Q: Our son is almost 2 years old. Last weekend, he suddenly had a seizure. The doctors said a fever caused the seizure. He seems perfectly fine now, but we're afraid it might happen again.
"A: Febrile seizures" are relatively common among children between the ages of 6 months and 6 years. About 1 in 25 children has at least one. The good news is that febrile seizures cause no lasting problems. They are harmless.
Febrile seizures are most likely to occur in the early part of an illness, often as the fever is rising. The seizure begins abruptly and may be the first sign the child is ill.
Though associated with fever, the cause of febrile seizures is unknown. It is difficult to avoid an event that is unpredictable and poorly understood. Attempting to prevent further febrile seizures by aggressively treating fever can make parents into thermometer-wielding, acetaminophen-dispensing neurotics.
We don't encourage the use of phenobarbital for simple febrile seizures. We, and many other doctors, think the side effects of this medication outweigh the benefits.
Likewise, we don't think the margin of success is large enough to warrant the use of diazepam in most cases, but you can discuss it with your child's doctor.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.