Q: My 29-month-old had a febrile seizure and now has seizures without fever. Should we go to a university hospital?

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Question:

My 29-month-old child had a high fever of over 40 degrees Celsius for 5 days due to tonsillitis. On the second day, my child had one febrile seizure. After the fever went down, my child suddenly started falling forward or backward while standing or sitting. A day later, my child had two more seizures, but this time without a fever.

We are currently hospitalized for tonsillitis. The doctors here say the tonsillitis is improving and that we can be discharged tomorrow. They told us not to worry about the seizures and said it was nothing major, but offered to write a referral letter for an EEG at a university hospital upon discharge tomorrow if we wanted one.

Even though they told me not to worry, I am very anxious. My baby almost fell out of the wheelchair earlier, which makes me even more nervous. Right now, my baby has been sleeping for over 3 hours. I don't know if it's better to just watch and wait, or if I should get the referral right now and go to a university hospital immediately.

This is the first time my child has ever had a febrile seizure, the first time collapsing/falling over like this, and the first time having a seizure without a fever. Could this be an aftereffect of the high fever? Will it get better over time?

Answer:

You must have been really shocked going through 5 days of high fever and even seizures.

【Current Situation Summary】

• Tonsillitis is improving + fever has gone down

• 1 febrile seizure (during fever) → 2 seizures without fever + suddenly falling forward/backward

• Currently sleeping for over 3 hours

【What to Check Immediately】

If you see any of the following → Notify the on-call doctor right now

• Difficult to wake up, or responses are different from usual when woken up

• Irregular breathing or abnormal facial/lip color

• Seizures restart or trembling on only one side of the body

• Walking/balance is much worse than usual after waking up

If there are none of the above symptoms and the child wakes up and responds as usual → You can double-check with the attending physician tomorrow morning before discharge.

【Why Seizures Without Fever are Concerning】

• Febrile seizures typically appear only during a fever

• 2 seizures after the fever has gone down + sudden falling is a different pattern from a simple febrile seizure

• EEG and neurological evaluations may be necessary

Please observe carefully and discuss with your attending physician whether an evaluation by a pediatric neurologist is needed.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us