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What Is a Febrile Seizure?

Learn about febrile seizures from Steve Wolf, MD and Patty McGoldrick, NP in this Howcast video.


Patty McGoldrick NP, MPA: So febrile seizures are seizures that are associated with fever. They usually occur in young children between the ages of one and five. Most kids outgrow them by five, which is great for the parents, because if you're child is seizing every time they have a fever, I'd be happy to have them outgrow it. They are self-limiting. They usually are generalized tonic-clonic, although they can be different kinds of seizures. And they usually don't go on in most cases, only about 10 percent of them go on to develop epilepsy afterwards.

Steve Wolf MD: And that's a great thing. So febrile seizures are not epilepsy.

Patty: Right.

Steve: They're clearly being triggered by the fever. It's not necessarily the height of the fever. We most of the time think of it as how quickly the fever transitions, so goes from 99.8 to 102. That rapid transition seems to be the trigger of a lot of kids with febrile seizures.

Patty: And some think some children have febrile seizures at a lower temperature. Some have them only when their temperature is really high. The thing that's most disturbing for the parents is just as Steve said, that it's as the temperature rises. So you can have a child in your stroller strolling them around, and they look fine. And all of a sudden, they seize, and then you realize that they're really, really hot.

Steve: And you describe that sometimes the kids can jerk and twitch. Sometimes they can be looking at you and just pass out and become limp and unresponsive. And then the parents feel them, and they notice they have a fever.

Patty: Right. So the way that you treat them is that you don't need to be treated preventatively. These are not kids that deserve to go on medications to prevent epilepsy. You treat the seizure when it occurs, if it lasts for a prolonged period of time. If it's just a short seizure, you don't have to treat it at all.

Steve: Do you need to go to the emergency room every time you have a febrile seizure?

Patty: No. You do not need to go to the emergency room. The parents should be managing the fevers. They should be giving ibuprofen, acetaminophen. And if they have a long seizure, we do have rescue medications that we use if the seizure goes on for more than three to five minutes.

Steve: But you know, the febrile seizure, we always tell parent it's like the alarm system for children. Because since kids can't sit there and say, "Oh, I have a headache. I have a fever," it's almost like, "Hey, pay attention to me. I obviously have some illness." The most common cause of febrile seizures is one, a virus, and two, an ear infection.

Patty: And you don't have to go to the emergency room for either of those things. You can call the pediatrician and get them on the phone. They often also, febrile seizures, run in families. So if you have a child or two that's had a febrile seizure, there's some family history of it, you're more likely to have children with febrile seizures. But again, febrile seizures occur with fever. They run in families. They usually occur between the ages of one and five and very rarely after that. This is a good thing to have a conversation with your pediatrician and your neurologist about. Most people don't even need to go to a neurologist for febrile seizures. You need a rescue medication in case it goes on for a long time. You don't need preventative medications, don't need a trip to the emergency room. Just good fever control and a rescue medication if needed.

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