Febrile seizures in children: all that you need to know

Febrile seizures in babies and toddlers can be terrifying, but usually cause no long-lasting damage. Know what to do in the moment and later


Seizures are scary. Your baby goes rigid, may have jerky movements of the body, and then goes into a deep sleep. They may also pass urine or stools during the episode.

Febrile seizures happen with fever. It’s the most common nervous system disorder in children, occurring in 2-5% of children. The usual age is six months to five years, but they’re most frequent between 12 and 18 months.

What causes febrile seizures?

Febrile seizures are a reaction of the immature brain to fever. Seizures result from electrical discharges in the brain. At young ages, there is increased excitability of the brain. Seizures happen quickly in response to stimuli.

Genetic factors are important. About a third of children with febrile seizures have family members who also had them.

The height of the fever is related to the likelihood of febrile seizures. According to Leung and Hon, 80% of febrile seizures occur with viral infections. Some vaccines also cause febrile seizures.

How does one know it’s a febrile seizure?

Children often have irregular movements of their limbs. Seizures are different, however. Your baby may become rigid and have rhythmic or jerky movements of all their limbs. Most babies roll up their eyes and become unresponsive during a seizure. The seizure usually lasts less than 5 minutes, but most are shorter.

This loss of consciousness is an important sign. Many metabolic seizures cause limb and body movements, but your baby is completely conscious. Seizures caused by low calcium or low glucose blood levels are such seizures.

It’s not easy to tell a febrile seizure from epilepsy or a brain infection. Once the seizure has stopped, you should have your child seen by your pediatrician.

What to do when your child is having a seizure

The American Academy of Pediatrics recommends the following steps in case your child shows symptoms of a febrile seizure:

  • Move your child to a flat surface, on their side, away from hard and sharp objects. Don’t try to hold them down
  • Turn their head to one side so that saliva and secretions drain out. This keeps the air passages clear
  • Don’t try to put fingers or objects into the mouth; it’s unnecessary and may even cause injury
  • If the seizure goes on beyond 5 minutes, call for help or rush to an emergency room.

Are febrile seizures harmful?

Your child having a seizure is a terrifying experience. Panic and anxiety about whether your child will survive the episode are natural. You may also worry about brain damage and disabilities.

Most febrile seizures last only a minute or two. These short seizures do no long-lasting harm to your baby. Your baby will awaken in a few minutes. There is no brain damage, intellectual disability, long-term paralysis, or nervous system problem.

Nevertheless, if a seizure goes on for several minutes, it can damage the brain. This is exceedingly rare with febrile seizures.

Will it happen again?

Yes, there is a possibility. There is a risk of febrile seizure every time your baby has a fever.

If your baby was less than a year old at the time of the first febrile seizure, the risk of more seizures is about 50%. If they were over a year old, the risk is about 30%.

Can febrile seizures be avoided?

Antiepileptic drugs like phenobarbital and valproate can reduce the recurrence of these seizures. However, these drugs have to be taken daily and have adverse effects.

Febrile seizures themselves are not very damaging. More than half of children don’t have repeat seizures. Preventive medicines are not recommended.

Diazepam can prevent febrile seizures if started as soon as your child has fever. This drug can be given by mouth. However, sometimes a seizure happens before you notice your child’s fever. Diazepam also has adverse effects and is not recommended unless there have been multiple or prolonged febrile seizures.

Will your child develop epilepsy?

Parents worry that if their baby had a febrile seizures, she may go on to have epilepsy and that’s a worrying thought indeed, because people with epilepsy have to live with restrictions. They also have to take medicines for years. The good news is, epilepsy is not more common in children who have febrile seizures. The likelihood of future epilepsy is almost the same as in children who have never had a febrile seizure.

What medicines to store at home

You should have fever medicine in stock. Acetaminophen [Tylenol] or ibuprofen [Advil or Motrin] are safe medicines to bring down fever.

You can’t totally avoid febrile seizures, because they may happen within minutes of the fever. Sometimes, a seizure happens before the fever. Being alert about your baby’s fever and keeping fever medicine handy reduces febrile seizures.

Anti-epileptic medicines are not helpful when given for a day or two with fever. They’re dangerous to store at home, too.

Most drugs that stop seizures are given by an injection into a vein. One medicine that can be given at home is midazolam, which is sprayed into the nose. In some situations, your doctor may advise you keep it at home.

Should my baby be taken to the hospital?

Your pediatrician will want to see your child when you inform them about a seizure. You can ask for a same-day appointment. Conversely, sometimes you will have to rush to the hospital or emergency room if:

  • The seizures don’t stop after several minutes.
  • You can’t wake your baby later
  • The fever is very high
  • Your baby has more than one seizure

Seizures with fever are not always febrile seizures. Serious diseases like meningitis or encephalitis also cause fever and seizures in children. Your physician may need to test for them.

Usually, children with febrile seizures are not hospitalized. Once your doctor has made sure there’s no serious disease, and your child is conscious, they’ll be sent home with you.

About 2-5% of children will have a febrile seizure at some point. Most of these seizures are scary but brief, and your child will recover quickly and completely. You should visit your pediatrician to make sure there’s no serious disease. About a third of children have repeat seizures, but they too outgrow these seizures by the age of six. There’s almost no increased risk of epilepsy or mental disability.

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