Understanding Febrile Seizures in Kids
By Dr. Soo

As a paediatrician, one of the most distressing situations parents face is seeing their child experience a seizure. It is particularly alarming when it happens in the context of a fever, often unexpectedly. Febrile seizures can be terrifying to witness, but fortunately, they are usually harmless and self-limiting. Understanding what febrile seizures are, why they occur, and how to respond can help ease some of the anxiety parents may feel.

What Are Febrile Seizures?

Febrile seizures are seizures that occur in young children, typically between the ages of 6 months and 5 years, and are triggered by a fever. The fever is usually caused by a viral infection, such as the common cold, influenza, or an ear or throat infection. Febrile seizures are not caused by a brain infection, epilepsy, or any serious neurological condition.

These seizures happen in about 2 to 5 percent of children and are most commonly seen in otherwise healthy children who are experiencing a sudden spike in temperature. Importantly, febrile seizures are not uncommon and do not necessarily indicate a lifelong seizure disorder.

Types of Febrile Seizures

There are two main types of febrile seizures: simple and complex.

A simple febrile seizure is the most common type. It typically lasts less than 15 minutes, does not recur within 24 hours, and involves the entire body, such as shaking or stiffening of both arms and legs. The child usually recovers fully and quickly.

A complex febrile seizure may last longer than 15 minutes, occur more than once in 24 hours, or affect only one part of the body (for example, just one arm or leg). Children who have complex febrile seizures may require further evaluation to rule out other causes.

Why Do Febrile Seizures Happen?

The exact mechanism behind febrile seizures is not completely understood, but it is believed that the immature brains of young children are more sensitive to the effects of sudden changes in body temperature. When the temperature rises rapidly, especially in the early phase of a fever, it can trigger abnormal electrical activity in the brain, leading to a seizure.

There is also a genetic component. Children with a family history of febrile seizures are more likely to experience them. In some families, several siblings or even parents may have had febrile seizures during childhood.

Recognising a Febrile Seizure

Seeing your child have a febrile seizure can be frightening, especially if it is the first time. A typical febrile seizure may involve:

• Loss of consciousness

• Jerking or twitching movements of the arms and legs

• Stiffening of the body

• Eye rolling

• Drooling or foaming at the mouth

• Skin turning slightly blue or pale due to irregular breathing

These episodes usually last less than 5 minutes, although they can feel much longer to a distressed parent.

What to Do During a Febrile Seizure

If your child experiences a febrile seizure, try to stay calm and follow these steps:

1. Lay your child on their side on a flat, safe surface like the floor to prevent choking if they vomit or have secretions.

2. Remove any nearby hard or sharp objects to prevent injury.

3. Do not put anything in your child’s mouth. Contrary to popular belief, children cannot swallow their tongues, and putting objects in their mouths can cause injury.

4. Loosen tight clothing, especially around the neck.

5. Time the seizure if you can. This information is important for healthcare providers.

6. Do not try to hold or restrain the child’s movements.

7. Once the seizure ends, your child may be drowsy or confused. Allow them to rest.

If the seizure lasts more than 5 minutes, or if your child is having difficulty breathing, turns blue, or does not regain consciousness, call for emergency medical help immediately.

When to See a Doctor

Even if the seizure stops quickly and your child seems to recover, it is always a good idea to seek medical attention after a febrile seizure. Your child’s doctor will want to evaluate the cause of the fever and determine whether any further investigations are necessary.

You should seek immediate medical attention if:

• The seizure lasts longer than 5 minutes

• Your child has difficulty breathing or turns blue

• The seizure affects only one part of the body

• Your child has more than one seizure in 24 hours

• Your child is under 6 months old

• There are signs of a serious illness, such as stiff neck, persistent vomiting, or extreme drowsiness

Reassurance for Parents

It is completely understandable for parents to feel anxious or overwhelmed when their child has a febrile seizure. The most important thing to remember is that these seizures are common and usually harmless. Knowing what to do and when to seek help can make a significant difference in how you respond during an emergency.

If your child has had a febrile seizure, speak with your paediatrician to discuss what happened, address your concerns, and receive guidance on how to manage future episodes. With the right information and support, you can feel more confident in caring for your child through these temporary health challenges.

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