Mercury Rising

With sirens wailing, a mother learns about febrile seizures. Dr.Joseph Zanga of Loyola University Medical Center gives the advice every parent should know.

By Troya Yoder

I could feel the heat from Brittany's fever. She seemed to drift in and out of sleep. Slight twitches coursed through her body.

Suddenly, she stiffened.

Her eyes rolled back in her head. Her arms and legs began to thrash. A bluish color outlined her lips.

I screamed for my husband to call 911, while I tried desperately to still her body.

After three or four minutes her body calmed, but she remained entirely unresponsive.

Her breath returned in jagged gasps. A terrible thought kept running through my head: my beautiful, intelligent, sixteen-month-old daughter was likely brain damaged.

Minutes later, the paramedics rushed in, started her on oxygen, and loaded us into the ambulance.

Amidst the wailing sirens, a paramedic told me that Brittany probably had a febrile seizure. A what?

Febrile seizures are convulsions caused by fever, most common in children six months to five years old.

The statistics are hard to ignore: one in twenty-five children will experience at least one febrile seizure by their fifth birthday. However, a child's risk of having a febrile seizure decreases after his/her second birthday - and such seizures are extremely rare after the age of seven.

Experts don't know why some children have these seizures. Some think it's related to how fast the fever rises, and a genetically determined fever threshold unique to each child.

Dr. Joseph Zanga, MD, medical director of The Ronald McDonald Children's Hospital of Loyola University Medical Center, describes five basic characteristics of a typical febrile seizure:

• Brief, less than 15 minutes
• Generalized, the whole body is involved. Arms and legs jerk back and forth uncontrollably and the eyes roll back in the head
• The child loses ability to respond
• The child loses bladder and bowel contro
• Occurs only once during a twenty-four hour period in a child who has a fever

There is little a parent can do to prevent a febrile seizure. However, parents can protect their children from injuring themselves in a seizure.

The appropriate steps are:

• Lay the child on a solid, flat surface
• Remove any objects from the child's mouth (pacifier, food, etc.) to prevent choking
• Turn the child on his/her side to prevent saliva from pooling in the back of the throat
• Never put objects or your fingers in the child's mouth. Many parents worry that a child could swallow his/her tongue, but this is a myth.
• Do not restrain a child during a seizure
• Call for medical help immediately

"While frightening, febrile seizures are neither immediately, nor over the long term, dangerous to the child," said Dr. Zanga.

A recent study published in the New England Journal of Medicine (New England Journal of Medicine, 1998, 338: 1723-28.) found no significant differences between children who had one or more febrile seizures and children who did not in over a hundred indicators of:

• Academic progress
• Intelligence
• Behavior

This confirms previous studies that indicate febrile seizures do NOT cause:

• Death
• Brain damage or mental retardation
• Epilepsy
• Learning disabilities or decreased I.Q.

Approximately, one third of children who have had a febrile seizure will have another. Those who do have a second seizure have a fifty- percent chance of having at least one more.

Other factors increase a child's risk of additional seizures:

• The younger the child is at the time of the first seizure
• The lower the temperature at the time of the first seizure
• The earlier the seizure occurs in the course of an illness
• A family history of febrile seizures

Febrile seizures are largely unpreventable because they are often the first sign that a child has a fever. Some physicians recommend continual doses of an antipyretic such as acetaminophen at the first sign of fever in a child that has had a past febrile seizure. However, this treatment has not been found to prevent seizures.

Seizure suppression medications are often reserved for children with seizure disorders such as epilepsy. These medications can cause side effects, and are not generally recommended as treatment for febrile seizures.

Brittany's seizure, while traumatizing, offered an unexpected gift: it helped me ignore trivial worries and treasure each moment I share with my daughter.

Now three years old, Brittany has had no additional febrile seizures. She is a bright, outgoing and very stubborn little girl.

Thankfully, she has no recollection of that terrifying night that will haunt her parents forever.

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