Febrile seizures are seizures triggered by fever in children aged 6 months to 5 years old, when the body temperature is higher than 38ºC with no other seizure-provoking causes. Though febrile seizures look frightening, they do not affect intelligence or harm the brain if the seizures end quickly.

Causes
The cause of febrile seizures cannot yet be pinpointed. The condition can be related to a family history of febrile seizures. A physical exam must be performed to rule out central nervous system infections such as meningitis as the cause of the seizure.

Febrile seizures are commonly associated with:                          

• Infection with bacteria or virus such as human herpesvirus 6 (HHV-6) virus causing pityriasis rosea or roseola infantum causing high fever without other symptoms, or influenza virus.
• Immunization such as whole celldiphtheria-tetanus-pertussis (DTwP), measles-mumps-rubella (MMR), or influenza vaccination, which can cause fever.

Symptoms
Febrile seizures commonly occur with fever higher than 38ºC, within the first 24 hours when fever is rising. The condition can be categorized into:

• Simple febrile seizure. This is the most common type. The convulsion is generalized and lasts less than 15 minutes (often longer than 5 minutes) and does not recur within 24 hours. Once it is over, a child may feel weak and may continue to be drowsy. But upon waking up, there should be no weakness.
• Complex febrile seizure. This is less common. It differs from the simple febrile seizure by at least one of the following characteristics: focal seizure, convulsion longer than 15 minutes, and recurrence within 24 hours. Afterwards, a child may remain sleepy, does not feel like waking up, or have neurological signs such as focal weakness. Complex seizures must be further investigated for possible predisposing causes.

Simple febrile seizure is usually harmless because it quickly ends and does not affect the brain and intelligence. However, 30-35% of children who experience a febrile seizure have recurrences. The risk of recurrence is higher in children younger than 15 months, who have a parent, or sibling with a history of febrile seizures.  Subsequent seizures may develop from a low-grade fever with a body temperature not as high as the first seizure. Close observation is necessary.

Treatment
Specific treatment for febrile seizures is not necessary aside from promptly lowering the body temperature. If the seizure does not end within 5 minutes, the doctor may prescribe an antiseizure medication to stop the seizure, preventing it from causing inadequate breathing and potential harm to the brain.

Treatment or additional tests are not required for children presenting with a simple febrile seizure. However, those with risk factors or complex febrile seizure need to be investigated further with electroencephalography (EEG) or MRI.

What you can do during the child’s seizure

• Parents should not panic. Place the child on a flat ground, away from anything that could injure him/her. Then, turn him/her on the side to prevent choking.
• Never put a hand or anything into the child’s mouth because it can block the airway.
• Loosen the child’s clothes. Sponge bath to bring the fever down.
• If the seizure does not stop within 3-5 minutes, seek immediate medical care.
• If the seizure stops on its own, stay with the child and observe for any abnormalities. Then, take the child to see a doctor for a proper diagnosis.
• If the child has a history of seizure with recurrence, the doctor may have prescribed a home antiseizure medication which should be strictly administered as ordered by the doctor. The medication should be given only once. If the seizure persists, seek immediate medical care.

Prevention
If the child has a fever, antipyretics can be given along with a tepid sponge bath. Avoid using cold water because it can constrict the sweat gland duct pores and prevent the body from cooling off.

If the child has a cold but no fever, do not give pre-emptive antipyretics to forestall fever. Do not give preventive antiseizure medication if the child has no seizure. Taking medications does not lower the risk of fever or febrile seizures.