Keeping Kids Healthy
By Sally Robinson and Keith Bly

Seizures are frightening. Our identities are so tightly bound to the nervous pulses that generate our hopes, plans, fancies and fears that a seizure endangers our sense of self.

It is especially devastating when it occurs in one of our own children.

It is important for parents to remember that fewer than 1 in 10,000 children suffer from seizures, and some seizures are relatively harmless, even though they are frightening.

Seizures triggered by a fever (febrile seizures) occur in less than 5 percent of children between the ages of 6 months and 5 years. And in almost all cases, after a febrile seizure, the child quickly returns to normal.

These seizures occur during the first few hours of a fever. Signs are a strange expression, rolling eyes and stiffening and twitching of all four limbs. The child might be unresponsive with irregular breathing and have some skin discoloration.

Febrile seizures usually last less than a minute but can last up to 15 minutes. Episodes rarely occur more than once in a 24-hour period.

Parents should not fear the worst. According to the American Academy of Pediatrics, these seizures do not cause long-term health problems, and they do not cause epilepsy, brain damage, nervous system problems, paralysis, mental retardation or death.

You can distinguish them from other seizures — non-febrile seizures — in that the latter last longer, might affect only one part of the body, and might occur more repeatedly.

If your child has a febrile seizure,

• Place the child on the floor away from hard or sharp objects;

• Turn the head to the side so that any saliva or vomit can drain from the mouth;

• Do not put anything into the mouth; your child will not swallow his or her tongue; and

• Call your pediatrician or 911 immediately.

Antipyretics — fever fighters like acetaminophen for infants less than 6 months of age or acetaminophen or ibuprofen for older children — will make them more comfortable but have no influence on the chance of avoiding a later seizure.

Doctors search for the cause of the fever not the cause of the seizure. Usually it will be a cold, flu or ear infection. Occasionally it might be more serious infections such as pneumonia or meningitis.

As with all fevers, if it is accompanied by conditions such as having been in an overheated car; seeming confused or drowsy; breathing with difficulty; or having a stiff neck, severe headache or vomiting, call your pediatrician or 911 at once.

Anti-seizure medications seldom prevent subsequent febrile seizures and often have side effects more serious than the seizures themselves. Untreated, the chance of further seizures decreases by half.

Of children younger than 1 year old at the time of their first febrile seizure, 50 percent might get another.

Of those who get a second, 50 percent might get a third.

Virtually all children grow out of febrile seizures by the age of 6, and there is no current evidence that having febrile seizures increases the chances of having other types of seizures later in life.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.