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A febrile seizure is a convulsion in a child triggered by a fever. These convulsions occur without any brain or spinal cord infection or other nervous system (neurologic) cause.
Alternative NamesSeizure - fever induced
Causes, incidence, and risk factorsAbout 3 - 5% of otherwise healthy children between ages 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. Febrile seizures often run in families.
Most febrile seizures occur in the first 24 hours of an illness, and not necessarily when the fever is highest. The seizure is often the first sign of a fever or illness
Febrile seizures are usually triggered by fevers from:
- Ear infections
- Roseolainfantum (a condition with fever and rash caused by several different viruses)
- Upper respiratory infections caused by a virus
Meningitiscauses less than 0.1% of febrile seizures but should always be considered, especially in children less than 1 year old, or those who still look ill when the fever comes down.
A child is likely to have more than one febrile seizure if:
- There is a family history of febrile seizures
- The first seizure happened before age 12 months
- The seizure occurred with a fever below 102 degrees Fahrenheit
A febrile seizure may be as mild as the child's eyes rolling or limbs stiffening. Often a fever triggers a full-blown convulsion that involves the whole body.
Febrile seizures may begin with the sudden contraction of muscles on both sides of a child's body -- usually the muscles of the face, trunk, arms, and legs. The child may cry or moan from the force of the muscle contraction. The contraction continues for several seconds, or tens of seconds. The child will fall, if standing, and may pass urine.
The child may vomit or bite the tongue. Sometimes children do not breathe, and may begin to turn blue.
Finally, the contraction is broken by brief moments of relaxation. The child's body begins to jerk rhythmically. The child does not respond to the parent's voice.
A simple febrile seizure stops by itself within a few seconds to 10 minutes. It is usually followed by a brief period of drowsiness or confusion. A complex febrile seizure lasts longer than 15 minutes, is in just one part of the body, or occurs again during the same illness.
Febrile seizures are different than tremors or disorientation that can also occur with fevers. The movements are the same as in a grand mal seizure.
Signs and testsThe health care provider may diagnose febrile seizure if the child has a grand mal seizure but does not have a history of seizure disorders (epilepsy). In infants and young children, it is important to rule out other causes of a first-time seizure, especially meningitis.
In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, the child will not need a full seizure workup, which includes an EEG, head CT, and lumbar puncture (spinal tap).
To avoid having to undergo a seizure workup:
- The child must be developmentally normal.
- The child must have had a generalized seizure, meaning that the seizure was in more than one part of the child's body, and not confined to one part of the body.
- The seizure must not have lasted longer than 15 minutes.
- The child must not have had more than one febrile seizure in 24 hours.
- The child must have a normal neurologic exam performed by a health care provider.
During the seizure, leave your child on the floor.
- You may want to slide a blanket under the child if the floor is hard.
- Move him only if he is in a dangerous location.
- Remove objects that may injure him.
- Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
- If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach. This is also important if it looks like the tongue is getting in the way of breathing.
Do NOT try to force anything into his mouth to prevent him from biting the tongue, as this increases the risk of injury. Do NOT try to restrain your child or try to stop the seizure movements.
Focus your attention on bringing the fever down:
- Insert an acetaminophen suppository (if you have some) into the child's rectum.
- Do NOT try to give anything by mouth.
- Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol may make the fever worse.
- After the seizure is over and your child is awake, give the normal dose of ibuprofen or acetaminophen.
After the seizure, the most important step is to identify the cause of the fever.
Expectations (prognosis)The first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage. However, simple febrile seizures are harmless. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.
A small number of children who have had a febrile seizure do go on to develop epilepsy, but not because of the febrile seizures. Children who would develop epilepsy anyway will sometimes have their first seizures during fevers. These are usually prolonged, complex seizures.
Nervous system (neurologic) problems and a family history of epilepsy make it more likely that the child will develop epilepsy. The number of febrile seizures is not related to future epilepsy.
About a third of children who have had a febrile seizure will have another one with a fever. Of those who do have a second seizure, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime.
Most children outgrow febrile seizures by age 5.
Complications- Biting oneself
- Breathing fluid into the lungs
- Complications if a serious infection, such as meningitis, caused the fever
- Injury from falling down or bumping into objects
- Injury from long or complicated seizures
- Seizures not caused by fever
- Side effects of medications used to treat and prevent seizures (if prescribed)
Children should see a doctor as soon as possible after their first febrile seizure.
If the seizure is lasting several minutes, call 911 to have an ambulance bring your child to the hospital.
If the seizure ends quickly, drive the child to an emergency room when it is over.
Take your child to the doctor if repeated seizures occur during the same illness, or if this looks like a new type of seizure for your child.
Call or see the health care provider if other symptoms occur before or after the seizure, such as:
- Abnormal movements
- Agitation
- Confusion
- Drowsiness
- Nausea
- Problems with coordination
- Rash
- Sedation
- Tremors
It is normal for children to sleep or be briefly drowsy or confused right after a seizure.
PreventionBecause febrile seizures can be the first sign of illness, it is often not possible to prevent them. A febrile seizure does not mean that your child is not getting the proper care.
Occasionally, a health care provider will prescribe diazepam to prevent or treat febrile seizures that occur more than once. However, no medication is completely effective in preventing febrile seizures.
ReferencesJohnston MV. Seizures in childhood. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 593.
What else can I help you with?
What types of febrile seizures are there?
There are two types of febrile seizures: simple (or benign) and complex.
How many children with roseola will have febrile seizures?
About 5-35% of all children with roseola will have these "febrile seizures."
Is there a connection between febrile seizures and Asperger's Syndrome or autism?
I have read an article about the connection between febrile seizures and autism. It suggests that febrile seizures which go on to progress to 'status epilepticus' may cause brain damage and result in autistic traits. The article is called "Febrile Seizures and the Amygdala in autism spectrum disorders" by Teresa Binstock.
Is it normal for an eight year old boy to have febrile seizures?
Febrile seizures are not uncommon in children between the ages of 6 months and 5 years old. While it is rare for an eight year old to have febrile seizures, it can still occur. It is important to consult with a healthcare provider to assess the underlying cause and appropriate management.
What is the role of zinc in febrile seizures?
Children with febrile seizures have been found to have decreased zinc levels in both the serum and the cerebrospinal fluid, which is the fluid that bathes the brain and the spinal cord.
Can the influenza type b virus create seizures?
Seizures are not a common symptom in influenza, however, they can accompany a high fever, such as often occurs with the flu. These are called febrile seizures. Children are most vulnerable to febrile seizures. However, do not assume this is just a symptom of the flu if there are seizures, all seizures should be evaluated immediately by a physician to determine the type, cause, and need for treatment.
Most common cause of seizures in children?
Febrile seizures, which are triggered by a high fever in young children, are the most common cause of seizures in children. Other common causes include epilepsy, infections, brain injuries, and genetic factors. Proper diagnosis and treatment are necessary to manage seizures in children effectively.
What happens when body temp rises above normal?
You have a fever (febrile). The normal body temperature is 36-37 degrees centigrade (celcius). Fever is an indicator for us to know, that the body is beyond normal. See also hyperthermia, hypothermia
Benign febrile convulsions with amoebiasis?
The pathophysiology of febrile seizures remains unclear.[17] It is generally believed that an FS is an age-dependent response of the immature brain to fever.[17] This postulation is supported by the fact that most (80-85%) febrile seizures occur between 6 months and 3 years of age, with the peak incidence at 18 months.[6,7,8] Although the mechanism of this increased susceptibility is unclear, animal models suggest that there is enhanced neuronal excitability during the normal brain maturation.[17] It is well known that febrile seizures tend to occur in families, and this genetic susceptibility can be transmitted through both parents.[18,19] A positive family history for febrile seizures can be elicited in 25-40% of children with febrile seizures, and the reported frequency in their siblings ranges from 9-22%.[18] Familial clustering studies indicate a doubling of risk in children when both parents, rather than one parent, had febrile seizures.[19] Studies show a higher concordance rate in monozygotic as compared to dizygotic twins.[20] Although there is clear evidence for a genetic basis, the precise mode of inheritance is unclear.[20,21] Most studies suggest that the mode of inheritance of susceptibility to febrile seizures is mostly polygenic and rarely autosomal dominant.[20,21] No single human leukocyte antigen (HLA) haplotype has been found to be statistically more frequent among pooled FS subjects because of the considerable genetic heterogeneity of proneness to febrile seizures.[20,21] In recent times, linkage studies in several large families in Japan have mapped the FS susceptibility genes to two putative loci, FEB1 (chromosome 8q13-q21) and FEB2 (chromosome 19p13.3), indicating an autosomal dominant pattern with reduced penetrance.[21] Preliminary studies in children suggest that the cytokine network is activated and may have a role in the pathogenesis of febrile seizures.[22] Children with febrile seizures have been reported to have significantly low levels of plasma ferritin, suggesting a possible role of iron insufficiency.[23] The incidence of febrile seizures in thalassemic children is significantly lower, and iron overload may be a major factor that prevents their occurrence.[24] Also, significantly lower levels of zinc have been reported in the serum and cerebrospinal fluid of children with febrile seizures.[25,26] However, the precise clinical significance of these observations remains unclear. The systemic effects of CSE are initially dominated by the body's attempt to maintain homeostasis.9 Blood pressure and central venous pressure increase, blood glucose increases, and the patient becomes tachycardic.9 10 CSE may also result in electrolyte imbalance and hyperthermia.11 Cerebral blood flow, blood glucose, and oxygen utilisation increase in the initial phases of a seizure to maintain cerebral homeostasis. After 30 minutes homeostatic failure begins and the patient may need systemic support.9 Cerebral blood flow, brain glucose, and parenchymal oxygenation all decrease and potentially play a part in the cell damage associated with CSE.9 10 Respiratory and metabolic acidosis, electrolyte imbalance (for example, hyperkalaemia), hyperthermia, and rhabdomyolysis may all occur (table 1).Treatment with drugs with depressant cardiorespiratory side effects (for example, benzodiazepines and barbiturates) may worsen the systemic complications of CSE. Golda Meir Ruiz
Atypical febrile convulsions?
What is mean by atypical febrile convulsion
What is the cause of temporal lobe epilepsy?
The cause of temporal lobe epilepsy has been linked to febrile seizures and other studies has shown abnormalities of the hippocampus on MRI scans which supports the theory that prolonged seizures damage the brain. Still it's a topic that is under constant research and there is no easy explanation.
What does post febrile mean?
'Post-' means 'after'. 'Febrile' means 'pertaining to a fever'. Therefore 'post-febrile' means 'pertaining to the period after a fever'.
