Febrile Convulsion

Febrile means "related to fever". A febrile convulsion is triggered off by a rapidly rising temperature (to over 38°C).


A febrile convulsion is a common medical condition. Approximately three percent of children aged 6 months to 6 years have a convulsion when they have a fever or high temperature.

A febrile convulsion is a seizure (a 'fit') which occurs in some children when they have a fever (high temperature). The vast majority of febrile convulsions are not serious.

Full recovery with no permanent damage is usual.


About 3 in 100 children have a febrile convulsion sometime before their 6th birthday. They most commonly occur between the ages of 18 months and 3 years. They are rare in children under 6 months old, and virtually never occur over the age of 6 years.


Any illness which causes a fever (high temperature) can cause a febrile convulsion. Most occur with common illnesses such as ear infections, coughs, colds, flu, and other virus infections. Serious infections such as pneumonia are less common causes.


It is unclear why children of this particular age have these convulsions, although the children do have a raised temperature. Conditions commonly causing fevers include middle-ear infection (otitis media), tonsillitis, kidney or urinary infection, pneumonia and any of the common infectious diseases of childhood such as measles, mumps, chicken pox and whooping cough. The common cold or flu can sometimes also be a trigger. 


What happens?

The febrile convulsion or fit happens when the normal brain activity is disturbed. It usually occurs without warning. During the fit your child may:

·         become stiff or floppy

·         become unconscious or unaware of their surroundings

·         display jerking or twitching movements

·         have difficulty breathing.


What can the doctors do for my child?

Your child's fit may stop without any medical treatment. If it does not stop within 5 minutes, the doctor will need to manage the fit and ensure it is treated quickly.


Can my child get another convulsion the next time they have a fever?

Yes. The chance of having another febrile convulsion in the following year is 30%, but this means that 70% (or 7 out of 10 children) will not have another fit. The risk of a second fit reduces every year and it becomes extremely rare after they turn 6 years old.


What does the future hold for my child?

The outlook for a child with simple febrile convulsions is excellent. There is no evidence of "brain damage" in these children. Your child is at no greater risk of developing epilepsy in the future than children who have not had a febrile convulsion.


What should I do when my child develops fever in the future?

To reduce the fever you can use medicines, such as paracetamol (Panadol, Dymadon or Tylenol) as directed. Remember that these medications will make your child feel better from the fever but they do not treat the infection that caused the fever. These medicines do not prevent the fit from occurring. You should take your child to see your local doctor if your child looks unwell or if the fever persists.


What should I do if my child has a convulsion in the future?

Remember, most fits will stop within seconds or a couple of minutes without any medical treatment.

·         Stay calm.

·         Look at your watch or a clock and time the convulsion.

·         Do not try to restrain your child and do not put anything in their mouth.

·         Stay with your child and lie them on their side.

·         Loosen tight clothing from around the neck and move objects away that may cause injury.

·         Arrange to see your local doctor/general practitioner after the convulsion has stopped.

Call an ambulance if:

·         the fit last more than 5 minutes

·         another fit starts up after the first one stops

·         your child has difficulty breathing or looks particularly unwell.


Why is my child sleepy after the episode?

Your child's brain will become tired after the fit and your child will need time to recover. If your child remains drowsy or difficult to rouse after sleep, you should seek medical attention.

Is there any treatment available if my child has more frequent febrile convulsions at home?

There is a medication called Diazepam that is sometimes recommended for children who have frequent febrile convulsions or if the child has a history of febrile convulsions that last longer then 5 minutes. Most children do not require this medication. If you would like more information about this treatment you should talk with your doctor. 


Are there any other medications available to prevent febrile convulsions?

Yes, however these medications have to be taken every day and they can have serious side effects. Because the outlook for children with febrile convulsions is so good, these regular medications are rarely necessary.


Treating a Febrile Convulsion

If your child has a febrile convulsion, act immediately to prevent injury:

·         Place him on the floor or bed away from any hard or sharp objects.

·         Turn his head to the side so that any saliva or vomit can drain from his mouth.

·         Do not put anything into his mouth; he will not swallow his tongue.

·         Call for emergency medical help if the convulsion lasts more than two or three minutes or is particularly severe (difficult breathing, choking, blueness of the skin, several in a row).


What help is needed?

It is important to prevent the temperature rising further and to try to bring it down. Remove clothing and sponge the child all over with tepid (not cold) water. Direct cool air on to the child by fanning. As soon as possible turn the child on his/her side to ease breathing. The child may be confused after the convulsion and need reassurance. Talk to the child throughout, as hearing will be the first sense to return.


Do's and Dont's for febrile convulsions

Do keep calm, cool your child, turn your child on to his/her side, reassure your child, and get medical help promptly.

Do keep a good, easy-to-read thermometer in the house, and Calpol or junior paracetamol (NOT aspirin) to reduce temperature in your child.

Do call your GP if you are worried.

Don't give a child with a fever, extra clothes and blankets, or a hot water bottle.

Don't panic - most convulsions are quickly over and do not create long-term problems.


Does a febrile convulsion cause any permanent damage?

Usually not. Full recovery is usual with no after effects. (Sometimes the infection causing the convulsion causes complications, but the convulsion itself does not usually cause any damage.) Rarely, a long convulsion which lasts 30 minutes or more may cause some injury to the brain.


Is a febrile convulsion a type of epilepsy?

No. The cause of a febrile convulsion is related to the fever and is not due to any brain abnormality. Epilepsy causes convulsions (seizures or fits) without fever.

About 1 in 100 children who have a febrile convulsion develop epilepsy in later childhood. This is similar (slightly higher) to the chance of epilepsy developing in children who have not had a febrile convulsion. So, febrile convulsions are not thought to be a cause of epilepsy.




Compilation Courtesy : Aparna Chatterjee

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