Fever Seizures
Topic OverviewFever seizures
(sometimes called fever convulsions or febrile seizures) can
occur in children who have a rapid increase in body temperature. You may not
even know that your child has a fever. The rapid increase in body temperature in a
short period of time may happen at the same time as the fever seizure. After a fever has reached a
high temperature, the risk of a seizure is probably over. Most children who
have a fever seizure have temperatures above
102°F (39°C). A
seizure is likely to be fever-related if:
- There is one seizure in a 24-hour period.
- The seizure lasted less than 15 minutes.
- The seizure affected the entire body, not just one side of the
body.
- The child is between 6 months and 5 years
old.
- The child does not have nervous system (neurological)
problems.
- The child has had fever seizures before.
Fever seizures affect 2% to 5% of children.
Children can have another seizure. The chance of another fever seizure varies
with age, but about 30% to 50% will have another within a year of the first
one. These seizures are not a form of
epilepsy. A child who is having a seizure
often loses
consciousness and shakes, moving his or her arms and
legs on both sides of the body. The child's eyes may roll back. The child may
stop breathing for a few seconds and might also vomit, urinate, or pass stools.
It is important to
protect the child from injury during a seizure. Fever seizures usually last 1 to 3 minutes. After the seizure, the child
may be sleepy. You can let the child sleep, but check him or her frequently for
changes in color or breathing, or for twitching arms or legs. The child also may
seem confused after the seizure, but normal behavior and activity level should
return within minutes of the seizure. Fever seizures can
be frightening, but they are not usually harmful to the child and do not cause
long-term problems, such as brain damage,
intellectual disabilities, or learning
problems. Check
your child's symptoms to decide if and when your child should see a
doctor. Check Your SymptomsHas your child had a fever seizure? Fever seizures are uncontrolled muscle spasms that can happen when a child's body temperature goes up quickly. How old are you? Less than 6 months Less than 6 months 6 months to 2 years 6 months to 2 years 7 years or older 7 years or older Is this your child's first seizure? Have the child's other seizures occurred during the same illness (within the past day or so)? Yes Seizures occurred during same illness No Seizures occurred during same illness Has the seizure lasted more than 3 minutes? Yes Seizure lasting more than 3 minutes No Seizure lasting more than 3 minutes Are the symptoms severe, moderate, or mild? Moderate Moderate dehydration Is your child having trouble drinking enough to replace the fluids he or she has lost? Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids. Yes Unable to drink enough fluids No Able to drink enough fluids Is your child having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than stuffy nose No Difficulty breathing more than stuffy nose Would you describe the breathing problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Does your child have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness Yes Symptoms of a joint infection No Symptoms of a joint infection Yes Sudden appearance of red or purple spots or bruising No Sudden appearance of red or purple spots or bruising Does your child have pain? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Do you think your child has a fever? Did you take your child's temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild Does your child have a health problem or take medicine that weakens his or her immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Sudden tiny red or purple spots or
sudden bruising may be early symptoms of a serious
illness or bleeding problem. There are two types. Petechiae (say "puh-TEE-kee-eye"): - Are tiny, flat red or purple spots in the skin or
the lining of the mouth.
- Do not turn white when you press on
them.
- Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
- May spread over a large area of the body within a few hours.
- Are different than tiny, flat red spots or birthmarks that are
present all the time.
Purpura (say "PURR-pyuh-ruh" or “PURR-puh-ruh”): - Is sudden, severe bruising that occurs for no clear
reason.
- May be in one area or all over.
- Is different
than the bruising that happens after you bump into something.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues: With a high fever: - The child feels very hot.
- It is likely
one of the highest fevers the child has ever had.
With a moderate fever: - The child feels warm or hot.
- You are
sure the child has a fever.
With a mild fever: - The child may feel a little warm.
- You
think the child might have a fever, but you're not sure.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
Symptoms of difficulty breathing can range from mild to severe. For example: - You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example: - The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
- The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Severe trouble breathing means: - The child cannot eat or talk because he or she is
breathing so hard.
- The child's nostrils are flaring and the belly
is moving in and out with every breath.
- The child seems to be
tiring out.
- The child seems very sleepy or confused.
Moderate trouble breathing means: - The child is breathing a lot faster than
usual.
- The child has to take breaks from eating or talking to
breathe.
- The nostrils flare or the belly moves in and out at times
when the child breathes.
Mild trouble breathing means: - The child is breathing a little faster than usual.
- The child seems a little out of breath but can still eat or talk.
Symptoms of heatstroke may
include: - Feeling or acting very confused, restless, or
anxious.
- Trouble breathing.
- Sweating heavily, or not
sweating at all (sweating may have stopped).
- Skin that is red,
hot, and dry, even in the armpits.
- Passing
out.
- Seizure.
- Nausea and vomiting.
Heatstroke occurs when the body can't control its own
temperature and body temperature continues to rise. Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever. Symptoms of dehydration can range from mild to
severe. For example: - The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).
- The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - The baby may be very sleepy and hard to wake
up.
- The baby may have a very dry mouth and very dry eyes (no
tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means: - The baby may have no wet diapers in 6 hours.
- The
baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means: - The baby may pass a little less urine than usual.
Severe dehydration means: - The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more
hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The
child may pass out.
Moderate dehydration means: - The child may be a lot more thirsty than
usual.
- The child's mouth and eyes may be drier than
usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means: - The child may be more thirsty than
usual.
- The child may pass less urine than usual.
Symptoms of serious illness in a baby
may include the following: - The baby is limp and floppy like a rag doll.
- The baby doesn't respond at all to being held, touched, or talked
to.
- The baby is hard to wake up.
Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
Symptoms of a joint infection may
include: - Severe
pain.
- Swelling.
- Sudden redness over or around the
joint.
- Warmth in or around a joint.
- Not being able to
move the joint because of pain or swelling.
- Pus draining from the
area.
Pain in children 3 years and older - Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature. Oral (by mouth), ear, or rectal temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate. Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seizures Home TreatmentProtect your child from injury
during a seizure: - Ease the child to the floor, or lay a very small
child facedown on your lap. Do not restrain the child.
- Turn the
child onto his or her side, which will help clear the mouth of any vomit or
saliva. This will help keep the tongue from blocking the air passage so the
child can breathe. Keeping the head and chin forward (in the same position as
when you sniff a flower) also will help keep the air passage
open.
- Loosen clothing.
- Do not put anything in the
child's mouth to prevent tongue-biting. This could cause
injury.
- Try to stay calm, which will help calm the child. Comfort
the child with quiet, soothing talk.
- Time the length of the seizure
and pay close attention to the child's behavior during the seizure so you can
describe it to your child's doctor.
Check your child for injuries after the seizure: - If the child is having trouble breathing, turn
his or her head to the side and, using your finger, gently clear the mouth of
any vomit or saliva to aid breathing.
- If the child does
not need to see a doctor right away, put him or her in a cool room
to sleep. Sleepiness is common following a seizure. Check on the child often.
Normal behavior and activity level should return within minutes of the
seizure.
If your child has had a fever seizure in the past and you have
talked with your child's doctor about how to care for your child after a
seizure, be sure to follow the doctor's instructions. For home treatment of a
fever, see the topic
Fever or Chills, Age 11 and Younger. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Other symptoms of illness develop, such as an infection.
- Symptoms become more severe or frequent.
PreventionThe best way to prevent fevers is to reduce
your child's exposure to infectious diseases.
Hand-washing is the single most important prevention
measure for people of all ages. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You may feel upset
after seeing a
fever seizure. Stay calm. You can help your child's
doctor diagnose and treat your child's condition by being prepared
to answer the following questions: - What is the history of the fever?
- When did the fever start?
- Did it
come on suddenly or increase over several hours?
- How high is the
fever?
- Does the child have any other symptoms?
- Does your child have frequent fevers? How long do
they usually last?
- How was the child's health and behavior before
the seizure?
- Had the child had an accident or an injury before the
seizure?
- What happened during the seizure?
- What kind of
body movements were there?
- How long did the seizure
last?
- How did the child act immediately after the
seizure?
- Have you noted any injuries from the
seizure?
- Has the child ever had a seizure before?
- What
other health problems, if any, has the child had over the past 3
months?
- Has your child been eating, drinking, and playing
normally?
- What home treatment measures, including nonprescription
medicines, have you used? Did they help?
- Does your child have any
health risks?
Ask your child's doctor what you can do to prevent
another seizure and what to do if another seizure occurs. ReferencesOther Works Consulted- American Academy of Pediatrics (2008). Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures. Elk Grove Village, IL: American Academy of Pediatrics.
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerH. Michael O'Connor, MD - Emergency Medicine David Messenger, MD Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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