Understanding Febrile Seizures in Children: Debunking Myths about Paracetamol and Ibuprofen

A common question I’m asked when discussing fevers is whether paracetamol or ibuprofen can prevent a febrile seizure in children.

A febrile seizure is a convulsion or fit and can be terrifying to witness [especially if it is your own child] so it’s understandably something that parents want to avoid.

Febrile Seizures in Children and the Role of Paracetamol and Ibuprofen

However, it is a common misconception that you should use paracetamol or ibuprofen for preventing febrile seizures in kids. They’re caused by a sudden change in body temperature, NOT because of a fever [although they are usually associated with one].

They are not harmful to your child and although scary and alarming to see, they almost never cause harm, nor do they cause brain damage or create an increased risk of epilepsy.

It's important to be aware that Paracetamol and Ibuprofen do NOT prevent febrile seizures.

Data on Febrile Seizures and Antipyretics

Data collected from a literature search found that 22.7% of children who were given antipyretics (paracetamol and ibuprofen) and 24.4% who were given a placebo prevention, all had febrile seizures during a 1-2 year follow up period.

No statistically significant difference was found between the two groups and the research concluded that antipyretics were ineffective in reducing the recurrence of febrile seizures.

Managing Fever in Children: What Parents Need to Know

Most children will only ever have one febrile seizure, and whilst some may have more than one, it’s likely to be while they are unwell with an illness that causes a fever. 

Preventing febrile seizures in kids is not possible, as nothing can be done to stop them occurring. So if your child ever has a fever do not feel rushed or hurried to administer pain relief with the aim to prevent a febrile seizure. The goal with pain relief while they’re unwell is simply to keep your little one feeling as comfortable as possible. 

Ok so now that  you know that paracetamol and ibuprofen will not prevent a febrile seizure, here’s what to do during a febrile seizure:  

The most important thing is to stay calm – don't panic. There’s nothing you can do to stop it, but here are some practical steps to follow:

1. Stay Calm and Place Your Child Safely:

• Place your child on a soft surface, lying on their side or back.

2. Observe and Document:

• Try to watch exactly what happens, so that you can describe it to the doctor later.
• It can be useful if you are able to record video footage of the seizure to show the doctor.

3. Monitor the Duration:

• Time how long the seizure lasts, if possible.

4. Avoid Restraining:

• Do not restrain your child.

5. Be Mindful of the Mouth:

• Do not put anything in their mouth, including your fingers.
• Your child will not choke or swallow their tongue.

6. Avoid the Bath during Seizures:

• Do not put a child who is having a seizure in the bath to lower their temperature.

Conclusion: Educating Parents on Febrile Seizures and Medication

By staying informed about the realities of febrile seizures and the limitations of antipyretics, parents can approach fever management more confidently and effectively. If you have any concerns about your child's health, it's always advisable to consult with a healthcare professional.

Written on the 7th February 2024 by Nicole, a Paediatric Emergency Nurse and new mum.

As always, information on this website is for educational purposes only. Please consult your GP for information specific to your child.

References: https://www.ejpn-journal.com/article/S1090-3798(13)00065-2/fulltext