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On Call: The Facts About Fevers and Seizures

Q. Our child recently had a febrile seizure. Does this mean he might have epilepsy?

Probably not. Luckily, over 95 percent of children who've had one don't develop epilepsy. That disorder is more likely in kids with cerebral palsy or other neurologic problems and in those who have a seizure that lasts more than 15 minutes, affects only one part of the body, or recurs within 24 hours. If any of that applies to your child, you should talk to your pediatrician about further testing (such as an electroencephalogram) and an appointment with a neurologist.

Febrile seizures are relatively common; 1 in 25 children has at least one. They occur most often in those between 6 months and 5 years old, usually when there's a high fever (greater than 102°F) and typically on the first day of an illness. During a febrile seizure, a child generally loses consciousness and has twitching movements all over. Most of the time it's brief, lasting a few seconds to a few minutes.

It's not known what causes these seizures, but some people are more prone to them. The risk of having another is about one in three, with the chances increasing when the first seizure occurs before 15 months, if there's a family history of them, or when the fever associated with the seizure is low. They're difficult to prevent because they often occur as the fever first rises, before the parent even realizes the child is sick. Even so, treating any fevers with acetaminophen or ibuprofen for the first day or two of illness may be helpful (check with your pediatrician regarding dosage, and never give them the medicine more frequently than directed). During a febrile seizure, it's best to lie the child on his side on a safe surface like the floor (this is better than holding him).

Don't put anything in his mouth, stay calm, and let the seizure pass. If it goes on for longer than ten minutes, call 911; sometimes medications are necessary to stop it. Even if it's brief, you should always call your doctor after your child has one.

Febrile seizures can certainly be scary, but they don't cause brain damage. They usually disappear by age 5 or 6, sometimes earlier. When kids go a year or more without one and have had at least a couple of fevers during that time, they're probably home free.