A febrile seizure (sometimes called a febrile convulsion or febrile fit) happens when some babies and toddlers have a high temperature (a fever). It can be alarming and scary to see, but it's usually harmless and most children make a complete recovery. It’s best to get your child checked out the first time this happens, so take them to the nearest hospital or call an ambulance if your child is having a seizure.
Children aged between 6 months and 3 years are most commonly affected and around 5% of children have a febrile seizure before the age of 6 months. It doesn’t affect every child, but once they’ve had one febrile convulsion, they have a higher chance of having a seizure with the next feverish illness – the chance is about 1 in 3. They are rare under the age of 3 months and after the age of 6 years.
There is no clear cause for febrile seizures. We know that it is linked to the start of a high temperature which can be caused by any viral or bacterial infection. There is also a genetic link, so there’s a slightly higher risk if a parent or sibling had them. On very rare occasions a seizure may occur after a vaccination.
This depends on the type of febrile seizure – there are three types but a febrile seizure is usually obvious to spot – you may get one or all of the possible signs.
Simple febrile seizure. This is the commonest type, affecting around three quarters of children who have a febrile fit. In this type, the symptoms are usually triggered as the child’s body temperature starts to rise and it causes them to look hot and flushed initially. Their eyes may then roll back in their head before they become unconscious and twitch (sometimes violently). They may also wet themselves before the fit ends. It usually only lasts a few seconds, although it may take a few minutes to subside in some cases. They’re then often very sleepy afterwards, but after an hour or so are usually much better, often because their temperature has started to come down.
Complex febrile seizures are less common – affecting around 4 in 20 cases - and are recognized as lasting longer than 15 minutes and possibly just affecting one area of the body. They may look similar to simple febrile fits but can reoccur within 24 hours and it can take longer than one hour for the child to recover fully.
Febrile status epilepticus is the least common of all – affecting 1 in 20 cases – and simply means the convulsion lasts longer than 30 minutes.
Although it's unlikely to be anything serious, you should take your child to the nearest hospital or call 911 and ask for an ambulance if this is your child’s first seizure, if it lasts more than 5 minutes, if your child has difficulty breathing or if you’re concerned there’s something more concerning going on.
Normally there is full recovery, with no after-effects. However, febrile seizures have been linked to a small increased risk of a condition called epilepsy, where people have repeated seizures without a fever. The risk is about 1 in 50 with simple febrile seizures, and a little higher (about 1 in 20) if the seizures are the complex type. This is compared to a 1 in 100 chance of developing epilepsy without any history of febrile seizures.
It can be distressing to see a febrile seizure, and you’ll want to do everything to keep your child safe and prevent them from happening in the future. Unfortunately, you can't prevent them, you can only keep your child feeling secure and calm when they occur. It's not really understood why, but keeping a tight control over a fever with medications doesn't seem to prevent febrile seizures if your child has a tendency towards them. But you can use acetaminophen or ibuprofen, as you usually would, if your child has a high fever.
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