febrile seizure

A febrile seizure is a seizure caused by sudden elevation of the body temperature in a child in the proper age range, generally six months to three years old (some authorities extend the age range a bit but not beyond five or six years). Points about febrile seizures:

  • Febrile seizures are frightening to the parents but do not cause any harm to the child unless very prolonged. The usual seizure lasts three to five minutes and is harmless to the child.
  • Febrile seizures are essentially impossible to prevent. They generally occur on a rapid upswing in the temperature, often before the parents are aware the child even has a fever.
  • Most children only have one or at most two such seizures in childhood. They do not cause epilepsy later in life.
  • Febrile seizures are limited to the young, probably under three years old. A seizure with a concomitant fever in an older child is a different animal and may indeed be related to epilepsy.
  • True febrile seizures are usually thought to be generalised (the whole body is involved) and not focal (for example involving only one arm or one side of the body) although a true febrile seizure may begin focally and progress to the whole body.
  • After the seizure subsides the child's brain is electrically discharged and he will be "out of it" for a little while while the brain rests and recharges. Don't worry, he'll perk up soon and be his old self.

If this happens to your child, since you don't know what's going on when the seizure starts and you don't know how long the seizure will last, you'd better take the child to the emergency room. After exam and any lab tests, if it is clear that only a febrile seizure was involved, the doctor will probably let your child go home on whatever medicine is appropriate for the infection that caused the fever and will recommend some pretty aggressive fever control.

Febrile seizures are almost never treated. After the first febrile seizure, the risk of another one is about 1/3. After a second febrile seizure, the risk of further febrile seizure is about 1/2. The risk of progression to epilepsy (repeated non-febrile seizures) is about 3% by 7 years of age. This risk is increased if there are any relatives with epilepsy, if the child has any other nervous system problems, or if the febrile seizures are complex (not the usual grand mal type).

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