Seizures and Fever (cont.)
What Are the Symptoms of Febrile Seizures?
By definition, febrile seizures occur when the child has a fever. Most febrile seizures are generalized. In other words, the whole body may be involved.
During a generalized seizure, any or all of the following may be seen:
- Stiffening of the entire body
- Jerking of the arms and legs
- Complete lack of response to any stimuli
- Eyes deviated, staring, rolling back, moving back and forth
- Tightness of the jaws and mouth
- Urinary incontinence (wet their pants)
- Noisy breathing, labored, slower than normal (unusual for a child to stop breathing completely)
- Although it may seem like an eternity if you are witnessing a seizure, most of these episodes last only 1-5 minutes. Afterward, the child is typically drowsy but usually starts to become responsive within 15-30 minutes.
- Following a seizure, a child may remain somewhat “twitchy,” with intermittent small jerks of the arms or legs. It can be difficult to distinguish these movements from seizure activity, but the caregiver should be reassured if the child’s body tone has become relaxed, breathing is regular, and the child begins to show some signs of responding to stimulation (will respond if talked to, for example).
- Focal seizures are less common and, as the term implies, involve only a part of the body. Abnormal movements may be seen only in the face (eye blinking, lip smacking, other movements of the mouth) or one side of the body. Variable degrees of alteration in consciousness are seen in focal seizures. Some seizures begin as focal ones and then become generalized.
When Should I Call the Doctor for Febrile Seizures?
With any medical concern, if you determine immediate medical emergency is not necessary, you may call your doctor for instructions on how to handle a febrile seizure. Your doctor may advise you to come to the office or to proceed directly to a hospital’s emergency department.
Understandably, unprepared parents and other caregivers who have never dealt with a seizure before will likely be compelled to call 911 when their child is having a seizure. In most cases, the seizure will have stopped by the time emergency medical personnel arrive. Even so, it is wise to have the child seen promptly either by the regular physician or in the hospital’s emergency department.
- It is important to consider and exclude other causes of seizures. Although serious infections such as meningitis are infrequent, these should be ruled out with a careful medical evaluation.
- If a child should have another febrile seizure, the parents should understand that it is not necessary to automatically call 911. The home care measures should be followed.
- Even after a brief repeated febrile seizure, it is wise to take the child to the physician’s office or hospital emergency department for an examination.
- Call 911 for emergency medical transport in these cases:
- The seizure lasts more than 5 minutes.
- The child has serious trouble breathing or stops breathing.
- The child develops cyanosis (blueness of the skin) indicating insufficient oxygen in the bloodstream.
Medically Reviewed by a Doctor on 11/11/2016
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Thomas Rebbecchi, MD, FAAEM
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