From the Guidelines
Febrile seizures occur during sleep in an unknown percentage of cases, as there is no recent, high-quality study that provides a specific percentage. Most febrile seizures happen when a child's temperature rises rapidly during the early stages of a fever, which can occur at any time of day or night 1. Sleep may be a vulnerable period because temperature regulation changes during sleep, and the threshold for seizures may be lower during certain sleep stages. Additionally, parents might not notice the initial fever symptoms when a child is sleeping, allowing the temperature to rise higher before intervention. It's essential to note that while febrile seizures can be frightening to witness, they are generally benign and don't cause brain damage. If your child experiences a febrile seizure during sleep, place them on their side in a safe area, don't put anything in their mouth, and seek medical attention, especially for a first seizure. Fever management with appropriate doses of acetaminophen or ibuprofen (as recommended by a healthcare provider based on the child's weight) may help alleviate symptoms, but it has not been definitively proven to prevent febrile seizures 1.
Some key points to consider:
- Febrile seizures are a common benign condition in childhood, affecting approximately 2% to 4% of children 1.
- The use of antipyretics, such as acetaminophen or ibuprofen, can help children feel better but will not prevent subsequent seizures 1.
- The most recent guidelines recommend that EMS be activated for prolonged seizures, respiratory distress, seizures with associated traumatic injuries, seizures occurring in the water, and seizures associated with choking events 1.
In terms of prevention, there is no proven method to prevent febrile seizures, but managing fever with appropriate doses of acetaminophen or ibuprofen may help alleviate symptoms 1. It's crucial to follow the recommended dosage and consult with a healthcare provider for guidance on fever management and seizure prevention. The American Heart Association and American Red Cross guidelines for first aid recommend placing the person on their side in a safe area and seeking medical attention if necessary 1.
From the Research
Febrile Seizures During Sleep
- Febrile seizures are a common seizure disorder in childhood, occurring in 2-5% of children 2
- The risk of developing epilepsy is extremely low, and there is no evidence that recurrent simple febrile seizures produce structural central nervous system damage 2
- Complex febrile seizures can be life-threatening, and a child with a history of complex febrile seizures can die suddenly and unexpectedly after a suspected seizure while in bed at night during the beginning phases of sleep 3
Frequency of Febrile Seizures During Sleep
- There is limited information available on the frequency of febrile seizures occurring during sleep
- One study reported a case of a child with complex febrile seizures who died suddenly and unexpectedly after a suspected seizure while in bed at night during the beginning phases of sleep 3
- However, this study does not provide information on the frequency of febrile seizures during sleep in the general population
Prevention and Treatment of Febrile Seizures
- Intermittent diazepam and continuous phenobarbitone have been shown to reduce the recurrence rate of febrile seizures 4, 5
- However, the potential toxicities associated with antiepileptic therapy outweigh the relatively minor risks associated with simple febrile seizures, and long-term treatment is not recommended 2
- Parents and families should be supported with adequate contact details of medical services and information on recurrence, first aid management, and the benign nature of the phenomenon 4, 5