking care of children in Jacksonville, Florida since 1981.