What Is a Febrile Seizure?

Medically reviewed by Carissa Stephens, RN, CCRN, CPN on June 14, 2017Written by Diana K. Wells

Overview

Febrile seizures usually occur in young children who are between the ages of 3 months to 3 years. They’re convulsions a child can have during a very high fever that’s usually over 102.2 to 104°F (39 to 40°C) or higher. This fever will happen rapidly. The rapid change in temperature is more of a factor than how high the fever gets for triggering a seizure. They usually happen when your child has an illness. Febrile seizures are most common between the ages of 12 and 18 months of age.

There are two types of febrile seizures: simple and complex. Complex febrile seizures last longer. Simple febrile seizures are more common.

Symptoms of febrile seizures

The symptoms of febrile seizures vary based on the two types.

Symptoms of simple febrile seizure are:

  • loss of consciousness
  • twitching limbs or convulsions (usually in a rhythmic pattern)
  • confusion or tiredness after the seizure
  • no arm or leg weakness

Simple febrile seizures are the most common. Most last less than 2 minutes, but can last as long as 15 minutes. Simple febrile seizures only happen once in a 24-hour period.

Symptoms of complex febrile seizure are:

  • loss of consciousness
  • twitching limbs or convulsions
  • temporary weakness usually in one arm or leg

Complex febrile seizures last for more than 15 minutes. Multiple seizures may happen over a 30-minute period. They may happen more than once during a 24-hour time frame as well.

When a simple or complex febrile seizure occurs repeatedly, it’s considered a recurrent febrile seizure. Symptoms of recurrent febrile seizures include:

  • Your child’s body temperature for the first seizure may have been lower.
  • The next seizure often happens within a year of the initial seizure.
  • Fever temperature may not be as high as the first febrile seizure.
  • Your child has fevers frequently.

This type of seizure tends to occur in children under 15 months of age.

Causes of febrile seizures

Febrile seizures generally happen when your child has an illness, but many times they occur before you may realize your child is sick. That’s because they usually take place on the first day of an illness. Your child may not be showing any other symptoms yet. There are several different causes for febrile seizures:

  • A fever that occurs after immunizations, especially the MMR (mumps measles rubella) immunization, can cause febrile seizures. A high fever after immunizations most often occurs 8 to 14 days after your child has been given the immunization.
  • A fever that’s the result of a virus or a bacterial infection can cause febrile seizures. Roseola is the most common cause of febrile seizures.
  • Risk factors, such as having family members who have had febrile seizures, will put a child at a higher risk for having them.

Treating febrile seizures

While febrile seizures often don’t cause any lasting issues, there are important steps to take when your child has one.

Always contact a doctor or medical professional in the emergency department immediately following a seizure. The doctor will want to make sure your child doesn’t have meningitis, which can be serious. This is especially true for children less than 1 year of age.

While your child is having a febrile seizure:

  • roll them onto their side
  • don’t put anything in their mouth
  • don’t restrict the movement of the convulsions or twitching
  • remove or move any objects that might harm them during the convulsions (furniture, sharp items, etc.)
  • time the seizure

Call 911 if the seizure lasts longer than 5 minutes or your child isn’t breathing.

After the febrile seizure ends, see a doctor or emergency medical professional. Have your child take medication to lower their fever, like ibuprofen (Advil) if they’re over 6 months old or acetaminophen (Tylenol). Wipe their skin with a washcloth or sponge and room temperature water to cool them down.

Hospitalization is only required if your child has a more serious infection that needs to be treated. The majority of children don’t need any medication for a febrile seizure.

Treatment of recurrent febrile seizures includes all of the above plus taking a dose of diazepam (Valium) gel that’s administered rectally. You can be taught to give the treatment at home if your child has recurrent febrile seizures.

Children with recurrent febrile seizures have an increased chance of having epilepsy later in their lives.

Can you prevent a febrile seizure?

Febrile seizures can’t be prevented, except in some cases of recurrent febrile seizures.

Reducing your child’s fever with ibuprofen or acetaminophen when they’re sick doesn’t prevent febrile seizures. Since the majority of febrile seizures have no lasting effects on your child, it’s normally not recommended to give any anti-seizure medications to prevent future seizures. However, these preventative medications may be given if your child has recurrent febrile seizures or other risk factors.

Outlook

Febrile seizures are normally nothing to worry about even though it can be frightening to see a child have one, particularly for the first time. However, have your child seen by your doctor or another medical professional as soon as you can after your child has a febrile seizure. Your doctor can confirm that it was in fact a febrile seizure and rule out anything else that may need further treatment.

Contact a medical professional immediately if the following symptoms occur:

  • neck stiffness
  • vomiting
  • difficulty breathing
  • severe sleepiness

Your child will usually go back to normal activities soon after the seizure ends without further complications.

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