“One of the most frightening things for any parent to say, and I can tell you from personal experience, because one of my children had a febrile seizure -- a fever-related seizure -- is the look that they have when that occurs,” says Dr. Mark Flanzenbaum, M.D., FAAP of KidMed.
Not every fever causes a seizure, but kids who have typically higher fevers can have a seizure. Basically, a febrile seizure is almost a reaction to the temperature, like putting your hand on a hot stove, explains Dr. Flanzenbaum. “It's not a seizure in the sense of epilepsy, having true seizure disorder.”
“What we see in kids who have that, it's almost always when the fever first begins. That's the majority of times we see it occur,” says Dr. Flanzenbaum. “A child will be unresponsive, they will be having jerking movements.” Sometimes parents will describe the children having their back arched. Usually it lasts, on average, one to three minutes. A simple non-dangerous febrile seizure could last as much as fifteen minutes. Usually there's a short period of sleepiness afterwards but, it resolves.
“The important thing though about febrile seizures is they are not in and of themselves dangerous,” says Dr. Flanzenbaum. “They are a manifestation of a reaction to two things. One, the height of the fever and, two, how quickly the fever goes up. There's some difference of opinion as to which is the more important part of it but, either way, fevers above a 102 and a rapidly rising fever can be triggers for that.”
When they occur, do you need to bring your child in to be seen?
If it is a short seizure and it lasts less than one to three minutes, and your child looks fine afterwards, they should be evaluated for the sense of having the fever. But, the seizure itself, usually does not require much of an evaluation, says Dr. Flanzenbaum.
“When children have what they consider a complex febrile seizure where it lasts more than 15 minutes or they have some unusual symptoms like temporary paralysis on one side of the body -- of course any parent would be terrified in seeing -- those kids need more of an evaluation for other causes of their seizure, something going on in their brain, an infection up there or meningitis,” says Dr. Flanzenbaum. “The vast majority of kids who have febrile seizures do not need any more evaluation than a simple evaluation of what's causing the fever.”
For most of the children, the cause of the fever is usually either a viral infection, most common of which is a very common childhood infection caused, roseola, where there's several days of a high fever, no symptoms and then rash begins, says Dr. Flanzenbaum. “Anything -- cold viruses, any urine infections, multiple things that can cause fever – any one of those can cause the seizure. There's no specific infection particularly that's a higher risk of causing that. Kids who develop fever following immunizations can also develop a febrile seizure.”