Should I Be Worried of Febrile Seizures?


As the name indicates, a febrile seizure refers to convulsions (fits) that can occur in a child at the time of a febrile illness. It can be quite frightening, but most of the episodes last only for a few seconds without leaving any permanent damage.
A brief guide on febrile seizures.
Who can get febrile seizures?
Children aged between six months to five years are susceptible. The most common age group is less than two years.
What causes these seizures?
They are typically due to sudden high temperatures and underlying infections. An episode generally occurs in the first 24 hours of the onset of fever. Children who have febrile seizures tend to have a rectal temperature that’s higher than 102 degrees Fahrenheit.
Positive family history is a substantial risk factor, as well as the history of one previously.
The risk of febrile seizures may increase after childhood vaccinations such as DPT or MMR. But remember that the fever and not the vaccines cause the convulsions.
How do I recognise one?
The child would have a high-grade fever with shivering of a part or whole of the body. Sometimes, there is a loss of consciousness. Take note of the following:
  • Biting of the cheek or tongue.
  • Rolling of the eyes.
  • Clenching of the teeth or jaw. 
  • Losing control of urine or stool. 
There are two types of febrile seizures:
1. Simple seizures: last for a few seconds, do not recur for another 24 hours and are not localised to one part of the body.
2. Complex seizures: typically last for more than 15 minutes, tend to recur within the next 24 hours and are confined to one side of the body.
What should I do if my child develops an episode of febrile seizure?
  • Do not panic.
  • Gently place the child on the floor or a hard surface and turn the head in one direction.
  • Remove any objects in the child’s mouth carefully to prevent aspiration. 
  • See that there is no tight clothing around the neck.
  • If possible, note the duration of the episode. 
  • Get medical help once the seizures stop. 
  • Treatment and prophylaxis
Tepid sponging and antipyretic medications, mainly paracetamol, are crucial to management. Aspirin must be avoided in children. Anticonvulsant drugs might be given rectally for seizure control in case of complex seizures but are rarely needed in the long term.
Children with a history of prolonged febrile seizures and those who live in more remote areas with poor access to prompt medical care should be given rescue medication. The most commonly used among these would be diazepam for rectal use. Giving diazepam at the onset of illness or fever can prevent further attacks also but is not shown in all cases.
Commonly asked questions
1. Can febrile seizures progress into epilepsy in the future?
Just because your child had an episode of febrile seizure that has no bearing on the development of seizure disorder later, if they have multiple risk factors with complex seizures, the future risk is slightly more.
2. Are febrile seizures hereditary?
Febrile seizures can run in the family. So, if the elder sibling has a positive history, it must be anticipated in the child when he gets a febrile illness. 
3. Why is it that my child’s fever is not coming down despite administering paracetamol as advised by the paediatrician?
Check if you are giving the correct dosage appropriate to their age. It is common to see parents give dosage as per what the paediatrician had advised months ago. Your child’s weight increases over time, and so should take your medication dose too!
Remember-Febrile seizures are unpredictable to an extent, so temperature control should be of primary concern in any fever. Stay calm but be aware of what is not to be done in case they occur. Always contact your paediatrician if febrile seizures develop.
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