Portland, Ore.

Evidence-based study also dispels myths and provides advice for parents

Watching a child have a seizure can be frightening for parents, especially when that child appears only to have a high fever. Pediatric emergency physicians at Oregon Health & Science University's Doernbecher Children's Hospital have used evidence-based medicine to effectively evaluate and manage these seizures, while also providing good advice for parents. These seizures, known as febrile seizures, are common in children younger than 5 and generally harmless. Doernbecher pediatric emergency physicians treat four to five children with these fevers each week. The team's review paper, "Evaluation and Management of Febrile Seizures in the Out-of-Hospital and Emergency Department Setting," is published in the February 2003 edition of the Annals of Emergency Medicine.

"Simple febrile seizures brought on by high fevers are not only common in young children, but they are also terrifying for parents," said Craig Warden, M.D., M.P.H., chief of pediatric emergency medicine at OHSU's Doernbecher Children's Hospital, associate professor of emergency medicine and pediatrics in the OHSU School of Medicine, and a parent himself.

The team's review of more than 50 scientific articles on febrile fevers provides an evidence-based study of the evaluation and management of simple febrile seizures for emergency medical personnel and offers sound advice to parents facing this frightening, but generally harmless condition.

"Our paper not only provides an overview of the current science, but we also present the strongest evidence to date on what parents should know regarding this condition, and we dispel any myths or misinformation that may be circulating," said Warden.

Here's some information and advice to parents :

• Febrile seizures often occur in the first 24 hours of a febrile illness and only occur once during that time period. If the seizure lasts more than one to two minutes, or if the seizure recurs, your child should be evaluated immediately. If the seizure is shorter, you should call your primary care provider for advice.
• Signs and symptoms of febrile seizure include: body stiffening; face, arm and leg twitching; eye rolling; jerking of the arms and legs; staring; or loss of consciousness.
• Febrile seizures generally last fewer than 60 seconds, but can last up to 15 minutes.
• If your child's skin color becomes darker or if he/she appears not to be breathing, call 911 or emergency personnel and lay the child on the floor on his or her back. DO NOT place your fingers or anything else in your child's mouth.
• Febrile seizures do not cause brain damage or paralysis.
• A child who has a febrile seizure has only a slightly increased risk of having a seizure disorder compared with that of a child who has never had a febrile seizure.
• Febrile seizures tend to run in families.
• Febrile seizures can recur when a child has another fever. Medicines are generally not prescribed to prevent febrile seizures.
• Use of medicines such as acetaminophen or ibuprofen for fevers has not been shown to prevent febrile seizures.

Doernbecher Children's Hospital is a Level 1 pediatric trauma center and provides comprehensive pediatric emergency services for more than 15,000 children each year.

Annals of Emergency Medicine is the peer-reviewed journal of the Dallas-headquartered American College of Emergency Physicians, a national medical organization with nearly 23,000 members. ACEP is committed to improving the quality of emergency care through continuing education, research and public education.

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