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All Seizures during a Febrile Illness is Not Epilepsy

Seizures triggered by a high body temperature are called febrile seizure (FS). About 5% of children under 5 years of age can have a seizure precipitated by fever due to any cause. They are usually linked to childhood illnesses, such as respiratory tract infections, tonsillitis, etc. Febrile seizures are not epilepsy. But children who have had febrile seizures have a slightly higher chance of developing epilepsy when they are older, than children in general. There are two types of FS with reference to its prognosis

Simple Febrile Seizures

Convulsions occurring with fever and fulfilling the following criteria:
  • Occurring between the ages of six months and five years.
  • Cause of fever is a systemic infection without CNS involvement.
  • Seizures are primary generalized tonic clonic (GTCS) of <15 minutes duration.
  • Fever is more than 38°C (100.4°F).
  • Single seizure during a single febrile illness.
  • Total number of such seizures in the child should not exceed six.
Children with Simple Febrile Seizures have no or extremely little chance to have epilepsy.


Complex Febrile Seizures

All other seizures which do not fulfill the above criteria are categorized as Complex Febrile seizures. Children with Complex Febrile Seizures are more prone to have epilepsy.


Seizures with Fever

Fever can precipitate seizures in people with epilepsy at any age. Seizures precipitated with fever person above 6 years age are labeled as seizures with fever. They are not febrile seizures.

First Aid

For GTCS the same and any other similar seizure (refer to First Aid), along with immediate focus on reducing the degree of fever and keeping it less than 37.8° C (100° F). This can be very quickly achieved by tap water (not cold water) sponging and antipyretics.
Most seizures terminate by the time any formal medical help is reached. However, if the convulsions are continuing (> 5 minutes), diazepam suppositories or intranasal midazolam can be given, however all should be taken as per advice of treating pediatrician. Children with febrile seizures must be seen by a pediatrician to diagnose and treat the cause of fever.