Unless your child, or a friend, has had one, many parents have never heard of febrile seizures. But it is one of the reasons doctors instruct us to use Tylenol and Advil when our kids' fevers get too high - to lower the fever and thus prevent a seizure. However, in recent years, many pediatricians have cautioned against using these medications for any fever, citing the immune system's need to react, to fight the infection with its built-in response. They don't want parents to overuse the medications.
When my 18-month-old had a febrile seizure last month, I was shocked. I have an older child, age four, who's had plenty of high fevers over the years. I knew next to nothing about them. When I spoke with other parents, it was clear that many parents had no idea what they were. The day it happened, my daughter just seemed to have a cold. She had been fussy, but slept well overnight and we chalked it up to teething. Then, later in the day, she woke up from a nap very hot and unhappy. I didn't even check her temperature, but called the doctor because I was sure she must have an ear infection. I didn't give her any medication. At the doctor's, her fever was 102. She was tired and just wanted to be held. But she let the doctor examine her, and she didn't have an ear infection. After talking with the doctor about how this might be her first bad virus, we got ready to leave. I bundled her up for the 20 degree weather. When we got to the car she started convulsing.
I was grateful that all I had to do was run back into the office for assistance. The pediatrician timed the event. He told me what to do, that we would wait for it to end before trying to help her. He evaluated her when it was over. It was traumatic and scary, but she recovered after the seizure, and the virus ran its course without another event and with the aid of Tylenol and Motrin. But, I felt that I could have prevented it, if only I'd given her medicine early in the day. Or maybe if I hadn't bundled her up. Or if we'd given her the medicine first at the doctor's office when we saw the fever was 102. I wondered what I would have done if we were in the car at rush hour, or if I was at home alone or in a store, surrounded by strangers. I realized that I knew very little about febrile seizures. I wasn't allowed to panic because we were in such a safe place, but I felt completely unprepared.
Thankfully my daughter was fine. We were advised to give her medicine whenever her fever reaches 101, but I'm sure it will cause us a few sleepless nights whenever she gets her next virus. Most kids who have febrile seizures do not go on to have another. And overall, only 2-5 percent of kids between 18-months and age six ever have them. Yet when we went in for some testing, doctors repeatedly said things like, "We're seeing a lot of them with this year's flu." "They're fairly common in this age group." Why hadn't I ever been warned, I thought. Where was the educational handout, the poster in the waiting room?
The pediatrician cautioned me that there was nothing I could have done to prevent it - unfortunately for parental sanity, the seizure is probably caused not by the high fever alone, but by its rapid rise or spike. Thus, in some children, a seizure might even occur before the fever presents. Yet many children will have very high fevers and never have a febrile seizure. And they can run in families - if your sibling has had one, you are more likely to have one. Here are a few things I learned you may find helpful.
What to do:
Once a seizure starts, there is not anything you can do to stop it. Lie your child down on the floor or somewhere safe and time the seizure. You may tilt their head to one side to let the airway clear, but do not reach inside their mouth or try to restrain them. You may also lie them on their side, with their head in line with their body. When the seizure ends, it may take some time before they can talk or seem alert. This is called the postictal period. Take off layers or clothes if the room is hot. They may be drowsy.
When to call 911:
If the seizure lasts more than five minutes, call 911.
Some guidelines say if it is your child's first seizure, call 911.
Call 911 if they are turning blue or laboring to breathe.
Call 911 if they do not return to their normal state within one hour after the seizure.
If you do not need emergency assistance, you will need to call your doctor for advice on how to lower the fever, typically with Tylenol or Motrin. You should see your pediatrician as soon as possible. Hospitalization is not typically necessary, though your doctor may advise testing to rule out a serious infection such as meningitis or pneumonia.
The good news:
In itself a febrile seizure is not dangerous. Most babies and toddlers who have a febrile seizure do not have another, though parents may be advised to use medication for fevers. Febrile seizures are not related to seizure disorders.