Febrile Seizure – Symptoms and Causes

Understanding Febrile Seizures

Febrile seizures are convulsions in children caused by high fevers, usually from infections. These seizures occur in otherwise healthy children with normal development and no prior neurological issues.

While frightening for parents, these seizures generally last only a few minutes and rarely indicate serious health problems. Most febrile seizures resolve on their own without specific treatment.

The primary approaches to managing febrile seizures include:

• Temperature management using appropriate fever-reducing medications
• Comfort measures during and after the seizure
• Medical evaluation to identify any underlying infection
• Seizure safety protocols to protect the child during an episode

It’s important to have your child evaluated by a healthcare provider after experiencing a febrile seizure. Your doctor can determine if additional testing or treatment is necessary.

Signs of Fever Seizures

When a child has a fever seizure, they often shake all over and lose awareness. Sometimes they might get very stiff or have twitching in just one area of their body.

A child experiencing a fever seizure may show these signs:

• Fever higher than 100.4°F (38.0°C)
• Loss of consciousness
• Shaking or jerking arms and legs

Fever seizures come in two main types:

Simple Febrile Seizures

• Last from a few seconds to 15 minutes
• Don’t happen again within 24 hours
• Affect the whole body, not just one part

Complex Febrile Seizures

• Continue longer than 15 minutes
• Happen more than once in 24 hours
• Affect only one side of the child’s body

These seizures typically happen within 24 hours after a fever starts. In fact, the seizure might be the first sign that a child is sick. Parents should pay close attention to how long the seizure lasts and what parts of the body are affected.

When to Contact a Medical Professional

If your child has a fever-related seizure, see their doctor as soon as possible, even if it only lasted briefly.

Call emergency services right away if the seizure continues for more than five minutes. Other warning signs that require immediate medical attention include:

• Throwing up
• Neck stiffness
• Difficulty breathing
• Unusual drowsiness

Don’t wait to seek help if these symptoms appear with a seizure, as they may indicate a more serious condition.

Why Febrile Seizures Happen

When Germs Attack

Febrile seizures happen when the body temperature rises above normal levels. Even mild fevers can trigger these seizures in susceptible children.

Most febrile seizures result from viral infections. Viruses causing influenza (flu) and roseola frequently lead to high fevers that may trigger seizures. Bacterial infections can also cause fevers that lead to seizures, though this happens less often.

After Vaccines

Some children experience febrile seizures following certain childhood immunizations. This can occur after receiving vaccines like:

• Diphtheria, tetanus, and pertussis vaccine
• Measles-mumps-rubella vaccine

It’s important to understand that the seizure comes from the fever that develops after vaccination, not from the vaccine itself.

Some children develop low-grade fevers as their bodies build immunity, and this temperature increase can trigger a seizure in sensitive children.

Risk Factors

Age, Genetics, and Inherited Traits

Children have a higher chance of getting febrile seizures in certain situations:

• Age: Children between 6 months and 5 years old face the greatest risk, with the highest likelihood occurring between 12–18 months.
• Genetics: Children whose family members have had febrile seizures are more likely to experience them.
• Inherited Traits: Scientists have found specific genes that may make some children more prone to having seizures when they have a fever.

These factors don’t cause seizures but can make them more likely during a fever.

Problems That May Occur

When Febrile Seizures Happen Again

Febrile seizures usually don’t cause lasting harm. They don’t damage the brain or lead to learning problems. Having a febrile seizure doesn’t mean your child has a serious health condition.

Several factors can increase the chance of having more febrile seizures:

• The first seizure happened with a mild fever
• The seizure was the first sign that the child was sick
• A close family member has had febrile seizures
• The child was under 18 months old during the first seizure

Febrile seizures are different from epilepsy. While febrile seizures happen when a child has a fever, epilepsy involves unprovoked seizures caused by unusual electrical activity in the brain.

Most children who have one febrile seizure will not develop epilepsy. However, parents should watch for signs of future fevers and talk with a doctor about what to do if another seizure occurs.

Ways to Prevent Fever Seizures

Most fever seizures happen during the first few hours when a child’s temperature starts rising.

Over-the-Counter Fever Medicines

When your child has a fever, you may give them children’s acetaminophen (like Tylenol) or ibuprofen (like Advil) to help them feel better. However, these medicines will not stop a seizure from happening.

Be careful with aspirin. Children and teens recovering from chicken pox or flu should not take aspirin. It can cause a serious condition called Reye’s syndrome in these situations.

Medicine for Seizure Prevention

Doctors rarely prescribe regular anti-seizure medications to prevent fever seizures. This is because these medications often have serious side effects. These side effects may be worse than the seizures themselves.

For children who have long-lasting febrile seizures, doctors might prescribe:

• Rectal diazepam (Diastat)
• Nasal midazolam

These medications are typically used only when:

• A seizure lasts longer than five minutes
• A child has multiple seizures within 24 hours

Important note: These medicines are not usually given just to prevent febrile seizures from happening. They are emergency treatments for when seizures occur and last too long.