Febrile Seizures in Children

What are Febrile Seizures?

Febrile seizures are convulsions or seizures that usually occur among children within the age of 6 months to 5 years. These convulsions are often triggered by ear infections, flu, fever, or any minor childhood illness. In some cases, a child may experience these seizures without a spike in temperature and get fever  after a few hours. The condition may occur in children with normal neurological as well as physical development and are often harmless. The risk of febrile seizures occurs between 12 and 18 months of age.

Febrile seizures last only for a few minutes, and, in some cases, more than 15 minutes, and are usually accompanied by a temperature of around 103° Fahrenheit. Although these seizures are harmless, the condition can be quite frightening for the parents.

What are the Symptoms of Febrile Seizures?

During the onset of febrile seizures, a child will lose consciousness, and his/her arms and legs will start shaking uncontrollably. Some children may also experience stiffening of limbs, twitching on one side or a part of the body, and eye-rolling. The common symptoms of these convulsions are:

• Violent shaking of arms and legs
• Stiffness of arms and legs
• Twitches on one part of the body
• Eye rolling backward
• Losing of consciousness
• Contraction of muscles and clenching of the jaw
• Difficulty in breathing and spontaneous breathing
• A spike in body temperature of around 103° Fahrenheit

Based on the convulsions’  duration, febrile seizures are classified into two types — simple febrile seizures and complex febrile seizures. Seizures that last from a few seconds to up to 15 minutes are termed simple febrile seizures. These are the most common types that do not recur within 24 hours. In contrast, complex febrile seizures last for more than 15 minutes and may recur within 24 hours. Experiencing a febrile seizure does not imply the onset of epilepsy.

When to See a Doctor?

Although febrile seizures are quite harmless, visiting a doctor after the child’s first episode of febrile seizure is advisable. If convulsions last more than 5 minutes and are accompanied by any of the following symptoms, seek medical help immediately.

• Extreme drowsiness
• Vomiting
• Difficulty in breathing
• Stiffness in the neck and back

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What are the Causes of Febrile Seizures?

A spike in body temperature can cause febrile seizures. The two most common causes of occurrence are:

Disease-like flu or Infections. Viral infections, and in rare cases, bacterial infections may cause febrile seizures in children. Viral infections like flu accompanied by high body temperatures are often the cause of these seizures. Ear infections, which are a common occurrence in children, can also cause febrile seizures.

Vaccines or Immunization. Immunizations for diseases like diphtheria, tetanus, pertussis, or measles-mumps-rubella increase the risk of febrile seizures. As children often experience fever after administering vaccines, febrile seizures may occur after such a session.

What are the Steps to be taken by Parents?

It is advisable for the parents or family members of the child experiencing febrile seizures to be composed and calm. Parents should observe the child and take a few primary first-aid measures. When a child is experiencing an episode of febrile seizures, the following measures should be taken:

• Note down the seizures’ duration—if it lasts more than 5 minutes, it is advisable to call for an ambulance and immediately seek medical help.
• If the child does not recover from a seizure, even though it is less than 5 minutes, seek medical help.
• Place the child in a comfortable position—avoid holding or restraining the child when the convulsions are in process.
• To prevent choking, place the child on his/her side or stomach. Loosen any restrictive clothing that might restrict the airways.
• Seek medical help immediately if there are symptoms of extreme lethargy, vomiting, infections, and a stiff neck.

What are the Risk Factors of Febrile Seizures?

Children who are prone to febrile seizures are those who have:

• Family History of Febrile Seizures. Children may inherit the risk of possible febrile seizures from their kin.
• Young Age. Children in the age group of 6 months to 5 years are at risk of experiencing febrile seizures.
• Medical History. A child who already has a history of febrile seizures.

What are the Complications of Febrile Seizures?

The majority of febrile seizures are harmless and get over within a short period of time. There exists, however, a nominal risk that the child may choke.

Children experiencing a brief, full body febrile seizure are slightly more prone to develop epilepsy compared to the general population.  Children who suffer from seizures that reoccur within 24 hours; a focal seizure (seizure that starts on one side of your brain); or a febrile seizure that continues longer than 10 minutes, have a moderately greater risk (about 10 percent) of developing epilepsy as compared to those children who do not experience febrile seizures.

Of greatest worry is a small group of children suffering from a very prolonged febrile seizures that lasts longer than 30 minutes.  In such children, the risk of epilepsy is as higher as 30 – 40 per cent though the condition might not happen for many years.  Recent studies show that prolonged febrile seizures can injure the hippocampus, a brain structure involved with temporal lobe epilepsy (TLE).

What are the Preventive Measures to be taken during Febrile Seizures?

Although febrile seizures are not preventable, a few avoidable measures can be taken by the parents.

• Administering prescribed medicines to suppress fever might help make your child more comfortable, but there are no proven effects on preventing febrile seizures.
• Giving your kids plenty of fluids and ORS.
• Treating any possible infections quickly to prevent fever.

Since febrile seizures are not harmful, it is not advisable to treat them with anticonvulsant medications.

Febrile seizures can be frightening for the parents of the child suffering from it, but a calm and composed attitude mixed with the awareness of this condition can help treat the child better.

Frequently Asked Questions (FAQs):

1. What is the frequency of febrile seizures?

Febrile seizures are often unpredictable. Fever, infections, or immunization accompany the convulsions. The frequency of the occurrence may vary with the individual. About 40% of children with a history of febrile seizures experience a recurrence.

2. Is it possible for febrile seizures to occur during sleep?

Yes, there have been multiple recorded episodes of febrile seizures occurring when a child is fast asleep. The seizure usually lasts for a few minutes, which is why they might pass unnoticed.

3. Can febrile seizures cause permanent neurological disorders?

No. Since febrile seizures are quite harmless and result from a spike in body temperature, it does not cause any neurological disorders. It is still advisable to seek medical help if the convulsions last for more than 15 minutes.

4. Are febrile seizures and epilepsy the same?

No. Febrile seizures are accompanied by high body temperature. In contrast, epilepsy is a neurological disorder characterized by seizures and loss of consciousness. Epilepsy is not the result of a spike in body temperature.