Febrile Fits (Febrile Seizures)

What is a febrile seizure?

Seizures are also called 'fits', 'spells' or 'convulsions.' In some children, fevers can trigger seizures. These are called febrile fits. Febrile seizures occur in 2% to 5% of all children between the ages of 6 months and 5 years. A child may have a febrile seizure within the first few hours of the high rise in temperature. The child may stare ahead for a few moments, followed by stiffening and twitching. The child may also become unresponsive for a short time. Breathing may be disturbed. After the seizure, the child usually returns to normal quickly. The seizures usually last less than a minute, but rarely, they may last up to 15 minutes. Febrile seizures do not usually recur within 24 hours. Febrile seizures are caused by fever, which itself may be due to any reason such as viral fever, sore throat, ear infection or any other infection such as a urinary tract infection.

What are the immediate steps to be followed when a child has febrile seizures?

If a child has a febrile seizure, the first step should be to ensure that the child does not get hurt due to injury from any sharp object on the bed. Seizures may look frightening, but one should keep calm. There is no immediate danger to life because of febrile seizures. A Child Specialist or the family doctor should be informed immediately. The child’s head should be turned to one side to help any saliva or vomit drain out of the mouth. Nothing should be given orally during the seizure. The child should not be held too firmly. The child should be observed, to find out how long the seizure lasts and how the child reacts. The doctor may want to know as much detail as possible. If the seizure does not stop within 5 minutes, the child should be rushed to the nearest hospital immediately.

Will febrile seizures recur?

This depends on the age of the child. Children less than one year old at the time of their first seizure, have about 50% chance of having another febrile seizure. Children older than one year at the time of their first seizure, have only 30% chance of having a second febrile seizure.

Will a child who has a febrile seizure develop epilepsy?

Children with a history of febrile seizures are only at a slightly higher risk of developing epilepsy than children who have not had febrile seizures. Epileptic seizures are not caused by fever.

Are febrile seizures dangerous?

While febrile seizures may look frightening, they do not usually cause any harm to the child. Febrile seizures do not cause brain damage, paralysis, mental retardation, or death.

What is the treatment for febrile seizures?

The pediatrician will do a thorough examination, following which, some investigations may be required. The infection that is causing the fever will be the most important concern. Suitable medication to treat the infection may be given. Apart from blood tests, EEG and scan (CT / MRI) , a spinal tap may also be requested to rule out meningitis. Drugs such as paracetamol, ibuprofen or nimesulide may be given to reduce the fever. It is important to keep the fever under control till the infection passes off. Until then, the medication will have to be given regularly according to the advice of the doctor. Anti-convulsant drugs may also be given to prevent febrile convulsions. Some doctors may not prefer to give such anti-convulsants if they are sure that the fever is only a febrile seizure, because of the side effects of these drugs.