Fever Seizures

       Seizures that occur with fever (febrile seizures) are common in childhood. Under 5 years of age, 2-3 % of children with fever will have a seizure. These seizures are true, grand-mal seizures that cause the child’s arms and legs to jerk. The child will breathe irregularly and lose consciousness. They usually only last 1-2 minutes, but they are extremely frightening for parents.

        Doctors do not know what causes these seizures. They often occur in the first few days of a fever, when a child’s temperature may change rapidly up and down. It is possible that the brain cannot adjust to these rapid changes. But it is important for parents to know that seizures do not occur simply because the fever gets “too high”. Children can have a seizure at any temperature, low or high.

        If a child’s parent or sibling or the child himself has a history of fever seizures, the child has an increased risk to have a seizure with fever. The first time a child has a seizure, parents should contact their child’s caregiver because there are other problems that can cause a seizure and they need to be investigated. If a seizure lasts longer than 10 minutes, the irregular breathing can be dangerous and the parent should call 911.

        Parents of a child who has a fever seizure are frequently told to alternate fever medications such as acetaminophen or ibuprofen, to sponge the child or to use other means to “keep the fever down”. This advice is bad in two ways: first, it is simply wrong. There is no evidence that any kind of “fever control” prevents fever seizures. Second, it gives the parents the false sense that they can do something to prevent fever seizures. The parent can mistakenly feel guilty if the child has a seizure because they think that they “failed to keep the fever down”. A child’s fever is usually the result of an infection. Fever serves as an important part of the child’s immune defense and is necessary to fight the infection. Fever medications can lower the fever somewhat and make the child more comfortable, but they cannot eliminate the fever or the risk of fever seizures. Fortunately, even though fever seizures are very frightening for parents, they are not dangerous for the child. By the time the frightened parent has called 911, the seizure is usually over and the child is asleep.

        If a child has a fever seizure, the parent should not try to restrain the child but allow them to lie gently on the floor. Do not try to force anything into the child’s mouth. The child will not “swallow their tongue”. When the seizure is over, check the mouth to be sure nothing is in it and that the child’s airway is clear. The child will be sleepy for about an hour after the seizure. Have your child examined after the first fever seizure, if more than one seizure occurs within 24 hours or if the seizure occurs with other symptoms such as confusion, lethargy or dehydration.