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Febrile Convulsions (Seizures)
Q: What is the cause of febrile convulsions? Will my three-year-old ever outgrow them? He has now had 12 convulsions.
A: Febrile convulsions (seizures) are actually very common. They occur in 2 to 4 percent of the population, most commonly between 18 months and 3 years of age, though they can occur as young as 6 months and as old as 5-6 years. The exact cause of febrile seizures is still not known, though we know that the young child's brain is less mature, and it's felt that the nerve cells in the brain are stimulated more easily by fever. The seizure, however, does not cause brain damage. Most children who have them are otherwise well, and only have one to three episodes over a year or two. Also, most children outgrow them by age five and do not go on to have epilepsy. If there is a history in the family of epilepsy, or if the child had any previous neurological or developmental problem, there may be a higher risk of going on to have epilepsy as he gets older. Medicine won't prevent him from developing epilepsy.
Unfortunately, it is difficult to prevent febrile convulsions. You certainly should use acetominophen or ibuprofen when your child has a fever, but febrile seizures usually occur at the beginning of an illness, as the fever is rising, so you may not have much warning. Children who have very frequent febrile seizures may need to take an anticonvulsant (an anti-seizure medicine, which will prevent the convulsions) for a year or two, until they outgrow them. You should talk with your pediatrician about whether or not this is an option for your child.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.