What are febrile seizures. How do they affect children. What causes these seizures. How can parents recognize and respond to febrile seizures. When should medical attention be sought. What are the long-term implications of febrile seizures.

Understanding Febrile Seizures: An Overview

Febrile seizures are convulsions that occur in young children, typically between the ages of 6 months and 5 years, when they experience a fever above 100.4°F (38°C). These seizures, while alarming for parents, are generally not as dangerous as they may appear. They usually last for a few minutes and stop on their own, although the fever may persist for some time afterward.

Are febrile seizures a sign of a serious underlying condition? In most cases, febrile seizures do not indicate a severe health problem. They are distinct from epilepsy and do not typically cause long-term health issues. However, understanding the nature of these seizures, their potential causes, and appropriate responses is crucial for parents and caregivers.

Types of Febrile Seizures: Simple vs. Complex

Febrile seizures are categorized into two main types: simple and complex. Each type has distinct characteristics and implications:

Simple Febrile Seizures

• Most common type
• Usually last a few minutes, rarely up to 15 minutes
• Involve convulsions affecting the entire body
• May include eye-rolling, moaning, and loss of consciousness
• Can be accompanied by vomiting or urination

Complex Febrile Seizures

• Last longer than 15 minutes
• Occur more than once within 24 hours
• Involve movement or twitching of only one part or side of the body

How can parents differentiate between simple and complex febrile seizures? The key factors are duration, frequency, and the extent of body involvement. Simple seizures are shorter, occur in isolation, and affect the whole body, while complex seizures are longer, may recur, and often involve only part of the body.

Causes and Risk Factors of Febrile Seizures

The exact cause of febrile seizures remains unknown, but research suggests a link to certain viruses and the way a child’s developing brain reacts to high fevers. Several risk factors increase the likelihood of a child experiencing febrile seizures:

1. Family history of febrile seizures
2. Previous occurrence of a febrile seizure
3. Age of first seizure (younger than 15 months old)

Do all children with fevers experience seizures? No, febrile seizures affect only a small percentage of children with fevers. Approximately 1 in every 3 children who have had one febrile seizure will experience another, usually within 1-2 years of the first episode.

Recognizing the Signs and Symptoms of Febrile Seizures

Identifying a febrile seizure quickly is crucial for appropriate management. The following signs and symptoms may indicate a febrile seizure:

• Sudden convulsions, shaking, or twitching
• Rolling of the eyes
• Moaning or other unusual vocalizations
• Loss of consciousness
• Vomiting or urination during the seizure

Can febrile seizures occur without other symptoms? While a fever is always present during a febrile seizure, other symptoms may not be apparent before the seizure begins. This is why monitoring a child’s temperature during illness is important, especially for those with a history of febrile seizures.

Immediate Response: What to Do During a Febrile Seizure

When a child experiences a febrile seizure, quick and appropriate action is essential. Follow these steps to ensure the child’s safety:

1. Stay calm and place the child gently on the floor or ground
2. Remove nearby objects to prevent injury
3. Position the child on their side to prevent choking
4. Loosen any clothing around the head and neck
5. Monitor for breathing problems, including bluish coloration of the face
6. Time the duration of the seizure

What should parents avoid doing during a febrile seizure? It’s equally important to know what not to do:

• Do not try to restrain the child
• Avoid putting anything in the child’s mouth
• Do not attempt to administer fever-reducing medication
• Refrain from placing the child in cool or lukewarm water

When to Seek Medical Attention for Febrile Seizures

While most febrile seizures resolve on their own, certain situations require immediate medical attention. Call 911 or seek emergency care if:

• The seizure lasts longer than 5 minutes
• The child has difficulty breathing or turns blue
• The seizure affects only part of the body
• The child doesn’t respond normally after the seizure
• Another seizure occurs within 24 hours
• An anti-seizure medication was needed to stop the seizure

Is there a risk of meningitis associated with febrile seizures? Children who have missed certain vaccinations and experience a febrile seizure may have a higher risk of meningitis. Seek immediate medical care if signs of meningitis appear, such as neck stiffness, excessive vomiting, light sensitivity, or a bulging soft spot on a baby’s head.

Long-term Outlook and Management of Febrile Seizures

The long-term prognosis for children who experience febrile seizures is generally positive. Most children outgrow these seizures by the age of 5. However, understanding the management and potential implications is important:

• Follow-up care: After a febrile seizure, consult a doctor to determine the cause of the fever
• Fever management: Standard fever treatments like acetaminophen or ibuprofen may be recommended
• Preventive measures: Continuous medication to prevent febrile seizures is typically not recommended
• Anti-seizure medication: In some cases, doctors may prescribe medication for seizures lasting more than 5 minutes

Do febrile seizures increase the risk of epilepsy? Children who experience febrile seizures have only a slightly increased risk of developing epilepsy compared to the general population. This risk is higher for those with complex febrile seizures or additional risk factors.

Empowering Parents: Education and Support

Dealing with febrile seizures can be a frightening experience for parents. Education and support are crucial in managing these episodes effectively:

• Learn about febrile seizures and their typically benign nature
• Understand proper first aid techniques for seizures
• Communicate openly with healthcare providers about concerns and questions
• Connect with support groups or other parents who have experienced similar situations
• Stay informed about your child’s overall health and vaccination status

How can parents prepare for potential future seizures? While it’s impossible to predict if a child will have another febrile seizure, being prepared can help reduce anxiety. Consider creating an action plan with your doctor, including steps to take during a seizure and when to seek emergency care.

Febrile seizures, while alarming, are generally not indicative of a serious underlying condition. By understanding their nature, recognizing symptoms, and knowing how to respond appropriately, parents can navigate these episodes with greater confidence. Remember that most children outgrow febrile seizures, and they rarely lead to long-term health issues. Always consult with healthcare professionals for personalized advice and care regarding your child’s health.

Febrile Seizures (for Parents) – Nemours KidsHealth

en español: Convulsiones febriles

Reviewed by: Yamini Durani, MD

Primary Care Pediatrics at Nemours Children’s Health

What Are Febrile Seizures?

Febrile seizures are convulsions that can happen when a young child has a fever above 100.4°F (38°C). (Febrile means “feverish.”) The seizures usually last for a few minutes and stop on their own. The fever may continue for some time.

Most febrile seizures stop without treatment and don’t cause other health problems. Some kids might feel sleepy after a seizure, while others feel no lasting effects.

Who Gets Febrile Seizures?

Febrile (FEH-bryle) seizures happen in kids 6 months to 5 years old. They’re most common in toddlers 12–18 months old.

Kids are more likely to have a febrile seizure if:

• There’s a family history of febrile seizures.
• They’ve already had one. About 1 in every 3 kids who have had one febrile seizure will have another, usually within 1–2 years of the first.
• They had a first febrile seizure when they were younger than 15 months old.

Most children outgrow having febrile seizures by the time they are 5 years old.

Febrile seizures are not considered epilepsy (seizure disorder). Kids who have a febrile seizure have only a slightly increased risk for developing epilepsy.

What Are the Signs & Symptoms of Febrile Seizures?

There are two types of febrile seizures:

• Simple febrile seizures are most common. They’re usually over in a few minutes, but in rare cases can last up to 15 minutes. During this type of seizure, a child may:
  • convulse, shake, and twitch all over
  • roll the eyes
  • moan
  • become unconscious (pass out)
  • vomit or urinate (pee) during the convulsions
• Complex febrile seizures last longer than 15 minutes, happen more than once in 24 hours, and involve movement or twitching of only one part or one side of the body.

What Causes Febrile Seizures?

No one knows why febrile seizures happen. But evidence suggests that they’re linked to some
virusesand the way that a child’s developing brain reacts to high fevers.

What to Do if Your Child Has a Febrile Seizure

If your child has a febrile seizure, stay calm and:

1. Gently place your child on the floor or the ground.
2. Remove any nearby objects.
3. Place your child on their side to prevent choking.
4. Loosen any clothing around their head and neck.
5. Watch for signs of breathing problems, including a bluish color in the face.
6. Try to keep track of how long the seizure lasts.

If the seizure lasts more than 5 minutes, or your child turns blue, it may be a more serious type of seizure — call 911 right away.

It’s also important to know what you should not do during a febrile seizure:

• Do not try to hold or restrain your child.
• Do not put anything in your child’s mouth.
• Do not try to give your child fever-reducing medicine.
• Do not try to put your child into cool or lukewarm water to cool off.

When the seizure is over, call your doctor for an appointment to find the cause of the fever. The doctor will examine your child and ask you to describe the seizure. In most cases, no other treatment is needed. The doctor might order tests if your child is under 1 year old and had other symptoms, like vomiting or diarrhea.

The doctor may recommend the standard treatment for fevers, which is acetaminophen or ibuprofen. Giving these medicines around the clock is not recommended and won’t prevent febrile seizures.

The doctor might prescribe an anti-seizure medicine to give at home if your child has more than one or two febrile seizures that last more than 5 minutes.

When Should I Call 911?

Get emergency medical care if your child:

• has a febrile seizure that lasts longer than 5 minutes
• has a seizure that involves only some parts of the body instead of the whole body
• has trouble breathing or turns blue
• isn’t responding normally
• has another seizure within 24 hours
• had to take an anti-seizure medicine to make the seizure stop

A child who has missed getting some vaccines and has a febrile seizure could have a higher risk for meningitis. Get medical care right away if your child has any signs of meningitis, such as:

• a stiff neck
• a lot of vomiting
• sensitivity to light
• in babies, a bulging soft spot on the head

Febrile seizures can be scary to see. But they’re fairly common and not usually a symptom of serious illness. If you have questions or concerns, talk with your doctor.

Reviewed by: Yamini Durani, MD

Date reviewed: March 2023

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Absence Seizures (for Parents) – Nemours KidsHealth

What Is a Seizure?

A seizure (SEE-zhur) is unusual electrical activity in the brain. Normally, electrical activity in the brain involves neurons (nerve cells) in different areas sending signals at different times. During a seizure, many neurons fire all at once.

Depending on where in the brain the seizure happens, it causes changes in behavior, movement, or feelings. A seizure that affects both sides of the brain is called generalized. A seizure that involves only one side of the brain is called focal.

What Is an Absence Seizure?

An absence seizure is a type of generalized seizure. During this type of seizure, the person is not aware of what is going on around them.

What Are the Signs & Symptoms of an Absence Seizure?

Someone who is having an absence seizure suddenly stops what they are doing and stares into space. They also might:

• open and close their lips subtly or make chewing motions
• rub their fingers together
• flutter their eyelids

Someone can have many absence seizures in a day. They don’t remember having the seizures, but older kids may realize that they lost time around them. These seizures often may be mistaken for daydreaming or inattention.

What Happens After an Absence Seizure?

Absence seizures usually last about 20 seconds. After the seizure, most children return to what they were doing just before the seizure started as if nothing happened. But they won’t recall what just happened, or if someone talked to them during the seizure. Rarely, a child might feel confused or tired, have a headache, or have other symptoms. This is called the postictal (post-IK-tul) phase. It usually lasts just a few minutes, but can be longer. This phase can happen if a child has many absence seizures in one day or they happen too close together.

What Causes an Absence Seizure?

Absence seizures are thought to be genetic, though a child might not always have a family member who has seizures or epilepsy. Sometimes seizures are from gene mutations.

Anyone can get absence seizures, but they are more likely in:

• children ages 4–14 years
• people who have a family member with absence seizures
• girls

How Are Absence Seizures Diagnosed?

If your child had a seizure, the doctor probably will want you to see a pediatric neurologist (a doctor who treats brain, spine, and nervous system problems). The neurologist will ask questions about what happened during the seizure, do an exam, and order an EEG to measure brain wave activity.

How Are Absence Seizures Treated?

Doctors treat absence seizures with anti-seizure medicines. For some children, untreated seizures can get worse over time and may affect learning, development, or behavior. Most children can get complete seizure control by taking the medicine.

About 60% of children outgrow absence seizures in their teens, especially if medicine has worked well to control their seizures. Those who don’t outgrow them might have seizures into adulthood, but medicine can help control these.

What Problems Can Happen?

Absence seizures are brief, and usually do not lead to any physical injury. In rare cases, though, some children can have whole-body convulsions. This can happen if a child has many absence seizures in one day or many seizures close together. Learning and behavior problems also can happen. Talk to your child’s neurologist if you have concerns about these problems.   

How Can Parents Help?

Your doctor will help you create a plan for your child and talk to you about:

• what medicines your child should take
• if any “triggers” (such as fever, lack of sleep, or medicines) can make a seizure more likely
• any precautions your child should take while swimming or bathing
• whether your child should wear a medical ID bracelet
• if it’s OK for your teen to drive
• how to keep your child safe during a seizure. Share this information with caregivers, coaches, and staff at your child’s school.

If your child has another seizure, keep a record of:

• when it happened
• how long it lasted
• what happened right before the seizure
• what happened during and after the seizure

This information will help the doctor find the best treatment for your child’s seizures.

What Else Should I Know?

If your child has seizures, reassure them that they’re not alone. Your doctor and the care team can answer questions and offer support. They also might be able to recommend a local support group. Online organizations can help too, such as:

• Epilepsy Foundation
• CDC – Managing Epilepsy

Reviewed by: Lily Tran, MD

and
Andrew I. Mower, MD

Date reviewed: February 2022

Republican Children’s Clinical Hospital, Syktyvkar

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Convulsions at high temperature in children.

What Parents Need to Know

Hyperthermia or febrile seizures in children are seizures at high temperatures. The most common so-called convulsive syndrome of childhood. It has been established that this type of seizures are more often observed in winter and spring. It is assumed that this is due to a higher frequency of infectious diseases in the winter-spring period.

When there are febrile convulsions in children (at high temperature)

Febrile convulsions can develop in children with various infections, pneumonia, otitis, which are accompanied by fever.

Hyperthermic convulsions are an age-dependent pathology and debut mainly at the age of 18-24 months.

At what age do convulsions appear in children with a high temperature? Studies have shown that in the presence of a family burden, febrile convulsions can occur at a lower temperature in children.

Parents who first encounter a seizure in a child with a high temperature, as a rule, are psychologically unprepared, confused and do not know what to do first.

What to do if a child has convulsions with a high temperature

Recommendations of a pediatric neurologist to parents on providing first aid to a child with febrile convulsions:
• behave calmly, do not panic;
• unfasten the collar of clothing, free the chest from tight clothing;
• lay the child down with their head turned to one side;
• do not try to open the jaws with any object;
• measure temperature;
• do not give drugs by mouth;
• closely monitor the course of the attack.

Although febrile convulsions are triggered by high fever, excessive exposure of the child to cold should be avoided.

Clinical experience shows that cold wraps, rubbing with alcohol or a solution of vinegar, the use of fans do not give a significant beneficial effect and sometimes cause discomfort that negatively affects the course of an attack.

It is important to know and remember that in most cases the course of febrile seizures is benign, the probability of their transformation into severe forms of epilepsy is generally low (2-5%).

With the development of hyperthermic convulsions, it is necessary to call an ambulance.

This is especially important in the following cases:

• the duration of the seizure is more than 10 minutes;
• repeated convulsions, with impaired consciousness;
• manifestation of the first episode before the age of 6 months;
• the presence of neurological symptoms (prolonged impairment of consciousness, post-seizure paralysis, etc.).

Children who have had a febrile seizure should be observed by a pediatric neurologist:

• 1 month after the seizure,
• then 2 times a year.
• In terms of examination, a pediatric neurologist prescribes electroencephalography (EEG) after an attack, then once a year.

Prophylaxis in children to avoid recurrence of high fever seizures

The likelihood of recurrence of febrile convulsions is quite high. Therefore, preventive measures are of particular importance.