Febrile Seizures in Young Children: What Parents Should Know

About heat cramps?

Dear Doctor, a few days ago, my child (now 1 year and 10 months old) suddenly developed a high fever in the middle of the night, and in the morning, we noticed signs of convulsions, with his eyes rolling back.
This lasted for about three to four minutes.
My husband and I immediately took him to the emergency room.
The doctor asked about our family medical history, but we do not have any relevant history.
I would like to know what we should pay attention to if this happens again.
Also, are the convulsions associated with enterovirus the same as what we observed?

Jin Ma, 30~39 year old female. Ask Date: 2005/10/18

Dr. Lin Huizhen reply Pediatrics

Dear Ms.
Jin Ma,
Dr.
Lin Huizhen, Chief of Pediatrics at Tainan Hospital, Department of Health, Executive Yuan, would like to inform you: Any infection that causes a high fever (including enterovirus) can trigger febrile seizures in children who are predisposed to them.
Therefore, any fever poses a risk of seizures.
However, if the enterovirus affects the brain and leads to encephalitis, the seizures will be accompanied by other neurological symptoms after the seizure, such as coma, lethargy, or persistent convulsions.

Wishing you and your baby good health and all the best!
Sincerely,
Pediatrics Department, Tainan Hospital

Reply Date: 2005/10/18

More Info

Febrile seizures, or fever-related seizures, are relatively common in young children, particularly those between the ages of 6 months and 5 years. These seizures can be alarming for parents, especially when they witness their child experiencing one for the first time. Understanding febrile seizures, their causes, and how to respond can help alleviate some of the anxiety associated with them.

What Are Febrile Seizures?
Febrile seizures are convulsions that occur in children with a fever, typically defined as a body temperature of 100.4°F (38°C) or higher. These seizures can manifest as shaking, stiffening of the body, or loss of consciousness. In your case, the symptoms you described—such as the eyes rolling back and the seizure lasting for several minutes—are consistent with a generalized febrile seizure.

Causes and Risk Factors
The exact cause of febrile seizures is not fully understood, but they are believed to be linked to the rapid increase in body temperature rather than the fever itself. Common illnesses that can lead to febrile seizures include viral infections, such as those caused by the flu or roseola. It's important to note that febrile seizures are not caused by the underlying infection itself, but rather by the body's response to the fever.

While you mentioned that there is no family history of seizures, it's worth noting that a family history can increase the likelihood of febrile seizures. However, many children without a family history can still experience them.

What to Do During a Febrile Seizure
If your child experiences a febrile seizure, it is crucial to stay calm. Here are some steps to follow:
1. Ensure Safety: Gently place your child on the ground to prevent injury. Remove any nearby objects that could cause harm.

2. Time the Seizure: Most febrile seizures last less than five minutes. If the seizure lasts longer than this, seek emergency medical help.

3. Do Not Restrain: Avoid holding your child down or putting anything in their mouth, as this can lead to injury.

4. Positioning: After the seizure, turn your child onto their side to help keep their airway clear.

5. Monitor Recovery: After the seizure, your child may be confused or sleepy. Allow them to rest and recover.

After the Seizure
Following a febrile seizure, it is essential to consult with your pediatrician. They may recommend further evaluation to rule out other potential causes of the seizure. In most cases, febrile seizures do not lead to long-term health issues, and children typically outgrow them by the time they reach school age.

Preventing Future Febrile Seizures
While there is no guaranteed way to prevent febrile seizures, managing your child's fever can help. Here are some tips:
- Monitor Temperature: Keep an eye on your child's temperature, especially if they are ill. Use a digital thermometer for accuracy.

- Medications: If your child has a fever, you can administer age-appropriate doses of acetaminophen or ibuprofen to help reduce fever. Always consult your pediatrician for the correct dosage.

- Hydration: Ensure your child stays hydrated, as dehydration can worsen fever symptoms.

Distinguishing Between Febrile Seizures and Other Types
You asked about the difference between febrile seizures and seizures associated with enterovirus infections. While both can cause seizures, febrile seizures are specifically linked to fever, whereas seizures due to enterovirus may occur without a fever or may be due to other neurological complications. If your child experiences seizures without a fever, or if they have other concerning symptoms, it is crucial to seek medical attention.

Conclusion
In summary, febrile seizures are generally benign and self-limiting, but they can be distressing for both the child and the parents. Understanding what they are, how to respond, and when to seek medical help can empower you as a parent. Always consult with your pediatrician for personalized advice and to address any concerns you may have regarding your child's health.

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