Febrile seizure

Febrile seizures affect around 3 to 4 percent of children between the ages of 6 months and 5 years.

1 May 2021 | 5 Min. Reading Time

Overview

Febrile seizures affect around 3 to 4 percent of children between the ages of 6 months and 5 years. The seizures are triggered by a reduction in the seizure threshold and affect the whole body. This is not a brain disease. Children who suffer from febrile seizures are usually normally developed and healthy. If a seizure occurs, remain calm and protect the child from injury.

Symptoms

Usually occurs when fever is rising
Eyes are open and rolling back
Muscle tenseness
Rhythmic muscle convulsions
Seizure lasts 2 to 3 minutes, at most 15 minutes
Child may vomit afterwards
Child may be sleepy after the seizure

We distinguish between

Simple febrile seizure

Symmetric seizure affecting the whole body
Between the ages of 6 months and 6 years
Duration < 15 minutes
No repeat seizure within 24 hours

Complex febrile seizure

Seizure is confined to one area of the body
Paralysis and speech problems after seizure
Age < 6 months and > 6 years
Duration > 15 minutes
Repeated within 24 hours
Children with brain diseases

Causes and treatment

Causes

Unknown
Seizure threshold in brain is reduced
Risk factors: genetic, family predisposition

Good to know:

A simple febrile seizure isn't dangerous
Normally no lasting damage
Does not increase the risk of epilepsy

Further treatment by your doctor / in hospital

Possible tests

Search for cause of fever
Blood test
Removal of a sample of cerebrospinal fluid (lumbar puncture), if necessary
CT scan (computed tomography), if necessary

Possible therapies

Fever-reducing drugs (ibuprofen or paracetamol)
If seizure lasts > 5 min: interrupt seizure (benzodiazepines)

What can I do myself?

For a febrile seizure

Remain calm and stay with child
Note the time (duration of seizure)
Loosen clothing
Protect child (in particular the head) from injury (objects)
Don’t do anything to the child to stop the seizure (shake, bite block)
If the seizure lasts more than ten minutes, call an ambulance (tel. 144)
After the attack: lay child on its side (vomiting)

Prevention

Early measures to reduce the fever once it reaches a certain temperature aren't recommended; they won't prevent febrile seizures
It therefore isn't necessary to obsessively measure the fever

General measures to reduce fever

Lower body temperature (take off clothes, remove blanket)
Fever-reducing drugs such as paracetamol (see package insert for dosage)
Don’t apply cold compresses, poultices or wraps with solutions containing alcohol/essential oils

When to see a doctor?

Generally after the first febrile seizure
- Prescription for medication to interrupt a seizure (diazepam)
- Information about a renewed febrile seizure
Febrile seizures that repeat within 24 hours (call emergency number 114)
Febrile seizures in children < 6 months and > 6 years (call emergency number 114)
Fever
- Fever in babies up to 3 months old
- High fever (39 degrees) > 5 days in spite of medication
- After a trip to the tropics
Worsening of general health (call emergency number 114)
- Pain in the abdomen, back, joints
- Bleeding into the skin
- Severe vomiting
- Stiff neck
- Disorientation, apathy