|Febrile seizures are very common in children, occurring in about 2-5% of children. This rate is even higher if other family members also have febrile seizures. A febrile seizure is a seizure that is caused by your child having a fever, without having a specific infection, such as meningitis, which can also cause symptomatic seizures. They are most common in children between the ages of six months and five years, especially when they have a high fever that came on suddenly.
Febrile seizures can either be simple, brief generalized seizures that only occur once, or complex, with prolonged seizures (>15 minutes), which may be focal, and which may occur more than once on the same day.
Although frightening for parents when they occur, febrile seizures usually have no long term adverse affects. The biggest risk after having a febrile seizure is having another one, which occurs in about 30% of children, usually in the next six months. The risk of having another febrile seizure is higher if the first febrile seizure was when your child was under twelve months of age, if it was a complex febrile seizure, or if other family members have febrile seizures. It is lower, only about 10%, if the child has none of these risk factors.
Also, a child who has had a febrile seizure has an increased risk of having non-febrile seizure, or epilepsy, later in life. However, only about 2% of children with simple febrile seizures will develop epilepsy. The risk is higher, up to 10%, if the child had a complex febrile seizure, has other family members with epilepsy, or if he has other neurological problems.
Children should be evaluated by a doctor after having a febrile seizure. For most children, especially if they are over twelve to eighteen months of age, no further testing or interventions will need to be done if the child appears normal and there is no suspicion that he has meningitis. It can be difficult to recognize meningitis in younger children, especially if they are under twelve to eighteen months of age, and so a lumbar puncture may need to be done in these infants.
The American Academy of Pediatrics recommends that a lumbar puncture, or spinal tap, be strongly considered in children under twelve months of age after having a febrile seizure. They also recommend that a lumbar puncture be considered in children between the ages of twelve and eighteen months. A lumbar puncture is only necessary for children over eighteen months if meningitis is suspected, especially if they have already been treated with antibiotics.
The AAP also recommends that other testing, especially anEEG, blood tests, or a head CT, MRI or skull x-rays, not be routinely performed on children after their first febrile seizures.
Most children with febrile seizures do not need treatment, even if they have more than one febrile seizure. It can sometimes be helpful if you begin to give your child fever reducers at the first sign of a viral illness, to prevent a high fever from occuring, which may trigger another febrile seizure. This doesn't always work though, because it is usually the intitial rapid rise in fever that triggers a seizure and this can happen before you even know your child is sick.
Treatment to prevent febrile seizures is sometimes necessary, and the anti-seizure medications phenobarbital and sodium valproate, are most commonly used. Another treatment that may be effective, is giving your child diazepam (valium) at the first sign of fever. Most children with febrile seizures do not need to be treated though. Children with neurological conditions who also have recurrent prolonged febrile seizures or status epilepticus are usually the children who need to be treated.
Seizures and Epilepsy Internet Resources:
- AAP Practice Parameter: The American Academy of Pediatrics endorses and accepts as its policy the Practice Parameter: The Evaluation of a First Non Febrile Seizure in Children.
- Epilepsy Foundation of America: The EFA Answer Place for parents of children with epilepsy. Includes info about treatment, medications, recognizing the signs of a seizure, managing seizures at school and questions to ask your doctor.
- Epilepsy Support Groups and Organizations: A comprehensive listing of support groups for parents of children with epilepsy and seizures.