Can Fever Cause Seizures? | Understanding Febrile Seizures

It’s a common concern for parents and caregivers when a child’s temperature rises, and for good reason. Understanding the connection between fever and seizures can help alleviate worry and guide appropriate action.

Understanding Febrile Seizures

A febrile seizure is a convulsion in a child caused by a fever, without any underlying brain infection or other known cause. These seizures typically occur in children between 6 months and 5 years of age, with the peak incidence between 12 and 18 months.

Febrile seizures are relatively common, affecting about 2% to 5% of young children. They are generally considered benign and do not cause long-term brain damage or developmental delays. The seizure itself is often triggered by a rapid rise in body temperature, not necessarily the absolute height of the fever.

It is important to recognize that febrile seizures are distinct from epilepsy. Epilepsy involves recurrent seizures without a fever, caused by abnormal brain activity. A child who experiences febrile seizures does not necessarily have epilepsy.

Simple Febrile Seizures

Most febrile seizures are classified as simple. They present with specific characteristics:

• They are generalized, meaning the entire body stiffens and jerks.
• They last for a short duration, typically less than 15 minutes.
• They occur only once within a 24-hour period.

A simple febrile seizure usually involves a child losing consciousness and experiencing rhythmic jerking of the arms and legs. The child’s eyes may roll back, and breathing might be labored.

Complex Febrile Seizures

A smaller percentage of febrile seizures are classified as complex. These differ from simple seizures in one or more ways:

• They are focal, affecting only one part or one side of the body.
• They last longer than 15 minutes.
• They recur within the same 24-hour period or during the same febrile illness.

Complex febrile seizures warrant closer medical evaluation due to their atypical presentation, although they still carry a generally good long-term outlook for most children.

Who is At Risk for Febrile Seizures?

Several factors influence a child’s susceptibility to febrile seizures. The primary risk factor is age.

• Age: Children between 6 months and 5 years are most vulnerable. The brain’s developing neural pathways during this period are more susceptible to the effects of fever.
• Family History: A child has a higher likelihood of experiencing a febrile seizure if a parent or sibling has a history of them. This suggests a genetic predisposition.
• Viral Infections: Common viral illnesses, such as roseola, influenza, or upper respiratory infections, are frequent triggers. The fever associated with these infections can precipitate a seizure.
• Vaccinations: In rare instances, some vaccinations, particularly the measles, mumps, and rubella (MMR) vaccine, can cause a fever that might trigger a febrile seizure. This risk is very low and the benefits of vaccination far outweigh this minimal risk.

A child’s temperament or personality does not correlate with their risk of febrile seizures. These seizures are a physiological response to fever in susceptible children.

What Happens During a Febrile Seizure?

During a febrile seizure, a child typically loses consciousness and may appear to stare blankly. The body often stiffens, followed by rhythmic jerking movements of the arms and legs. The child’s eyes may roll upward or to one side. Breathing can become irregular, and the child might drool or foam at the mouth.

The seizure usually lasts for a few minutes, rarely exceeding 5 minutes. While it can be distressing to witness, the child is not in pain during the seizure. After the seizure, the child often appears drowsy, confused, or irritable for a short period. This post-seizure state, known as the postictal phase, is normal.

The key is to remain calm and ensure the child’s safety during the event. Timing the seizure duration is also helpful information for medical professionals.

When to Seek Medical Attention

While most febrile seizures are harmless, certain situations warrant immediate medical evaluation. It is always wise to seek medical advice after a child’s first febrile seizure to confirm the diagnosis and rule out other conditions. For guidance on when to seek care, the CDC offers information on child health.

Call emergency services or take your child to the nearest emergency room if:

• The seizure lasts longer than 5 minutes.
• Your child has difficulty breathing or turns blue.
• Your child remains unresponsive or excessively drowsy long after the seizure ends.
• The seizure affects only one part of the body or is followed by weakness on one side.
• Your child develops a stiff neck, severe headache, or a rash.
• The seizure occurs in a child younger than 6 months or older than 5 years.
• This is your child’s first seizure.

Even if the seizure is brief and your child recovers quickly, contacting your pediatrician is always a good step to discuss the event and receive tailored guidance.

Managing Fever and Seizure Prevention

Managing a child’s fever is a common practice, but it is important to understand its role in febrile seizures. Fever-reducing medications, such as acetaminophen or ibuprofen (dosed appropriately for age and weight), can help a child feel more comfortable. However, these medications do not reliably prevent febrile seizures. The rapid change in temperature, rather than the sustained high temperature, is often the trigger.

Other fever management strategies include dressing the child in light clothing, ensuring a comfortable room temperature, and offering plenty of fluids to prevent dehydration. Cooling baths are generally not recommended as they can cause shivering and an uncomfortable rapid temperature drop.

During a seizure, the priority is to keep the child safe. Lay the child on their side on a soft surface to prevent choking. Remove any nearby objects that could cause injury. Do not try to hold the child down or place anything in their mouth. Time the seizure from start to finish. Stay with the child until the seizure ends and they are fully responsive.

Long-Term Outlook and Recurrence

The long-term outlook for children who experience febrile seizures is overwhelmingly positive. Most children experience no lasting effects. Febrile seizures do not cause brain damage, learning disabilities, or behavioral problems. They are a temporary phenomenon linked to the developing brain’s response to fever.

While the risk of developing epilepsy after febrile seizures is slightly higher than in the general population, this increase is very small. The vast majority of children with febrile seizures do not develop epilepsy. Risk factors for developing epilepsy include complex febrile seizures, pre-existing neurological conditions, or a family history of epilepsy. The National Institute of Neurological Disorders and Stroke provides additional details on seizure disorders.

There is a chance of recurrence for febrile seizures. Factors that increase the likelihood of another febrile seizure include a younger age at the first seizure (under 12 months), a family history of febrile seizures, and a lower temperature at which the seizure occurred. About one-third of children who have one febrile seizure will have another.

Common Misconceptions About Febrile Seizures

Several misunderstandings surround febrile seizures. Clearing these up can help parents and caregivers approach the situation with accurate information.

• Myth: Febrile seizures cause brain damage.

  Fact: Febrile seizures are generally benign and do not cause permanent brain damage or long-term developmental issues.

• Myth: High fever alone causes seizures.

  Fact: The rapid rate of temperature rise, rather than the absolute height of the fever, is often the trigger. Some children seize with relatively low fevers, while others tolerate very high fevers without incident.

• Myth: Antipyretics prevent febrile seizures.

  Fact: While fever reducers can make a child more comfortable, studies show they do not reliably prevent febrile seizures. The mechanism is complex and not simply controlled by lowering the temperature.

• Myth: All seizures with fever are febrile seizures.

  Fact: A seizure with fever could indicate another underlying condition, such as a central nervous system infection (e.g., meningitis) or a pre-existing seizure disorder. Medical evaluation is necessary to rule out these possibilities, especially after a child’s first seizure.

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