Dr Patrick takes a look at febrile seizures
febrile, seizure, fever, pediatrics, pediatrician, pediascribe
Copyright 2006 Mike Patrick Jr, MD
Your one-year-old is unresponsive. Her eyes roll back. Her arms and legs stiffen. She begins to jerk and twitch. You are suddenly shaky yourself as panic and fear grab hold. You snatch her up in your arms and discover her skin is hot to the touch. You don’t understand. She hadn’t been sick–until now. You rush to the phone, but aren’t sure who to call–911, the doctor, your husband, your mother? By this time, the twitching has stopped, her muscles have relaxed, and her eyes have closed. Like a spring tornado, the convulsive episode came and went in a flash, leaving you with an unarousable child and a whole lot of questions, the first of which is, “What do I do now?”
Witnessing a febrile seizure is a frightening experience. As a parent, you are helpless to control the unfolding situation. I am reminded of my daughter’s seizure several years ago. We had packed everything in the apartment and were preparing to move into our first house the following day. Excitement filled the air. Our daughter was 15-months old at the time and she felt a little warm. But we couldn’t take her temperature or give her Tylenol because when I say everything was packed, I mean everything was packed.
The dinner hour beckoned, so my wife volunteered to swing by the drug store on her way to KFC. That was fine by me. Katie wasn’t exactly what you’d call a cuddly baby. The low-grade fever had relaxed her temperament, and I took advantage of the situation, rocking her to sleep in my arms.
While waiting for my wife and the chicken to return, Katie woke up. But her eyes weren’t looking at me. Instead, they were forced high up in the sockets as if she were inspecting the hairs on her brow. Her tiny body became stiff and started to twitch, and I realized she wasn’t really awake at all. I remember her body suddenly burning like fire and I remember feeling helpless to do much of anything about her fever or the seizure.
Typical of most febrile seizures, the episode passed quickly, but it left me with a lasting impression of the experience. I understand why fever, and the prospect of a resulting seizure, scares parents.
Yet, you really shouldn’t be afraid. Fever is a normal function of our body, aiding in the elimination of infection. It should prompt you to seek a medical opinion regarding the source of the fever, but it shouldn’t scare you. And why not?
Well, only 4% of the population will ever have a febrile seizure. That means your child has a 96% chance of never having a fever seizure, even with temperatures in the 104-105 degree range. The chances, however, do increase slightly if other children in the extended family have a history of seizing with fever.
Also keep in mind that there’s little you can do to prevent a febrile seizure. This is because most of them occur at the very onset of an illness, with the first temperature spike. In these cases, the seizure is the first sign your child has a problem.
When febrile seizures occur, they tend to be brief (a few minutes that seem like an eternity) and uncomplicated. Your child may be sleepier than usual for an hour or so after the episode. Also, having a febrile seizure increases the odds of having another one sometime in the next few years–about one-third of kids with a febrile seizure will have a repeat episode. Will your child go on to develop epilepsy (seizure without fever)? It’s unlikely. Only one in one-hundred kids with febrile seizures will go on to have a lifelong seizure disorder.
How about brain damage? Nope. Neither high fevers nor febrile seizures cause brain damage. However, brain damage can lead to fever and seizure.
So back to the question on every parent’s mind: What do I do during and after a febrile seizure. During the seizure, you want to make sure your child is in a safe place and breathing fine. If there are breathing difficulties, call 911. Start rescue breathing if your child is apneic or blue (a CPR course through the American Red Cross is a good idea for any parent). But realize this situation is extremely rare.
After the seizure, you should call your child’s doctor. He may have you go to the emergency room or might see you in the office.
Witnessing a febrile seizure is scary–take it from me, a Dad and Pediatrician who lived through one. But in the overwhelming majority of cases, all is well in the end. Sure, we treat fevers in kids, but our primary goal is making your child more comfortable, not preventing a seizure. God made fevers for a reason. They have a purpose. Since seizures are a rare occurrence with fever, and since they are generally brief and without complication when they do occur, you should respect your child’s fever, but please don’t fear it.