What to Do If a Child Has a Febrile Seizure?

Febrile Seizure

A febrile seizure usually occurs when your child has a fever or high body temperature. It can also happen without brain inflammation or certain metabolic disorders. Even though febrile seizures occur with fever, you may not notice an increase in your child’s body temperature until after an episode of seizure.

This type of seizure is commonly seen in normal growing children from 6 months to 5 years of age. Children who experience febrile seizures do not always have an increased risk of developing epilepsy or certain cognitive problems in the future. Fevers that often trigger febrile seizures are usually caused by viral infections. The main factor in febrile seizures is the rapid rise of body temperature in children. A low-grade fever is unlikely to cause seizures than an abrupt peak in body temperature. 

There are two types of febrile seizures: simple and complex.

• Simple Febrile Seizures - They usually last for a few minutes to 15 minutes. You child may shake, twitch, or convulse. Your child may also moan, roll his or her eyes, or become unconscious. Some children may urinate themselves or vomit while having a seizure.  

• Complex Febrile Seizures - They usually last for more than 15 minutes and more than once within a 24-hour period. Children may also show twitching or movement on one part of their body. 

Another characteristic of febrile seizures is that they usually happen within 24 hours of acute infection and tend to stop on their own even if your child continues to have a fever for a few more days. After a febrile seizure, some children may feel disoriented and sleepy afterward. 

The risk of a febrile seizure recurrence may increase if:

• There is a family history of febrile seizures. 
• There is a low-peak temperature during a seizure.
• The child is younger than 18 months old.

All these risk factors tend to increase the risk of a recurrence. Another seizure may be experienced by one-third of children.

What to do if your child has a febrile seizure?

Seek immediate medical help if it is your child’s first febrile seizure. Medications to control fever are recommended when a child is sick. Although fever reducers can help lower down your child's temperature, they cannot prevent febrile seizures from happening. The reason is that some children will have a seizure at the onset of fever and even before reaching an elevated body temperature. 

When your child has a seizure, try to stay calm and place your child on a flat and safe surface. Turn your child on his or her side to avoid choking and respiratory difficulties. Time your child's seizure. A fever-induced seizure usually lasts for 3-5 minutes. Call for immediate medical help if your child has breathing problems.

Do not place anything in your child’s mouth during a convulsion. Parents should also be aware of their child's condition and ask the pediatrician for tips to reduce fever during any type of illness. 

Seek medical attention if your child has the following conditions:

• High-grade fever (more than 103 degrees Fahrenheit or 39.4 degrees Celsius)
• Seizure on one side of the body
• Seizures do not stop within 3-5 minutes
• Your child remains unconscious
• More than one seizure during the same illness 
• Nonfebrile seizures

Seizure in Babies

To see your child having seizures can be very worrying as a parent. However, it can be rarely dangerous if it is dealt with properly. Young children may experience febrile seizures since the electrical system in their brain is still not well-developed when it comes to dealing with sudden high body temperatures. 

What are the signs of seizures in babies?

• The body shakes vigorously with clenched fists and an arched back
• Eyes become fixed or upturned
• Twitching of the face and squinting
• Fever, sweating, or flushed skin
• Red, puffy face and neck
• Holding their breath
• Drooling 
• Possible vomiting
• Reduced response
• Loss of bowel or bladder control 

What to do when your baby is having a seizure?

• Make sure that they do not hurt themselves and are protected. You can place a soft padding or pillows around them. 
• Keep track of the time.
• Do not try to move them much or strain them. Any dangerous object near them should be removed. 
• Help your child cool down by removing additional clothing or beddings and opening the windows. 
• Once the seizure has stopped, your child may be unresponsive or feel very sleepy. You can place your child in the recovery position to keep his or her airways open. 

Febrile Seizure Symptoms 

Most febrile seizures have the following symptoms:

• Shaking of the body or involuntary twitching
• Drooling
• Eye rolling
• High body temperature
• Wetting or soiling 
• Hypoxia

Dos

• Try turning your child on his or her side if possible.
• Track the time.
• Remove dangerous objects near your child.
• Place a soft material such as a blanket under your child's head.
• Remove tight clothing.
• Remove eyeglasses (if your child wears any).

Don’ts

• Do not stop them from shaking.
• Do not hold them up.
• Do not place anything in your child's mouth.
• During a seizure, do not put them in a bathtub. It could cause drowning or a head injury.

What to Expect After a Seizure

The doctor will examine your child. The doctor will do a series of tests to rule out certain conditions as well as take the medical history of your child. To bring the temperature down, acetaminophen or ibuprofen may be given. Your child may require more observation or tests if the seizure is atypical.

At home, your child needs to be treated for the illness or infection. This can be done by continuing to keep their temperature down and by administering antibiotics.

After a seizure, your child may get a little bit cranky, but this may be related to his or her illness. The child can sleep safely in his crib or bed. Any soft toys or pillows should be removed from the bed. Follow the doctor’s advice if the child is acting sick or has any signs of illness. Usually, most children grow out of febrile seizures after five years old. However, around one out of three children will have one or more seizures.

Prognosis 

There is no brain damage. Five in every 100 cases may turn out to have epilepsy while the majority of them grow out febrile seizures by the time they reach kindergarten. 

Things to Keep in Mind

Children with febrile seizures may not need long-term antiepileptic medications because they do not have epilepsy. The doctor may prescribe a medication to stop a prolonged seizure. Since febrile seizures only last for less than five minutes, most seizures do not require medicine. If you live in remote areas where medical assistance is not available or when you are traveling with your child, medication is particularly useful, which you can discuss with the doctor.

It is very important to have a follow-up with the pediatrician after your child has experienced a fever-related seizure. If your child has a complex febrile seizure or any previous neurological problems, a neurological evaluation and additional investigation are highly recommended to determine the risk of another seizure.

The risk of first time and recurring febrile seizures increases due to genetic influences and family history. Mutation in the sodium channel gene in the family predisposes the child to febrile seizure and epilepsy in the future. This possibility can be evaluated by a neurologist. To diagnose this condition, certain tests are ordered.

Bottom Line

Typically, febrile seizures may happen during the first few hours of fever. The signs can be moderate to severe. For a few moments during the seizure, the child may look unusual, may stiffen, convulse, twitch, shake, and may roll their eyes. They may even urinate or vomit. For a short time, they may be unresponsive. Their skin color may also become darker and their breathing patterns will get disrupted. When a seizure ends, they may feel confused, tired, or very sleepy. However, they usually get back to normal after taking some rest.

Febrile seizures usually last for 3-5 minutes, but may also last for 15 minutes in some cases. It rarely occurs more than once a day. A febrile seizure is not dangerous by itself, but during an episode, children may hurt themselves. To prevent injury, you need to act immediately once your child has a febrile seizure. Although febrile seizures are harmless, they can be terrifying for parents and caregivers to witness.