Ask Nurse Lynn: Febrile Seizures and PWS

Question:

Male, 1 year old, unknown subtype

My son was recently admitted to the emergency room by ambulance due to a seizure. Now he has never had a seizure before. While we were in the hospital, he had a second seizure. So, two seizures within four hours. After testing, they confirmed he had the flu A and that his seizures were febrile seizures. They told me the likelihood of him getting a seizure due to the temperature rise can happen. I asked them if he could have another seizure if he were to overheat, especially living in Arizona. They told me environment wouldn’t cause him to have another seizure, more of if he was sick and got a fever. I wanted to confirm with someone who has more knowledge about PWS.

Nurse Lynn’s Response:

Febrile seizures are usually caused by a fever from an illness, such as the flu or another infection, and often happen when the body temperature rises quickly. They are not usually caused by being in a warm environment. Fever happens when the body is fighting an infection, while overheating happens from hot weather, heavy clothing, or dehydration. Most febrile seizures are linked to illness, not to being outside on a hot day.

For children with PWS, temperature control can work differently. Many have trouble regulating body temperature because of differences in the part of the brain that controls heat and cooling. They may not sweat normally or show clear signs when they are too hot or too cold, and some may not develop a high fever even when sick. Because of this, families need to watch closely for changes in behavior, sleepiness, or discomfort that may signal illness or overheating.

Research shows that seizures, including febrile seizures, happen slightly more often in people with PWS than in the general population, with about one in ten affected at some point. Living in a hot state like Arizona also makes it important to have a simple safety plan. Keep your child in air-conditioned spaces during very hot days, dress them in light clothing, offer plenty of fluids, and avoid being outside during peak heat. If your child seems very tired, flushed, irritable, or is breathing fast, check their temperature and help them cool down.

When your child is sick, it is helpful to check their temperature more often and follow your doctor’s advice if it reaches 100.4°F or higher. Early care can help, since febrile seizures often happen when fever rises quickly. Because your child has had two seizures close together, this may be called a “complex febrile seizure,” which means close follow-up is important. It does not mean your child will develop epilepsy, but your pediatrician may recommend seeing a neurologist to be safe and to help answer questions.

Resource:

Prevalence and genotypic associations of epilepsy in Prader-Willi Syndrome: A systematic review and meta-analysis – PubMed

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