A febrile seizure is a common event in childhood, characterized by a convulsion that occurs when a child has a fever. It can be a distressing experience for parents to witness, often leading to concerns about lasting harm. However, typical febrile seizures generally do not cause brain damage. These seizures are usually brief and are considered benign, meaning they do not lead to long-term health problems or affect a child’s development.
What Are Febrile Seizures?
Febrile seizures are bursts of abnormal electrical activity in a child’s brain, triggered by a fever. They typically affect children between the ages of 6 months and 5 or 6 years, with most occurring in the first three years of life. A fever is generally defined as a temperature of 100.4°F (38°C) or higher. The seizure may be the first sign a child is ill.
The physical presentation of a febrile seizure can include:
Uncontrollable shaking of the arms and legs
Stiffening of the body
Loss of consciousness
Eyes rolling back
Difficulty breathing
Foaming at the mouth
Loss of bladder or bowel control
Febrile seizures are categorized into two types: simple and complex. Simple febrile seizures are the most common, involving generalized full-body convulsions, lasting less than 15 minutes, and occurring only once within a 24-hour period. Complex febrile seizures, which are less common, may last longer than 15 minutes, affect only one part of the body, or occur multiple times within 24 hours.
Do Febrile Seizures Cause Brain Damage?
A common and understandable concern for parents is whether a febrile seizure can lead to brain damage. The medical consensus is that typical febrile seizures, particularly simple ones, do not cause brain damage, intellectual disability, or learning problems. These seizures are distinct from other types of seizures, like those seen in epilepsy, and the brain’s activity during a simple febrile seizure is usually too short to cause lasting harm.
Studies confirm simple febrile seizures do not affect a child’s cognitive development, intelligence, or learning abilities. The brain typically recovers fully without any long-term consequences. In very rare instances, febrile seizures that are exceptionally prolonged, lasting more than 30 minutes, a condition known as febrile status epilepticus, might lead to some brain changes. However, these prolonged events are uncommon, and prompt medical intervention can often prevent such outcomes.
When Medical Help Is Needed
While most febrile seizures are harmless, parents should know when to seek immediate medical attention. If a child is experiencing their first seizure, it is advisable to contact a healthcare provider or visit an emergency department to confirm it is indeed a febrile seizure and rule out other causes.
Immediate emergency medical care should be sought if the seizure lasts longer than five minutes. Call emergency services if the child has trouble breathing, their skin or lips appear blue, or they do not respond normally or recover quickly after the seizure. Other warning signs include signs of severe illness, such as a stiff neck, extreme lethargy, or an unusual rash.
What to Expect in the Future
The long-term outlook for children who have experienced febrile seizures is positive. Most children outgrow febrile seizures by age 5 or 6. Recurrence is possible, with about one in three children experiencing another one. This often occurs within a year of the first seizure. Factors that may increase the likelihood of recurrence include a younger age at the time of the first seizure, a family history of febrile seizures, or a short interval between the onset of fever and the seizure.
Febrile seizures should be differentiated from epilepsy. Most children who have febrile seizures do not develop epilepsy. While there is a slightly increased risk of developing epilepsy compared to the general population, this risk remains low, and for children with simple febrile seizures, the risk of developing epilepsy is similar to that of any other child. Even with complex febrile seizures, or if there is a pre-existing neurological condition, the overall risk is still small. Children who experience febrile seizures typically continue to develop normally without long-term health consequences.