My daughter had a febrile seizure. Will she develop epilepsy?

Febrile seizures (seizures during a fever) are common in children below the age of 5. Try not to worry. A young child who has a febrile seizure is hardly any more likely to develop epilepsy than a child who has never had one of these seizures.

A few factors do increase the likelihood of developing epilepsy by a small percentage:

• Abnormal child development before the febrile seizure
• Febrile seizures lasting longer than 15 minutes or more than one seizure in a 24-hour period
• Febrile seizures involving movement on only one side of the body
• Seizures without fever in a parent, brother, or sister

Even if your child has some of these factors, chances are good that she will not develop epilepsy.

Did my child inherit epilepsy?

Children may inherit epilepsy from their parents. It is known that children whose parents have seizures are at greater risk to develop epilepsy by age 25 than the general population. But many children with epilepsy have no family history of seizures, and many parents with epilepsy have children who never have seizures. Medical science is working on understanding all the possible causes of epilepsy. Right now it is known that certain syndromes, such as primary generalized seizures and benign rolandic epilepsy, tend to run in families. Research has even linked some syndromes to specific genes.

Should I tell my child that he has epilepsy?

Children should be told they have epilepsy. Social workers and psychologists have found that trying to hide the true nature of an illness often adds to the child's fear and confusion. The type and amount of information you give will depend on your child's age and maturity. The Epilepsy Foundation has books you can use to teach your child about epilepsy.

My son had one tonic-clonic seizure. Does he need antiepileptic medication?

Many children have seizures during their childhood. Not all seizures need to be treated with medication. In deciding whether to treat a seizure, the doctor generally will look at the chances that it will happen again. If the doctor finds abnormalities in an examination or in tests like an EEG or a CT scan, a recommendation for treatment is more likely. The decision also depends to some extent on factors in your child's life. For instance, children who participate in some sports could be injured if they had another seizure. These children may benefit more from treatment. On the other hand, seizure medicines can cause side effects such as problems with thinking or behavior that need to be considered. There is no simple answer. The decision about whether to prescribe medicine after one tonic-clonic seizure will require you and your doctor to consider and discuss many factors.

Can seizure medicines cause behavior problems in children?

Behavior problems have been reported, including hyperactivity, irritability, decreased attention span, memory problems, changes in sleep patterns, aggressiveness, and mood changes. Some medications are more likely than others to cause these problems, but they can occur with all major seizure medicines. They are usually more troublesome when higher doses are given, but sometimes they happen with very low doses. They are more likely if the child is taking more than one seizure medicine. The goal of epilepsy treatment is freedom from seizures without unwanted effects, so if your child has any changes in behavior while taking seizure medicine, talk to your doctor. A change may be possible that could help the situation.

Do kids with epilepsy have learning problems?

Children with epilepsy have a higher rate of learning disorders than the general public, but most children with epilepsy don't have learning problems. Some problems can result from seizures themselves: information may be missed, memory problems may keep information from being stored in the brain, or the child may have poor school attendance.

Other learning problems may be related to medication. If your child is having problems learning, speak with the teacher about obtaining an educational assessment. This assessment identifies the specific learning problem. Then interventions can be developed to improve your child's performance in school.

Will my child's seizures be controlled with seizure medicine?

Yes, there is a possibility that your child will remain seizure-free while taking medication. About two-thirds of all people with seizures achieve this goal. If the doctor says that your child's neurological exam is normal and there is no brain injury or abnormality, the chances are even greater. Individuals with the diagnosis of primary generalized epilepsy (especially primary generalized tonic-clonic seizures) have a high rate of seizure freedom. Your child's seizures are more likely to be well controlled if the doctor makes an accurate diagnosis and thus can choose the most appropriate medication.

Can my child outgrow epilepsy?

Most children will outgrow their epilepsy but it is hard for doctors to predict which ones. Children who have normal development, a normal EEG, and no seizures while they're taking medication have the best chance. So do children with certain types of epilepsy that are usually outgrown. These include the reflex epilepsies and benign rolandic epilepsy. Children with benign rolandic epilepsy routinely stop medications after age 15. Some who have just occasional seizures don't need medication at all.

My child wants to ride a bicycle and go swimming. Is that safe?

Some children with epilepsy who do things like bike-riding and swimming get injured, but so do children without epilepsy. You need to think about how much your child's risk will be increased and decide whether that increase is acceptable. It's good for your child to do as many "normal" activities as possible. Which ones are OK depends on the child, the type of seizures and how often they happen, whether the child has a warning before a seizure, and the surroundings in which the activity will take place. If your child always wears a bike helmet and doesn't ride in traffic, that should be pretty safe. Swimming in a pool with an adult watching closely is also not too risky for most children. Your doctor may be able to give you some advice, but only you and your child can decide how much increased risk is OK.

Can video games cause my child to have seizures?

There is no scientific evidence that video games cause epilepsy. It's possible that stress, fatigue, or hyperventilation (unusually fast or deep breathing) may trigger seizures during video games in some children with epilepsy. Video games also may trigger seizure activity in children with photosensitive epilepsy (seizures triggered by flashing lights or flickering images), but this affects only 3% of people with epilepsy. Most children with epilepsy should be able to play video games without any problems.

Should I tell the teacher that my child has epilepsy?

If your child does not have seizures during the day and is not experiencing any behavior or learning problems, you may not need to tell anyone at school. On the other hand, teachers certainly need to know about seizures that occur during the school day. The teacher also can play a vital role in helping to manage your child's epilepsy. Information about seizure activity, medication side effects, or any change in behavior during the school day will be very valuable for you and your doctor.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed: 3/1/04