Febrile Seizures: Frightening but not Dangerous
By Dale Peterson, MD – Building Health
A young couple recently related a story I have heard many times over the course of my career. Their seemingly healthy toddler had been put to bed as usual. An hour later they heard the child’s crib shaking and they ran to the nursery to investigate. They found him burning up with fever and in the midst of a convulsive episode. They rushed him to an emergency room where tests were run and found to be normal. The physician advised them that the seizure had been triggered by a viral infection and recommended that they follow up with their pediatrician or family physician.
Febrile seizures, which are also called febrile convulsions, usually occur between the ages of six months and five years. They are the one of the most common seizure types. Up to four percent of children will have at least one febrile seizure before their sixth birthday. Approximately a third of those who have one episode will have additional febrile seizures. The seizure episodes cease by five or six years of age.
Febrile seizures can be dramatic and frightening, but they are not dangerous. Multiple episodes are no more harmful or significant than a single seizure. They do not predispose to epilepsy later in life nor do they adversely affect intelligence or cause damage to the brain.
As the name implies, the seizure is associated with the presence of a fever. It has been my experience that the primary determining factor as to whether or not a seizure will occur is not the height of the fever, but the rate of rise in body temperature. Most cases occur as described above. A child is put to bed without any sign of illness. Later in the evening or during the night the parents are alerted by the sound of the infant thrashing about, at which time a high fever is present.
Many of the febrile seizures about which I have been consulted were caused by roseola, a viral infection that typically occurs between six months and three years of age. It is characterized by a high fever that appears suddenly and lasts for several days. As the fever subsides a rash usually appears that may fade after several hours or remain for several days. The rash consists of small flat spots or patches that are not itchy or painful. A few spots may be raised. The spots are pink or red and may be surrounded by a white ring. The rash usually starts on the chest, back and abdomen and then spreads to the neck and arms. It may or may not appear on the legs and face.
While physicians are always anxious to do something, there are times when doing nothing is the best course. Fever reducing medications have been shown to be of no value in preventing febrile seizures. This may be because by the time a fever is recognized the danger has generally passed.
Thankfully, anticonvulsant medications, which from the 1970s through much of the 1990s were widely prescribed to infants and children who had experienced a febrile seizure, are no longer recommended. The drugs were ineffective when used intermittently (probably for the same reason that fever reducers are ineffective) and caused behavioral changes, weight disturbances, decreased learning capacity, and in some instances fatal reactions involving the liver and pancreas when taken on an ongoing basis. Spinal taps, which were once done routinely, are now rarely performed.
When a seizure occurs it is important to seek medical attention to determine whether it was due to fever or to a more serious condition. If it is determined that it was a febrile seizure you can rest assured that your child will not suffer any adverse consequences as a result of having experienced it.
Dr. Dale Peterson is a graduate of the University of Minnesota College of Medicine. He completed his residency in FamilyMedicine at the University of Oklahoma. He is a past president of the Oklahoma Academy of Family Physicians. He had a full-time family practice in Edmond, Oklahoma, for over 20 years and was a Chief of Staff of the Edmond Hospital. He was active in teachingfor many years as a Clinical Professor of Family Medicine through the Oklahoma University Health Sciences Center.
Dr. Peterson left his full-time family practice in 1999 to consult with individuals who are seeking ways to restore and maintain their health through improved nutrition and other lifestyle changes. He founded the Wellness Clubs of America to give people access to credible information on supporting and maintaining their health. His monthly wellness letter, Health by Design, and his Health by Design E-Newsletter provide helpful information to individuals interested in preventing and conquering health challenges. His book Building Health by Design: Adding Life to Your Years and Years to Your Life was released in December 2010.
Dr. Peterson speaks regularly on subjects related to health and nutrition. He hosted a weekly radio program,Your Health Matters, on KTOK in Oklahoma City for five years. For the past nine years he has addressed questions from across the nation on his Your Health Matters weekly teleconference.He offers a free video LifeXtension course at www.drdalepeterson.com.