Q. My 2-year-old daughter had a seizure and a fever and she was sent to the ER. They sent us home, but now I’m wondering if she’s going to have another one or how should she feel now because she is so fussy. She only wants to be carried by me and cries all day long. What do I do? Elizabeth, San Bernardino, CA
A. Since your child is still so fussy, you likely should seek further medical attention.
Although scary for parents, febrile seizures (a seizure that is caused by a fever) are usually not serious.
They usually occur in young children, during a viral illness in which their fever spikes up high all of a sudden. About 2% to 5% of children have febrile seizures.
Children who have febrile seizures have a very small risk of later developing regular seizures, but according to the National Institute of Neurological Disorders and Stroke, ‘between 95% to 98% of children who have experienced febrile seizures do not go on to develop epilepsy.’
These children are at risk for having more febrile seizures though. In fact, about one=third of children who have febrile seizures go on to have another one later on. Fortunately, most children outgrow having febrile seizures by the time they are about 5 years old.
Remember that febrile seizures are not harmful though and they do not cause brain damage.
First Aid for Febrile Seizures
If your child is having a febrile seizure, according to the National Institute of Neurological Disorders and Stroke, you should “stay calm and carefully observe the child. To prevent accidental injury, the child should be placed on a protected surface such as the floor or ground. The child should not be held or restrained during a convulsion. To prevent choking, the child should be placed on his or her side or stomach. When possible, the parent should gently remove all objects in the child’s mouth. The parent should never place anything in the child’s mouth during a convulsion. Objects placed in the mouth can be broken and obstruct the child’s airway. If the seizure lasts longer than 10 minutes, the child should be taken immediately to the nearest medical facility for further treatment. Once the seizure has ended, the child should be taken to his doctor to check for the source of the fever. This is especially urgent if the child shows symptoms of stiff neck, extreme lethargy, or abundant vomiting.”
Medical Treatment for Febrile Seizures
Although febrile seizures are not harmful and usually don’t require any treatment, the concern comes when your Pediatrician is not sure that your child is in fact having a simple febrile seizures. Although a child has both a fever and a seizure, it is sometimes possible that a child has something else, like meningitis, causing both and that the fever didn’t trigger the seizure. In this case, further testing, like a spinal tap, might be done, especially in children younger than 12 to 18 months old. Blood and urine tests may also be done in some situations.
Most children with simple febrile seizures, who aren’t too fussy and appear well after the seizure, don’t require any testing though. In fact, that American Academy of Pediatrics recommends that other tests, like an EEG, CT, or MRI, not routinely be done in children with a first simple seizure.
Preventing Febrile Seizures
The only real way to prevent febrile seizures is to try and avoid allowing your child to get sick, which might lead to a fever, in the first place. Giving a fever reducer, such as Tylenol (acetaminophen) or Motrin (ibuprofen), at the first sign of a fever is often recommended, but likely won’t prevent a febrile seizure.
Some children who have a lot of febrile seizures are treated with Diazepam at the first sign that they have a fever, but this usually isn’t necessary. A pediatric neurologist can be helpful if you think your child needs treatment for her febrile seizures.