Febrile seizures, as the name suggests, are fits occurring as a result of febrile illnesses occurring outside the brain. It occurs between the ages of 6 months to 5 years (sometimes 6 years). They affect up to 5 in 100 young children and are slightly more common in boys than in girls.
Fever with seizure remains one of the commonest emergencies among children in our environment. The commonest cause is malaria. Others are upper respiratory tract infections, pneumonia, urinary tract infections and ear infections.
What are the symptoms?
The symptoms of a febrile seizure can be quite frightening. They are most commonly of the simple febrile seizure type. Here, the child’s body may twitch or shake, and they lose consciousness. They may foam at the mouth, vomit, or wet or soil themselves. Most children who have a simple febrile seizure twitch or shake evenly on both sides of their body. But some children go rigid, holding their arms and legs stiffly. The seizure lasts only a couple of minutes, and the child often goes into a very deep sleep afterwards.
Sometimes, one side of the child’s body twitches harder, or the seizure lasts more than 15 minutes, or the child has more than one seizure within 24 hours. This may be a complex febrile seizure. It is more dangerous and hence immediate medical attention is required.
What to do
If your child has a seizure:
- Check the time it started because it helps the doctor if they know how long the seizure has lasted.
- For babies, cradle them in your arms, on their side, with their feet slightly higher than their head.
- Do not put anything in the child’s mouth. If they vomit, clear it away from their mouth so they don’t choke.
- Try to remember which side of the body, if any, twitches more. The doctor may find such information useful.
If the child has had a febrile seizure more than 24 hours previously, they may not need to see a doctor. But always get medical help if you’re worried.
What treatments work?
Most febrile seizures stop quickly without any treatment. Antibiotics are usually not useful as most of the associated infections are caused by viruses, not by bacteria.
Drugs that control fever like paracetamol and ibuprofen can make the child feel more comfortable, but they don’t prevent further seizures from occurring. Paracetamol can be used for children 3 months and older and ibuprofen for children 6 months and older.
Anticonvulsants are generally not recommended for febrile seizures as there is not enough evidence to show they are effective.
What will happen?
Children recover completely from a simple febrile seizure. But the chances of repeat seizures during subsequent febrile illnesses are higher after a child has had one seizure. The chances of becoming epileptic in future is also slightly increased. This is however rare (less than 1 in 100 cases).
Febrile seizures don’t cause any problems with children’s learning or development. Children who’ve had seizures do just as well at school as other children. Most children out-grow them by 5 or 6 years of age.