When the body temperature of a child or baby increases due to an illness or inflammation, this may result in febrile seizure, or febrile seizure. It doesn’t mean the child’s having epilepsy.
Febrile seizures affect children under the age of 6 with a temperature of 38 ° Celsius or greater. It is most prevalent between 6 months and 5 years, and particularly between 6 months and 3 years. Typically 2 to 5 per cent of children suffer a febrile convulsion before they are 5 years old.
Seizures may seem disturbing to parents or caregivers, but most seizures are harmless and do not indicate a medical problem in the long run. They’re usually caused by a sudden temperature increase.
If a child with a high fever has a seizure and no clear cause or previous diagnosed neurological or developmental issue has been identified, it would be Consider a febrile seizure.
Types of febrile seizure
There are two types of febrile seizure:
- Simple febrile seizures last under 15 minutes and do not happen again during an infection
- Complex febrile seizures may happen several times during an infection, and may last longer than 15 minutes
About 9 in every 10 febrile seizures are simple febrile seizures.
What causes febrile seizures?
Febrile seizures tend to happen because the temperature of the child’s body suddenly rises.
They often occur during the fever‘s first day, but can occur as the high body temperature descends.
Infections of the central nervous system which affect the brain and spinal cord, including encephalitis and meningitis, are much less common but very serious. There may be a more serious cause for seizures linked to these conditions.
Do vaccinations cause seizures?
The risk of a febrile seizure after vaccination is very low. Some studies suggest that after the vaccine for measles, mumps, and rubella (MMR), 25 to 34 children out of every 100,000 suffer a febrile seizure.
After the antidiphtheria, whooping cough, tetanus, polio, and type b hemophilus influenza vaccine (DTaP / IPV / Hib) the risk is even lower. In every 100,000 vaccinations the rate is around 6 to 9 cases.
A febrile seizure that occurs soon after a vaccination is probably due to the fever itself rather than the vaccination itself.
Vaccination can cause a rise in temperature as the body “ramps up” to fight the intruder. That may result in a febrile seizure.
After immunization with DTP, the risk is greatest on the day of vaccination when the fever is most likely to increase, but it can occur between 8 and 14 days later after the MMR vaccination.
Research indicates that while there is a slight chance of seizure following a vaccination, there is no possibility of any long-term adverse effects.
Doctors encourage immunization and advise parents to complete the vaccination schedule, even if a child has febrile seizures after a jab. This is because illnesses such as measles have much greater dangers and complications.
How can parents recognize a febrile seizure?
A febrile seizure frequently happens at the beginning of a illness, when fever starts, and sometimes before the parents realize the child is sick.
The following symptoms can be detected by the parents or carers:
- The child’s body becomes stiff
- Arms and legs start to twitch, shake or jerk on both sides of the body
- They may have trouble breathing
- They will lose consciousness
- They may lose control of their bladder or their bowels
- They may vomit
- They may foam at the mouth
- Their eyes may roll back in the head
- They may cry or moan.
Most seizures last just a few minutes but for up to an hour they can cause drowsiness.
Complex febrile seizures can last for more than 15 minutes, and the child can suffer numerous seizures while ill. The child may twitch only on one side of the body, called a focal seizure.
Although a fever triggers a febrile seizure, the severity of signs and symptoms also isn’t directly linked to fever severity.
How are febrile seizures diagnosed?
An infection can be identified by blood and urine tests, or what kind of it is. If the child is very young, a urine sample can be hard to obtain. It may need to be in hospital.
If the doctor suspects an infection in the brain and spinal cord, it may require a spinal tap, or lumbar puncture. The doctor sticks a needle into the child’s lower back using a local anesthetic to extract a small amount of spinal fluid.
This will decide if the fluid that protects the brain and spinal cord contains any infection.
If the child has a complex febrile seizure it may need further testing.
What is the treatment for febrile seizures?
A child with a febrile seizure should be put in the position of recovery, on their side, with their face turned to one side.
This should prevent them from swallowing any vomit, keep their airways open, and help avoid injury.
If necessary, a caregiver will remain with the infant, and time the seizure.
The caregiver should call the doctor if it lasts less than 5 minutes.
They should call for an ambulance, if it lasts longer. While this may not be a serious issue, it is a sensible precaution.
In certain instances where the seizure occurs before the child arrives at the emergency department, medication can be administered by a hospital doctor to stop the seizure.
If the seizure is particularly long, the child will have to remain in the hospital for observation if the infection appears to be a serious one, or if the doctors may not know what is causing it.
During the seizure no one will bring something into the child’s mouth.
A person who has a seizure can not “swallow their tongue,” so it could be risky to place it in the mouth, potentially breaking a tooth which could then be inhaled into the lungs.
Treating recurring febrile seizures
About 1 in 3 children will have another seizure over the next 12 months, when they have a infection. That would be more likely if:
- The first febrile seizure happened before the age of 18 months
- The first seizure accompanied a low fever
- The child has previously had a complex febrile seizure
- There is a family history of seizures
- There is a family history of epilepsy
- The child attends a day nursery, where more childhood infections are likely.
It’s unlikely to have risks or lasting effects. A simple febrile seizure does not cause damage to the brain or neurology, learning disabilities, or other disorder.
Febrile seizures and epilepsy
A febrile seizure is separate from an epileptic seizure.
If a child has a feverless seizure this may indicate epilepsy.
After a febrile seizure there is a chance of developing epilepsy but it is low.
The risk of developing a non-febrile seizure disorder, such as epilepsy, after one or more common febrile seizures is between 2% and 5%, compared to 2% in a child who has never had a febrile seizure at all.
Epilepsy is more likely if:
- There are neurological abnormalities
- There was a developmental delay before febrile seizures started
- There is a family history of epilepsy
- The seizures are complex
- The seizure occurred within an hour of the onset of fever.
Preventing febrile seizures
Doctors normally do not consider taking anti-seizure medicine after a febrile seizure, since the long-term risk of taking medicine is greater than that of a seizure, which is typically harmless and relatively rare.
A doctor can prescribe medication for a child who has febrile seizures for long time.
If a child is suffering from a fever, acetaminophen or ibuprofen may help bring it down.