Ask Dr. Marla: Do febrile seizures continue when the child is older?

By Dr. Marla Shapiro on September 09, 2013
My 11-month-old had a febrile seizure. Does it mean he will have seizures as he gets older?

Answer:

A febrile seizure is exactly what it sounds like – a seizure or convulsion that is brought on by a fever. During a febrile seizure, a child often loses consciousness and moves limbs on both sides of the body. There can be other movements such as twitches in only a portion of the body, or on one side only, such as a single arm or leg. While it seems as if the seizure lasts an eternity, it actually is usually quite brief lasting no more than two minutes, but can be shorter or, on occasion, longer.

These seizures usually happen in the first 24 hours of a fever and no, your child does not have epilepsy as these seizures are not recurrent and only triggered by fever.

The National Institute of Neurological Disorders and Stroke (NINDS) estimate that one in every 25 children will have at least one febrile seizure, and more than one-third of these children will have additional febrile seizures before they outgrow the tendency to have them. Typical ages that we see these specific seizures are in children between six months and five years. They are more common in toddlers.

While definitely scary, most of these febrile seizures are self-limited and cause no harm such as brain damage. Between 95 and 98 percent of children who experience febrile seizures do not go on to develop epilepsy.

What to do:

  • Most important, stay calm.
  • Watch your child to prevent any kind of injury.
  • Lay your child on a flat, safe surface on their side or back. Don’t restrain them.
  • Remove any objects from your child’s mouth and never place anything in their mouth during a convulsion.
  • Once the seizure is over take your child to your healthcare provider to check for the source of the fever. Seizures longer than five minutes or associated with stiff neck, extreme lethargy or abundant vomiting must be assessed urgently. Once serious causes of fever are excluded, your child can go home.

While it makes sense to lower fever with acetominophen or ibuprofen, NINDS notes there are no studies that prove this will reduce the risk of a seizure. As always, your doctor will be the best source of advice for your child.

Marla’s daughter, Jenna Greenspoon, recalls her son’s first febrile seizure:

“I’ll never forget it. We were on a plane, coming home from a wedding in Jamaica. He had spiked a fever the night before and the medicine wasn’t bringing the fever down. He was tired and didn’t have much of an appetite, but other than the fever, he was his wonderful happy self. Then out of nowhere, he began to have a seizure. I was terrified, but somehow knew that he was having a seizure because of the fever. My husband completely froze and time moved slower than ever. I lay my son down on the floor of the plane in a safe area and watched as he was unable to control his body and his eyes rolled back in his head. What lasted less than two minutes felt like a lifetime. When the seizure was over, I wasn’t able to breathe until he cried again. Other than when he was born, I had never wanted my son to cry as much as I did in that moment. As I held him in my arms and he began to cry, so did I. When we landed and got into the ambulance, I felt a bit of peace as the ambulance attendants told me that there would be no long-term effects from the seizure and that he is not in pain while it occurs. They educated me on what a febrile seizure looks like and with more knowledge I began to feel better. When he gets sick, I stay on top of his fever with over-thecounter medication but I know that I can’t stop the seizure from happening. My son has now had three seizures, and while they are still terrifying, I continue to remind myself that they are worse for me than they are for him. I hold his hand as they happen and count do wn the seconds until it ends…and then I wait until it is over to let my legs shake uncontrollably for a just few minutes!”

Got a health question? Submit it to Dr. Marla.

Originally published in ParentsCanada magazine, October 2013.

By Dr. Marla Shapiro| September 09, 2013

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