Explaining febrile convulsions

Question 1

What is a febrile convulsion?

Answer 1

Seizure that occurs in some children with a high temperature (fever).
Most occur with common illnesses such as ear infections, tonsillitis, colds, and flue.

Question 2

How common are febrile convulsions?

Answer 2

About 5 in 100 children have a febrile seizure sometime before their 6th birthday.
Most commonly occur in children aged 3 months to 6 years.

Question 3

What does a febrile convulsion look like?

Answer 3

• Simple febrile seizure is the most common type
• Occurs early in the illness when the child’s temperature is beginning to rise
• Child may look hot and flushed
• Eyes may appear to roll backwards
• May appear dazed
• Body may go stiff and then twitch or shake
• Child becomes unconscious and unresponsive
• Child may also wet themselves during the seizure
• Children tend to feel sleepy afterwards

Question 4

What is a complex febrile seizure ?

Answer 4

• Seizure lasting >15 minutes
• Seizure recurs within 24h or within the same febrile illness
• Child is not fully recovered within 1 hour

Question 5

What should parents do when their child is having a febrile seizure?

Answer 5

• Note the time that the seizure started
• Lay the child on their side with their head tilted back slightly (in case they vomit)
• Do not put anything in their mouth or shake the child
• When the seizure stops, try to lower the child’s temperature (open the windows, take off their clothes)
• When the child has recovered, given them something to drink and some paracetamol or ibuprofen

Question 6

When should parents contact a doctor/seek medical attention?

Answer 6

• Call an ambulance if a seizure lasts >5 mins
• If it is the first time that the child has had a seizure
• If the child does not improve quickly once a short seizure is over (within an hour)
• Another seizure starts soon after the first one stops (within 24h)
• The child was not fully conscious before the seizure or 1h afterwards
• You are worried that the child may have a serious illness as the cause of the fever, such as meningitis

Question 7

What treatment is given to children after a febrile convulsion?

Answer 7

No treatment is usually needed for the seizure itself if it stops within 5 minutes

• Sometimes if a seizure lasts too long, we may give a medicine to stop it
• Medicine is called diazepam
• Usually given by putting it into the back passage

Question 8

Are febrile convulsions dangerous?

Answer 8

Although alarming, a febrile seizure in itself is not usually dangerous, and the vast majority of children make full recovery without further complications

Question 9

Can febrile convulsions be prevented?

Answer 9

No.

Medicines such as paracetamol can be given to bring down the fever to make the child more comfortable, but as it is not targeting the root cause of the fever it will not stop the febrile convulsion

Question 10

Will a febrile convulsion happen again?

Answer 10

The risk of another convulsion is 1 in 3
Higher risk of recurrence:
- <18 months
- Fever >39
- Shorter duration of fever before seizure
- Family history of febrile convulsions
- Once the child passes 3 years, the chance of another seizure is much less likely

Question 11

Is a febrile convulsion a type of epilepsy?

Answer 11

No
About 2 in 100 children who have a febrile seizure develop epilepsy later in childhood, this is very very slightly higher than the change of epilepsy developing in children who have not had a febrile seizure
But the most likely reason for this is that the number of children with both febrile seizures and epilepsy are more prone to having seizures, i.e. development of epilepsy is more due to their vulnerability to seizures rather than the febrile seizure itself