As a parent it can be quite distressing to witness your child having a seizure. However, if your child is under the age of 6 and has an elevated temperature above 100.4°F, the cause may be something known as a febrile seizure. Febrile seizures are generally harmless and require no further medical attention.
This blog post will provide an overview of febrile seizures, including triggers, treatments and prevention strategies.
Febrile seizures are convulsions or fits that sometimes occur in young children when their body temperature rises above 100.4°F or 38°C. They typically occur in children between the ages of 6 months and 5 years old who have recently been affected by a viral or bacterial infection that causes fever.
It is believed that up to 5% of young children will have a febrile seizure. The majority of febrile seizures last only a few minutes and do not cause any permanent harm to the child.
There are certain triggers and risk factors that can increase the chances of more frequent or intense febrile seizures, including:
- Family history of febrile seizures
- Childhood vaccination history
- Age (6 months-5 years)
- Low birth weight (<2500gm)
- Ethnicity (Caucasian/Asian)
- Sex (males more likely than females)
Sometimes febrile seizures happen when the child is at a normal temperature with a fever developing a few hours later but this is unusual. Additionally, some environmental triggers such as high temperatures can also trigger febrile seizures in susceptible individuals.
Febrile seizures can be classified into two main categories:
The most common type is characterized by single episodes lasting less than 15 minutes without any focal neurological signs or evidence of central nervous system involvement.
Multi-focal or generalized seizures lasting longer than 15 minutes with evidence of central nervous system involvement such as abnormal speech or behavior following the seizure episode.
The symptoms of febrile seizures vary from child to child. Parents should always consult their pediatrician immediately if their child experiences any unusual symptoms during a fever episode:
- Loss of consciousness or absence
- Uncontrollable shaking of the whole body or part of the body
- Eyes rolling back into the head
- Stiff rigid limbs
If your child experiences their first febrile seizure then it is important to call 911 right away as seizures can be frightening and you will want medical personnel to assess your child’s condition. It is also important that you take note of the duration of the febrile seizure and any other associated symptoms as this information will help healthcare providers diagnose the cause of the fever and provide appropriate treatment.
The medical team will want to take your child to the emergency room but will also want to know if your child has a history of febrile seizures, if she/he had more than one seizure or repeated seizures and if your baby has any serious illness or neurological disorders. Parents who know their child may have a brain or nervous system illness should communicate this to the 911 call operator.
Step 1: Stay calm
Step 2: If possible, get someone else to call the emergency services. If there is no one else available then do it yourself and follow the instructions from the call operator. Make a mental note of the time.
Step 3: Think ABC:
It is safe to touch your baby. Check your child’s mouth – if you can easily retrieve a foreign object stuck in the mouth then take it out but do not perform a blind finger sweep. You are likely to push an object even further down the throat.
A blind finger sweep involves inserting your finger into the mouth to search for a foreign object but you cannot see the end of your finger.
Turn your child’s body onto his or her side and open the airway. Make sure there is nothing obstructing the mouth including saliva or vomit. Do not place anything in their mouth or restrain your child if convulsing.
Be aware of your baby’s breathing pattern and take note if it becomes erratic or if there are any breathing difficulties.
Make sure that your baby’s skin remains warm by covering them with a blanket if necessary. Taking a baby’s pulse is very difficult especially if untrained. Do not feel you need to attempt this – just note the color of the lips and skin. Look for blueness or a purple tinge to lips. Loosen any tight clothing.
If your baby stops breathing then commence CPR and ask someone to update the emergency services.
Step 4: Stay with your baby at all times and if possible try to video the event on your phone. Often emergency crews arrive after a seizure has finished and the movements can be difficult to describe. Having video evidence can help to identify the type of seizure and how long the seizure lasted.
Step 5: You may like to sing or talk to your baby – it is entirely possible that he/she will be able to hear you.
Step 6: If your child feels hot to touch: While waiting for the ambulance and if safe to do so (when the seizure has stopped) remove a layer of clothing from your baby.
To learn more about how to dress your baby for sleep read my post here.
The kind of care and examinations that hospital personnel will perform is determined by the type and length of the febrile seizure. The ABC’s (airway, breathing circulation) will be addressed first so, if not applied already, an oxygen mask will be placed on your baby’s face and airway secured if your baby is unconscious.
Sometimes an IV (intravenous) cannula (little plastic tube) will be inserted into your child’s vein so that the staff can give medicine designed to treat seizures. Be sure to ask questions so that you know exactly what is happening – feeling in control will help you to stay calm in what will be a very challenging episode in your life.
Tests may be indicated and if your baby had multiple seizures then the medical staff may want to monitor your child’s electrical brain activity.
The staff may give you a febrile seizures fact sheet to take home with you. However, I always advise patients and parents to never leave a hospital without understanding:
- The diagnosis
- What treatment the patient has received
- What medications have been given
- What medications have been prescribed
- What action to take if there are further febrile seizures
Prolonged febrile seizures are defined as febrile seizures lasting over 15 minutes in duration. They can be dangerous and if they last this long it is important to seek medical attention right away usually by phoning 911.
Your child will be sleepy and disorientated. The phase immediately after a seizure is sometimes referred to as the postical phase. Recovery can take just a few minutes or a maybe an hour or two. Typically there will be no ill effects and your baby will make a full recovery. Always seek medical advice if not sure and certainly after the first febrile seizure.
In relatively rare cases a second febrile seizure can occur – it is believed that approximately 30% of children may have another febrile seizure with a subsequent infection and high fever.
Generally speaking there are no long-term effects associated with febrile seizures but in some cases recurrent febrile seizures might lead to other neurological conditions. Damage to the brain and spinal cord can occur if there is a lack of oxygen and it is possible that other seizure disorders can occur but in otherwise healthy children long-term side effects are not expected. There is no known associated risk of developing epilepsy.
The best way to prevent febrile seizures from occurring is by monitoring your baby for signs of fever and managing appropriately. Common childhood infections, such as ear infections, and childhood vaccinations can precede a febrile seizure if your child’s fever becomes elevated.
- Monitor temperature carefully and administer fever-reducing medications where appropriate.
- A cool (not cold) bath for fevers is also recommended.
- If appropriate remove a layer of clothing or use a lower tog sleep sack (if any).
To learn more about my top picks for sleep sacks click here.
While febrile seizures may seem frightening for parents when they first occur, rest assured that they are generally harmless and require no further medical attention once resolved spontaneously within a few minutes after onset.
A febrile seizure does not mean that a child has or will develop epilepsy.
Most children will never have a febrile seizure. However, it’s always best practice to consult your pediatrician if you have any worries about your child’s health following an episode just in case there’s something else going on that requires further investigation.
Commonly referred to as febrile seizures, febrile convulsions are seizures that occur in children with a fever.
The period of time following a seizure during which the person may be drowsy, confused or disorientated.
A neurological disorder characterized by recurrent seizures.
Generalized tonic clonic seizure
A type of seizure characterized by rhythmic muscle contractions that affect the whole body.
A type of seizure that affects only a part of the brain.
A doctor who specializes in treating disorders of the brain and nervous system in children.
Simple febrile seizure
A febrile seizure that lasts less than 15 minutes.
Prolonged febrile seizure
A febrile seizure that lasts more than 15 minutes.
Complex febrile seizure
A febrile seizure that has multiple parts and can last for more than 15 minutes.
As a paramedic I have frequently attended calls to children having febrile seizures. Often they only lasted a couple of minutes but I feel it is vital that parents are aware of what to do should a febrile seizure occur. I am always amazed that parents aren’t educated by medical staff about febrile seizures when they have a new baby.
Parents and care givers are easily forgotten when a child is ill, especially a young child, but truthfully this may be one of the most emotionally traumatic moments of your life. Some parents’ mental health can be affected for months or years after seeing their child unwell so the best advice I can give is to stay calm, be methodical in your approach and always, always talk to a medical professional about what happened so that you can come to terms with it and feel confident moving forward.
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