Febrile Seizure

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A febrile seizure is a convulsion that occurs in some children with a high temperature (fever). The vast majority of febrile seizures are not serious. Most occur with common illnesses such as ear infections and colds. Serious infections such as pneumonia, meningitis, etc, are less common causes. Full recovery with no permanent damage is usual. The main treatment is aimed at the illness that caused the fever.

What causes a febrile seizure and who has them?

A febrile seizure is sometimes called a febrile convulsion. Any illness that causes a fever (high temperature) can cause a febrile seizure. Most occur with common illnesses such as ear infections, coughs, colds, flu and other viral infections. Serious infections such as pneumonia, kidney infections, meningitis, etc, are less common causes.

About 3 in 100 children have a febrile seizure sometime before their sixth birthday. They most commonly occur between the ages of 18 months and three years. They are rare in children aged under six months and over the age of six years.

What does a febrile seizure look like?

The child may look hot and flushed and their eyes may appear to roll backwards. They may appear dazed and then become unconscious. The body may go stiff, then generally twitch or shake (convulse). It does not usually last long. It may only be a few seconds and is unusual for it to last more than five minutes. The child may be sleepy for some minutes afterwards.Another feature of a simple febrile seizure is that it does not recur within 24 hours or within the same febrile illness.

What first aid should I do for a febrile seizure?

- Note the time it started.
- Lie the child on their side with their head in line with the body or slightly lower (the recovery position).
- Do not put anything into their mouth or shake the child.
- When the seizure stops, try to lower the child's temperature to make them more comfortable. To do this, take off their clothes (if the room is warm). When the child has recovered enough to swallow, give a drink and some paracetamol or ibuprofen. In the past, common advice thought to help cooling was to sponge with lukewarm water but this is no longer thought to help so is not recommended.
- Stay with the child at night.

What should happen after immediate first aid?

Call an ambulance if a seizure lasts more than five minutes (this includes small twitching movements, even if large jerking movements have stopped).

You should also contact a doctor urgently or ring for an ambulance if:

- The child does not improve quickly once a short seizure is over.
- Another seizure starts soon after the first one stops.
- The child has difficulty breathing.
- The child was not fully conscious before the seizure or one hour afterwards.
- You suspect a serious illness is the cause of the fever for.

No treatment is usually needed for the seizure itself if it stops within a few minutes. (However, treatment may be needed for the infection causing the fever.)

In all cases, the child should be seen by a doctor as soon as possible after a seizure for a check over to rule out serious illness.

Is a febrile seizure dangerous?

Although alarming, a febrile seizure in itself is not usually dangerous. Full recovery is usual.

Can febrile seizures be prevented?

It may seem logical that if you keep a child's temperature down during a feverish illness it may prevent a febrile seizure. However, there is little scientific evidence to prove that this is so. If child appears hot and distressed then the following will help:

- Keep the child very lightly dressed, or take all their clothes off if the room is warm.
- Give paracetamolor ibuprofen.
- Give lots of cool drinks.

Will it happen again?

Only one seizure occurs in most cases. In about 3 in 10 children who have a febrile seizure, a second seizure occurs with a future feverish illness. In less than 1 in 10 children who have a febrile seizure, three or more further seizures occur during future feverish illnesses. A future febrile seizure is more likely if the first occurs in a child younger than 15 months, or if there is a family history of febrile seizures in close relatives (father, mother, sister, brother). Once the child is past three years old, the chance of a recurrence (getting more than one seizure) becomes much less likely.

Does a febrile seizure cause any permanent damage?

Usually not. Full recovery is usual with no after-effects.

One study that followed children who had a febrile seizure found that "children who had febrile seizures did at least as well as, if not better than, children without febrile seizures on measures of intelligence, academic achievement, behaviour and working memory".

Is a febrile seizure a type of epilepsy?

No. Febrile seizures and epilepsy are two different conditions.

- The cause of a febrile seizure is related to the feverish illness and is not due to epilepsy or any brain abnormality.
- Epilepsy causes seizures without a fever. There is a separate set of leaflets that explain epilepsy in more detail.

Having a febrile seizure does not cause epilepsy to develop.

Yes. Some children develop a fever following immunisation, but this is no reason to withold immunisations.


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