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Febrile convulsions - fits caused by fever

fever; febrile; convulsion; fit; seizure; epilepsy ;

A febrile convulsion is a convulsion, seizure or fit that occurs when a child has a fever. They occur in about 3% of children aged between 6 months and six years.The fit is almost always very brief (less than 2 - 5 minutes) and does not itself cause your child any harm

It is important to seek medical help if your child has a febrile convulsion to find out why the child has a fever and so that medical advice and treatment can be given.

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Why do they occur?

It is possible for anyone to have a fit if their brain is stressed enough, but some people are more likely than others to have one. The brains of some infants and young children are very sensitive to rises in body temperature. They may have a convulsion when they have a fever.

The fit usually occurs while the child's temperature is rising rapidly at the beginning of an illness and most often occurs on the first day of the illness.  It may be the first sign that your child is unwell.

Children are more likely to have a febrile fit if others in the family have had some.

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 only a very small risk of developing epilepsy in the future if they had a simple febrile convulsion.

What do they look like?

When a child has a fit they become unconscious, stiff or floppy, be unaware of their surroundings, their eyes may roll back and any part of their body may jerk or twitch. They may not breath smoothly for a minute or so, and may go blue around their lips, but this is not bad enough to harm them.

What do you do if your child has one?

  • lie your child on their sideLie your child on their side with their head in a neutral position. Never lie a person who is unconscious or having a fit, on their back.
  • Do not put anything inside their mouth - they cannot swallow their tongue.
  • Stay with your child during the convulsion which is usually less than 2 minutes. If someone else is there perhaps they could video the convulsion on their phone to show the doctor.
  • Do not give your child paracetamol or ibuprofen until your child is fully awake.
  • You could try to cool your child by removing outer clothing and putting a fan on if you have one. Do not use cold water, ice or put your child into a bath. If your child starts to shiver cover him with a light sheet. Shivering is the body's way of trying to raise the body temperature when it is exposed to cold air or water and this will push their temperature up again.
  • Seek medical help as soon as possible, eg. your local doctor or nearest hospital to find out why the fit has happened.

If the convulsion does not stop within five minutes call an ambulance.

Do not drive a car with your child in it if your child is still fitting. You will not be able to concentrate well enough to drive safely.

What should you do when it stops?

Your child may not wake up straight away so it is important to keep him/her lying on the side until fully awake. Stay with your child.

Do not put your child into a bath. Your child will not be awake enough to be able to sit safely.

Call an ambulance if your child does not wake within 20 - 30 minutes after the fit or if your child has more than one fit.

Will your child have another one?

Most children do not have more febrile convulsions; however some (about 30%) will within the next year. As your child gets older he or she will be less likely to have another fit.

Can you prevent your child having one?

There is no sure way of preventing febrile convulsions. 

  • The fit usually occurs when your child's temperature is going up - before you know your child is unwell.
  • The high temperature is usually caused by a viral infection and it is not possible to protect children from all viral infections.

You could try to lower a child's temperature when she is unwell, but this may not prevent another convulsion because often the fit happens before you know that a child has a fever.

Generally, children handle fever well, but you can do a few things to make your child more comfortable:

  • dress your child lightly or take off most of their clothes to allow cooling. Avoid fans and draughts.
  • encourage your child to drink clear fluids.  If your child isn’t hungry, that’s OK. The most important thing is to make sure he’s drinking enough to avoid dehydration.
  • Keep your child cool but do not allow shivering (cover your child's body with a sheet or light clothing if he starts to shiver). 
  • You could give your child medicine to control fever. This can lower a child's temperature but is unlikely to prevent another fit.
  • Do not place your child in a bath to bring her temperature down.
  • Tepid sponging (placing cloths that are wet with warm or cool water onto the child's skin) does not bring a child's temperature down for long; it will go back up as soon as the sponging is stopped. Sponging does not affect the part of the brain that controls temperature. Cool baths, sponging and fans can actually make your child more uncomfortable.

If your child has long febrile convulsions or has them often, your doctor may prescribe a medicine so they happen less often or to treat them when they occur.

Have a look at the topic Fever.

Will your child get epilepsy?

Most children who have febrile convulsions do not get epilepsy, but some children with epilepsy may have convulsions when they develop a fever.

You could have a look at the topic Epilepsy on the Raising Children Network site
 http://raisingchildren.net.au/

Medicines to reduce fever

Fever is one of the body's ways of fighting an infection. Many doctors recommend that children are not given medications to reduce their temperature unless it is very high.

These medications will make your child feel better from the fever but they

  •  do not treat the infection that caused the fever
  • do not prevent the seizure from happening.

Have a look at the topic Using paracetamol or ibuprofen - babies and children

Paracetamol

Paracetamol is the best medicine for fever.

  • Work out how much to give your child using the instructions on the bottle.
  • Be careful – there are many different products containing different strengths of paracetamol – check the dose on the bottle each time you give your child paracetamol.
  • You can give another dose 4 hours after the first dose. Do not give more than 4 doses in 24 hours.
  • Some cold products already contain paracetamol – so be careful when you work out whether to give paracetamol. If you are not sure, ask your pharmacist.

Ibuprofen

Ibuprofen (eg nurofen) is also used to lower fever.

  • Work out how much to give your child using the instructions on the bottle. 
  • Be careful: there are many different products containing different strengths of ibuprofen.  Check the dose each time you give your child ibuprofen.
  • Ibuprofen should be taken with food if possible. Paracetamol is safer if your child has been vomiting and not drinking.
  • Do not give more than 3 doses in 24 hours.

Reference and more to read 

Paediatric Emergency Department, Women's and Children's Hospital, South Australia 
http://www.wch.sa.gov.au/ 

Raising Children Network 
http://raisingchildren.net.au/ 

The Sydney Children's Hospitals Network 
http://www.schn.health.nsw.gov.au/ 

Pregnancy, birth and baby 
http://www.pregnancybirthbaby.org.au

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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