Most of the time, a febrile seizure occurs the first few hours of a fever, during the initial rise in body temperature.
Giving your child medications
Giving your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) at the first indication of fever will help reduce the fever, but it won't necessarily prevent a seizure. And, there are some caveats to giving medications to young children. Medications won't shorten the course of infection, and low-grade fevers generally don't need treatment.
Additionally, there's always a question of safety when giving medications to young children. For example, aspirin may trigger a rare but potentially fatal disorder known as Reye's syndrome. And, while acetaminophen is generally safe, if you give a child too much, it can cause liver failure. Ask your doctor what medications he or she recommends and what the proper dosage is for your child's age and weight.
Making sure your child drinks plenty of fluids and is appropriately dressed — not overdressed — may help control the fever.
Prescription prevention medications
Rarely, prescription medications are used to prevent febrile seizures. Anticonvulsant medications such as phenobarbital and valproic acid (Depakene, Stavzor) can prevent febrile seizures when taken daily. However, the use of preventive medications isn't generally recommended. The risks of side effects — including learning difficulties, sleep problems, irritability, hyperactivity and respiratory difficulties — outweigh any benefit to the child. Doctors rarely prescribe these preventive medications because most febrile seizures are harmless and most children outgrow them without any problems.
Rescue or abortive medications, such as oral diazepam (Valium), lorazepam intensol or clonazepam (Klonopin), are often prescribed. These are administered only with subsequent seizures and generally only if the seizure persists longer than three to five minutes or if there are a cluster of seizures. Rectal diazepam (Diastat) also can reduce the risk of febrile seizures if taken at the time of a fever.
Jan. 24, 2012
- Febrile seizures fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm. Accessed Nov. 14, 2011.
- What do I do if my child has a febrile seizure? American Academy of Pediatrics. http://www.aap.org/publiced/BR_FebrileSeizures.htm. Accessed Nov. 14, 2011.
- American Academy of Pediatrics. Clinical practice guideline — Febrile seizures: Guideline for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127:389.
- Febrile seizures. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pediatrics/neurologic_disorders_in_children/febrile_seizures.html. Accessed Nov. 14, 2011.
- Bernard TJ, et al. Neurologic & muscular disorders. In: Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6585048. Accessed Nov. 13, 2011.
- Cendes F, et al. Vaccinations and febrile seizures. Epilepsia. 2011;52(suppl):23.
- Sullivan JE, et al. Fever and antipyretic use in children. Pediatrics. 2011;127:580.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 10, 2011.
- Nickels KC (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 21, 2011.
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