Will It Happen Again?
About 30 percent of children who have one febrile seizure will go on to have another. Having a febrile seizure demonstrates that fever can trigger a seizure in your child and that he may be prone to them in the future, at least until he outgrows them altogether. (A subsequent seizure without fever is a different matter and merits a thorough evaluation.) "Febrile seizures occur between 6 months and 6 years of age, and should not persist beyond then," says Dr. Joshi. Recurrence is more likely if there is a family history of febrile seizures, if your child's first febrile seizure was accompanied by a relatively low temperature, or if he was under 18 months old at the time.
Perhaps the most widespread misperception is that febrile seizures cause, or indicate, epilepsy -- a neurological disorder marked by recurrent, unprovoked seizures. "A child's risk of epilepsy may double after a febrile seizure, but only from about 1 percent to 2 percent," explains Dr. Joshi. She stresses that the overall risk remains very small. What's more, the slightly higher incidence of epilepsy among kids who have had a febrile seizure could be because some of them had undiagnosed underlying epilepsy. Dr. Joshi insists that a child who has a febrile seizure is, by and large, fine. "The vast majority of children who have simple febrile seizures will not develop epilepsy."
Eager to do anything I could to prevent ever witnessing another episode, my plan was simple: I''d never let Simone's fever get out of the gate. Her fever had registered at a scorching 106?F at the time of her seizure, and I figured all I had to do was shovel in the acetaminophen at the first sign of a warmish brow. Unfortunately, my strategy has a serious flaw: "While aggressive fever control is safe, studies have shown that it won't prevent febrile seizures," says Dr. Joshi. This seems not only unfair, but extremely nonsensical. Simone + High Fever = Seizure, thus Simone - High Fever = No Seizure. The reason it doesn't work that way is (again!) unknown but may be because while medication can lower the fever, the cytokines released by the illness are still zipping around and exciting the brain.
Simone has had many fevers since that night, but thankfully no more seizures. Still, I worry every time her temperature rises. The unpredictability is daunting, but I suppose parenthood is all about learning to live with this kind of uncertainty. For now, I'll keep telling myself what Dr. Joshi told me: "Your child is fine."