Febrile Convulsions

What are febrile convulsions?

Convulsions are also called seizures. Febrile convulsions are seizures triggered by fever. They are the most common type of convulsion and are usually harmless. The average body temperature at which they occur is 104°F (40°C). The fever itself can be caused by an infection in any part of the body.

Children who have febrile convulsions are usually 6 months to 5 years old. A child's first febrile convulsion usually occurs by 3 years of age.

During a convulsion, your child may:

• become stiff
• become unconscious or not know where they are
• have jerking or twitching movements
• have the eyes roll backward
• have noisy breathing
• after the seizure, your child may be sleepy and confused for a while.

How long will the effects last?

Each convulsion usually lasts 1 to 10 minutes without any treatment. Febrile convulsions do not cause any brain damage. However, a few children (3%) will have convulsions without fever sometime in the future.

Febrile convulsions occur in 4% of children. Most of these children have just one febrile convulsion in a lifetime. About one-third of children who have had a febrile convulsion have 1 to 3 recurrences over the next few years. Febrile convulsions usually stop happening by the time a child is 5 or 6 years old.

What should I do when my child has a convulsion?

• Reduce the fever.

  Bringing your child's fever down as quickly as possible may shorten the seizure. Remove your child's clothing and apply cold washcloths to the face and neck. If the seizure persists, sponge the rest of the body with cool water. As the water evaporates, your child's temperature will fall. When the convulsion is over and your child is awake, give the usual dose of acetaminophen or ibuprofen for your child's weight and age, and encourage your child to drink cool fluids.

• Protect your child's airway.

  If your child has anything visible in the mouth, clear it with a finger to prevent choking. Place your child on the side or stomach (face down) to help drain secretions. If the child vomits, help clear the mouth. Use a suction bulb if available. If your child's breathing becomes noisy, pull the jaw and chin forward.

Call a rescue squad (911) IMMEDIATELY if the febrile convulsion continues more than 5 minutes.

• Driving to a medical facility.

  Drive to a medical facility for all other febrile convulsions. Dress your child lightly (weather permitting). (Warning: Prolonged seizures due to persistent fever have been caused by bundling up sick infants during a long drive.)

• Common mistakes in first aid of convulsions.

  During the convulsion, don't try to restrain your child or stop the seizure movements. Once started, the seizure will run its course no matter what you do. Don't try to resuscitate your child just because breathing stops momentarily for 5 to 10 seconds. Instead, try to clear the airway. Don't try to force anything into your child's mouth. This is unnecessary and can cut the mouth, injure a tooth, cause vomiting, or result in a serious bite of your finger. Don't try to hold the tongue. Children may rarely bite the tongue during a convulsion, but they can't swallow the tongue.

How can I take care of my child?

• Oral fever-reducing medicines

  Febrile convulsions usually occur during the first day of an illness. Although research is lacking, preventing high fevers may prevent some febrile seizures. Begin acetaminophen (Tylenol) or ibuprofen (Advil) at the first sign of any fever (a temperature over 100°F, or 37.8°C) and give it continuously for the first 48 hours of the illness. If your child has a fever at bedtime, awaken him once during the night to give the fever medicine.

  Because fever is common after DTaP immunizations, begin acetaminophen or ibuprofen in the health care provider's office when your child is immunized and continue it for at least 24 hours.

• Fever-reducing suppositories

  Have some acetaminophen suppositories on hand in case your child ever has another febrile seizure (same dosage as oral medicine). These suppositories may be kept in a refrigerator at the pharmacy, so you may have to ask for them.

• Light covers or clothing

  Avoid covering your child with more than one blanket when they are sick. Bundling during sleep can push the temperature up 1 or 2 extra degrees.

• Lots of fluids

  Keep your child well hydrated by offering plenty of fluids.

How can I help prevent convulsions?

The only way to prevent future febrile convulsions completely is for your child to take an anticonvulsant medicine on a daily basis until the age of 3 or 4 years. Because anticonvulsants have side effects and febrile seizures are generally harmless, anticonvulsants are rarely prescribed unless your child has other neurologic problems. Your health care provider will discuss this decision with you.

When should I call my child's health care provider?

Call your doctor's office IMMEDIATELY after the seizure is over.