By: Marissa Di Giovine, MD, FAAP & Eva Catenaccio, MD
Febrile seizures are a type of seizure that can affect otherwise healthy children around the time they have a fever. Seizures can involve stiffening or shaking part of the body or the whole body.
When do febrile seizures occur?
Febrile seizures happen in in 3 or 4 out of every 100 children. They can occur between 6 months and 5 years of age, but most often around 12 to 18 months old.
A febrile seizure usually occurs during the first few hours of a fever. While they are most common with fevers of 102°F (38.9°C) or above, they can also happen with milder fevers.
What happens during a febrile seizure?
Your child may look strange for a few moments, then stiffen, twitch and roll their eyes. They may be unresponsive for a short time, or have changes in their breathing or skin color. After the seizure, the child usually returns to normal quickly.
Seizures usually last less than one or two minutes but, although uncommon, can last longer. A seizure longer than 5 minutes is usually a medical emergency and requires urgent treatment to stop the seizure.
Other kinds of seizures (ones that are not caused by fever) last longer, can affect only one part of the body, and may occur repeatedly.
If your child has a febrile seizure, act immediately to prevent injury.
Place them on the floor or bed away from any hard or sharp objects.
Turn their head to the side so that any saliva or vomit can drain from their mouth.
Do not put anything into their mouth; they will not swallow her tongue.
Call your child's doctor.
If the seizure does not stop after 5 minutes,
call 911 or your local emergency number.
Are febrile seizures dangerous?
While febrile seizures may be very scary, they usually are harmless to the child. Most febrile seizures are short and do not cause brain damage,
nervous system problems, paralysis, intellectual disability or death. Long seizures need to be treated either with a rescue medication or by emergency medical services.
Will my child have more seizures?
Febrile seizures tend to run in families. The risk of having seizures with other episodes of fever depends on the age and development of your child. Children younger than 1 year of age at the time of their first seizure have about a 50% chance of having another febrile seizure. Otherwise healthy children older than 1 year of age at the time of their first seizure have only a 30% chance of having a second febrile seizure.
Most children out-grow febrile seizures by the time they get to school age. Only a very small number of children who have febrile seizures will go on to develop
Are there certain illnesses that cause febrile seizures?
Febrile seizures can happen with any condition that causes a fever, such as common colds, the flu, ear infection or
roseola. They can also happen if your child experiences heat-related illness such as heat stroke when there is a rise in core body temperature. Febrile seizures usually happen only once during any given illness, often with the first fever spike. However, they can occur just before or just after your child gets a fever.
Can febrile seizures happen after getting a vaccine?
Vaccines can cause your child to have a fever, but febrile seizures are generally rare after vaccination. Recommended vaccines can actually help prevent some febrile seizures, since getting sick with measles, mumps, rubella, chickenpox, influenza (the flu), pneumococcal infections and other diseases can cause fevers and febrile seizures.
Febrile seizure treatments
If your child has a febrile seizure, call your child's doctor right away. They will want to examine your child to identify the cause of their fever. It is more important to determine and treat the cause of the fever rather than the seizure. A spinal tap may be done to be sure your child does not have a serious infection like
meningitis, especially if they are younger than 1 year of age.
In general, doctors do not recommend treatment of a simple febrile seizure with preventive medicines. However, this should be discussed with your child's doctor. In cases of prolonged or repeated seizures, the recommendation may be different.
acetaminophen and ibuprofen can help lower a fever, but they do not prevent febrile seizures. Your child's doctor will talk with you about the best ways to take care of your child's fever.
If your child has had a febrile seizure, do not fear the worst. These types of seizures are not dangerous to your child and do not cause long-term health problems. If you have concerns about this issue or anything related to your child's health, talk with your child's pediatrician.
About the authors
Marissa Di Giovine, MD, FAAP, is a Pediatric Neurologist who subspecializes in epilepsy. She currently holds the position of Assistant Professor of Clinical Neurology at the University of Pennsylvania's Perelman School of Medicine and is an active member of the Pediatric Regional Epilepsy Program at the Children's Hospital of Philadelphia. She is an Advisory Committee member of the National Coordinating Center for Epilepsy, a member of the American Academy of Pediatrics Section on Neurology, and a founding member of the American Academy of Pediatrics' Committee on Mentorship.
Eva Catenaccio, MD, is a Pediatric Epilepsy Fellow at Children's Hospital of Philadelphia.