Your Next Move
Any child who has a seizure should be evaluated by a doctor, but there's no need to rush to the E.R. unless she injures herself or stops breathing while seizing or if the seizure doesn't end within 15 minutes. Call your doctor as soon as the seizure is over. You'll be asked questions to determine whether your child needs to be seen right away. Of course, given the horrifying spectacle of a seizure, it's common for parents to panic and dial 911. But in my case, by the time the paramedics arrived my daughter was no longer blue, her fever was down, her color had returned, and she was actually smiling. Simone slept through the entire exam, spent.
At the hospital or clinic, the workup will focus on finding the source of infection. Your doctor may run blood tests and take a urine sample. There's a perception that seizures are often a sign of meningitis, but this is untrue. "Simple febrile seizures are rarely caused by bacterial infections of the brain," says Dr. Joshi. The American Academy of Pediatrics recently changed its guidelines to reflect this and only recommends a post-seizure spinal tap for children who have other symptoms of meningitis (like a rash or neck stiffness), or are difficult to arouse and irritable. A spinal tap may also be considered for kids who are at increased risk because of their young age and/or because they haven't been immunized against Hib and streptococcus pneumonia. (These are the two most common causes of bacterial meningitis.)
Doctors will also do additional testing if a child's seizure lasts longer than 15 minutes or is limited to one side of the body. This is called a "complex" rather than a "simple" febrile seizure. Other causes for concern are confusion or lethargy that persists for more than an hour or two, or another seizure within 24 hours.