Febrile seizures are seizures that are triggered by high fever. They are the most common type of seizure (occurring in 4% of children) and in general are harmless. Most first seizures occur in children less than 2 years old. The average temperature at which they occur is 104F. The fever itself can be caused by an infection in any part of the body. Each febrile seizure usually lasts 1 to 10 minutes without treatment. Most of these children have just one febrile seizure in a lifetime. Febrile seizures usually stop occurring by 5 or 6 years of age. They do not cause brain damage.
Reduce the Fever. Bringing your child’s fever down as quickly as possible will shorten the seizure. Remove your child’s clothing and apply cold washcloths to the face and neck. Sponge the rest of the body with cool water. As the water evaporates, your child’s temperature will fall. When the seizure is over and your child is awake, give him the usual dose of acetaminophen or ibuprofen.
Protect Your Child’s Airway. If your child has anything visible in his mouth, clear it with a finger to prevent choking. Place your child on his side or abdomen to help drain secretions. If your child vomits, clear his mouth. Use a suction bulb if available. If his breathing becomes noisy, pull the jaw and chin forward.
Emergencies. Call 911 if the seizure lasts more than 5 minutes.
Common Mistakes. During the seizure don’t try to restrain your child or stop the seizure movements. Once started, the seizure will run its course no matter what you do. Don’t try to force anything into your child’s mouth. This can injure the mouth, cause vomiting, or result in him biting your finger. Don’t try to hold the tongue during a convulsion. Although children may rarely bite the tongue, they can’t “swallow the tongue.”
Driving In. If you are told to drive to a medical facility, keep the fever down during the drive. Dress
your child lightly and continue to apply cold washcloths to the forehead. Prolonged seizures can be
caused by bundling up your child during the trip.
Oral Fever-Reducing Medicines. Febrile seizures usually occur during the first day of an illness.
Try to control the fever more closely than is necessary for children who do not have febrile seizures.
Begin acetaminophen or ibuprofen at the first signs of a fever (rectal temperature over 100.4F) and give it continuously for the first 48 hours of the illness. If your child has a fever at bedtime, awaken her
once during the night to give the fever medicine.
Fever-Reducing Suppositories. Have some acetaminophen suppositories on hand in case your child ever has another febrile seizure. These suppositories may be kept in a refrigerator at the pharmacy, so you may have to ask for them.
Light Covers or Clothing. Avoid covering your child with more than one blanket. Bundling up during
sleep can raise the temperature as much as two extra degrees.
Lots of Fluids. Keep your child well hydrated by offering plenty of cool fluids.
The only way to completely prevent future seizures is for your child to take an anticonvulsant medicine daily until 3 or 4 years of age. Since anticonvulsants have side effects and febrile seizures are usually harmless, anticonvulsants are rarely prescribed unless your child had other neurological problems. Your physician will discuss this decision with you.
Call our office IMMEDIATELY if . . .
- Your child has a febrile seizure.
- The neck becomes stiff.
- Your child becomes confused, delirious or difficult to awaken.
- Your child starts to act very sick.