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Febrile Seizures

Febrile (fever) seizures are terrifying for parents to witness; however they are usually not serious and do not cause brain damage. Approximately 2 to 5 percent of children have one febrile seizure between the ages of 6 months and 5 years old; of those, one-third will have a second seizure, and about one half of those will have a third.

According to the National Institute of Neurological Disorders and Stroke, children rarely develop their first febrile seizure before the age of 6 months or after 3 years of age. The older a child is when the first febrile seizure occurs, the less likely that child is to have another.

The precise cause of febrile seizures is not known; however, they are associated with high fevers (over 102 degrees F) and they appear to be related to the rate of rise in temperature more than the actual temperature of the fever. In other words, a child who rapidly develops a fever of 103 degrees seems to be at greater risk of having a seizure than a child who slowly develops a fever of 104 degrees F. Febrile seizures also tend to run in families, causing doctors to believe they may be genetically related.

Many parents worry that if their child has a febrile seizure, he or she will develop epilepsy later in life. However, according to the National Institute of Neurological Disorders and Stroke, only 2 to 5 percent of children who have febrile seizures go on to develop epilepsy.

Most febrile seizures happen in the first few hours of a child's fever. During a seizure, his eyes may roll back in his head, his body may twitch or jerk, his limbs may stiffen, and he may drool and vomit. The seizure may last only a few seconds or up to several minutes. However, if the seizure lasts for more than 10 minutes or if your child starts choking, stops breathing, or turns blue, call 911 immediately.

If your baby is having a seizure, place him on a protected surface, such as the floor, away from any sharp objects. Lay him on his side or stomach to prevent choking if he does vomit. As hard as it may be to watch, don't try to hold or restrain your child during the seizure and never place anything in a seizing child's mouth as he could choke on it. After the seizure has subsided he may seem a bit sleepy, but many children return to normal activity immediately.

If your child has a seizure, he should be examined by a doctor to ensure the seizure was caused by the fever and not by another condition (such as meningitis or severe dehydration). You should seek immediate medical attention if he has a stiff neck, is extremely lethargic, or continues to vomit. Doctors will test on your child's blood and urine and may perform a spinal tap to determine the cause of the seizure. A child who has a febrile seizure usually doesn't need to be hospitalized; however, if the seizure is prolonged or is accompanied by a serious infection, or if the source of the infection cannot be determined, the doctor may recommend that the child be hospitalized for observation.

Oral anticonvulsant medications have been proven to reduce the risk of a recurrent febrile seizure when given during illness (Phenobarbital and valproate); however, the side effects of these medications may be significant and many pediatricians are hesitant to prescribe them.

Giving a fever reducer, such as Tylenol or Motrin, at the first sign of a fever is often recommended, but has not been proven to prevent a febrile seizure. The only real way to prevent febrile seizures is to avoid colds and the flu that can cause fever, which is no easy task with young children. However, the American Academy of Pediatrics now recommends infants older than 6 months receive a flu shot every autumn, which will help prevent illness.



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