Febrile Seizures: What Are They and Can They Be Prevented?

Febrile seizures are the most common type of seizure in children, but that doesn’t make it any less stressful when it happens to your child.

What Is a febrile Seizure?

A febrile seizure is a seizure that happens in otherwise healthy kids between 6 months and 5 years of age. It may be associated with a febrile illness (illness with fever present) that is not related to a brain infection (meningitis or encephalitis), head trauma or other health problem such as low blood sugar. Febrile seizures affect 2 percent to 5 percent of children.

Are There Different Kinds of Febrile Seizures?

Yes, there are. Here are the most common and their associated symptoms:

Simple Febrile Seizures

• Last less than 15 minutes
• Are generalized (everything starts shaking at once)
• Only happen once during an illness or 24 hour period

Complex Febrile Seizures

• Last longer than 15 minutes
• Have focal onset (one part of the body starts to shake, then spreads to the rest of the body)
• Happen more than once during the same illness or 24 hour period

Febrile Status Epilepticus

• Seizure lasting longer than 30 minutes

Do Febrile Seizures Cause Brain Damage?

No, there is not a higher risk of developmental, behavioral or school problems in children with simple or complex febrile seizures. Febrile status epilepticus is an exception and can cause brain injury. This is a neurologic emergency and your child should go to the emergency room!

Does My Child Have an Increased Risk of Epilepsy After a Febrile Seizure?

Epilepsy means someone has had two or more seizures not caused by infection, trauma or other health problems and occurs in 1 percent to 2 percent of children and adults.

In most children, simple febrile seizures slightly increase the risk of developing epilepsy, to 2 percent to 5 percent. However, your child may have a higher risk of epilepsy in the future if:

• The seizure was a complex febrile seizure
• Your child had developmental delays prior to the seizure
• Your doctor tells you your child has an abnormal neurologic exam
• There is a family history of epilepsy in your child’s mother, father, brother or sister
• Your child has had four or more febrile seizures

Will My Child Have Another Febrile Seizure?

• Most febrile seizures occur between 18 and 24 months of age
• 30 percent of all children will have a second febrile seizure
• Only 20 percent of children will have three or more febrile seizures

What Testing Is Needed After a Febrile Seizure?

Sometimes none at all! Your doctor should review your child’s history and do a physical exam, look for the cause of the fever and treat the infection if possible. Testing may be done at the time of the seizure if there is concern for a serious infection (such as an infection of the brain or spinal cord), or if your child does not return to acting like themselves within 30 minutes after the seizure. An EEG or MRI may be ordered if your child had a complex febrile seizure or febrile status epilepticus.

What Can I Do?

Daily seizure medications are not recommended for preventing febrile seizure. Use over the counter medications to keep your child comfortable during fevers, but research shows it may not help prevent febrile seizures.

Always take seizure precautions:

• NEVER leave your child in the bath alone
• Keep your child within arm’s length in the pool
• Your child should always wear a life jacket in fresh water
• Do not allow your child to climb higher than 10 feet above the ground on playsets or trees
• Always put a helmet on your child when riding a bike and stay away from busy streets

Ask your pediatrician if your child should have a rescue medication at home to stop febrile seizures lasting more than five minutes. Your child should always go to the emergency room for seizure activity lasting longer than five minutes, or a seizure that continues for five minutes after giving rescue medication.

Does My Child Need to See a Pediatric Neurologist?

Not all children who have had febrile seizures need to see a child neurologist. Please discuss a referral to a pediatric neurologist with your pediatrician if:

• Your child had a complex febrile seizure or febrile status epilepticus
• Your child has features that increase their risk of developing epilepsy

The majority of children who have febrile seizures continue to have typical development and can be safely followed by their pediatrician.

To learn more about neurology services offered at Nationwide Children's Hospital, click here.