DEAR DR.PAUL: My 2 year old son just had his first febrile seizure. It was horrible. He
is fine now but does this mean he is epileptic? I am worried.
DR.PAUL ANSWERS: Febrile seizures are perhaps one of the scariest things that parents witness. Reassuringly, simple febrile seizures do not result in any brain damage or long-term intellectual consequences.
Febrile seizures occur in 3% of children, mostly between the ages of 6 months and 5 years. There may be a family tendency. Although we do not know the exact cause of febrile seizures, experts suggest that it is due to immature brain wave activity in response to a sudden change of body temperature. So it is not the degree of fever, but rather the rate at which it rises that may be a trigger.
The key in evaluating a child that has had a febrile seizure is making sure that it is a typical or simple febrile seizure. Simple febrile seizures have the following characteristics:
Are generalized, in other words the whole body convulses or shakes
Last less than 15 minutes
Occur only once within a 24 hour period
The child has a normal development
There is no history seizures in the absence of fever(child and family)
No infection of the nervous system (like meningitis)
When we evaluate a child who just had a febrile seizure, we want to make sure that it is indeed a simple febrile seizure and that the convulsions were not due to any other factors. Accordingly, blood tests or even a lumbar puncture may be performed to make sure that there is nothing else going on. Once we are certain that it is a typical febrile seizure we want to find the cause of the fever, and if it's bacterial, treat with the appropriate antibiotics. In most cases it is usually of viral origin. An EEG or electroencephalogram may be performed 6 weeks later to make sure there is no brain wave seizure or epileptic abnormality.
Once a child has had a "confirmed" febrile seizure, parents want to know if it will recur. The chance of a child having another febrile seizure in the future is age dependent. Children less than 12 months have a 50% chance of recurrent febrile seizures. In children older than 1 year, the recurrence rate is 30%. Will this become epilepsy? Epilepsy means a seizure disorder where a person convulses for no apparent reason due to brain damage or without an obvious cause. The risk for developing epilepsy in children who have had a simple febrile seizure is just a bit higher than 1%( the risk is 1% in the general population). In children who have had heir first seizure before 12 months of age and had multiple simple febrile seizures, the risk for developing epilepsy by adulthood is 2.4%. The good news is that almost 98% of these children will not develop epilepsy.
On a final note, there is no specific treatment. Anticonvulsive (seizure) medications do not prevent febrile seizures. In certain cases where the seizures are prolonged or very recurrent, sedative type medications may be helpful. Although anti-fever medications can help lower a fever they do not prevent febrile seizures.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
