What Are Febrile Seizures?

Febrile seizures are convulsions that happen in young children, typically aged between 6 months and 5 years old, when their body temperature rises above 100.4ºF (38ºC). Most febrile seizures occur when children are around 12 to 18 months old. However, most of them are harmless and do not cause long-term effects.

Febrile seizures affect approximately 2 to 4 per cent of children under the age of 5. While they can be distressing, they typically do not result in brain damage or impact a child's intelligence.

It is important to note that experiencing a febrile seizure does not indicate the presence of epilepsy. Epilepsy is characterised by recurrent seizures that occur without the presence of fever, typically two or more episodes.

What Are the Symptoms of Febrile Seizures in Children?

Febrile seizures often occur early in the course of illness, and in some instances, they serve as the first indication that a child is unwell.

Febrile seizures are classified as being simple or complex.

• Simple febrile seizures are the most common. During these seizures, the child may lose consciousness and experience convulsions or rhythmic twitching in their arms or legs. Most seizures of this nature last no more than 1 to 2 minutes, although some can extend up to 15 minutes. Following the seizure, the child may feel confused or drowsy but does not exhibit weakness in their arms or legs.
• Complex febrile seizures are less common and can last more than 15 minutes or even up to 30 minutes if they occur in a series. Children experiencing complex seizures may exhibit temporary weakness in one of their arms or legs after the seizure episode.

What Are the Risk Factors of Febrile Seizures in Children?

While the exact cause of febrile seizures remains unclear, it is believed that a family history of febrile seizures may increase the risk.

Febrile seizures commonly occur when a child's body temperature rises significantly due to an infection. Among the various infections associated with febrile convulsions, the three most prevalent are:

• Viral infections, such as chickenpox and influenza (flu).
• Middle ear infections, medically known as otitis media.
• Tonsillitis.

How Are Febrile Seizures in Children Diagnosed?

It is crucial for a child who experiences a febrile seizure to be promptly evaluated by a doctor, ideally in an emergency department, to determine the cause of the fever. 

A description of the seizure can frequently be used to diagnose febrile seizures. It is helpful to note these signs: 

• How long the seizure lasted.
• What happened (such as stiffening of the body, twitching of the face, arms, and legs, staring, and loss of consciousness).
• Whether your child recovered within an hour.

Tests to identify the source of the infection are typically conducted to rule out more serious conditions that can present with similar symptoms, such as meningitis. These tests may include obtaining blood or urine samples to check for signs of infection. However, obtaining a urine sample from young children can be challenging, so it may require hospitalisation or specialised techniques to collect the sample accurately.

How Are Febrile Seizures in Children Treated?

Remaining calm and taking appropriate first aid measures during a febrile seizure is crucial for the child's safety. Here are the recommended steps for parents and caregivers during a febrile seizure:

1. Note down the start time of the seizure and if it lasts longer than 5 minutes, immediately call an ambulance and take the child to the nearest medical facility.
2. If the seizure is less than five minutes, but the child does not seem to be recovering quickly, call an ambulance for immediate medical attention.
3. Gradually place the child on a protected surface, such as the floor, to prevent injury. Do not restrain or hold the child during the seizure.
4. Position the child on their side or stomach to prevent choking. If possible, gently remove any objects from the child's mouth. Never put anything in the child's mouth during a seizure, as this can obstruct the airway and hinder breathing.
5. Seek immediate medical attention if it is the child's first febrile seizure. After the seizure has ended, take the child to the doctor. This is particularly urgent if the child displays symptoms of meningitis, such as a stiff neck, extreme lethargy, or persistent vomiting.

How to Prevent Febrile Seizures in Children?

Febrile seizures typically cannot be prevented.

Book an Appointment at Pantai Hospitals

A dedicated and expert team of Paediatric specialists at Pantai Hospital is available for consultation to provide patients with the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions about febrile seizures in children. 

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.