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Febrile convulsions - fits caused by fever

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

A febrile convulsion is a convulsion 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 minutes) and does not 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.

Contents

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.

What do they look like?

When a child has a fit they become unconscious, 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 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.
  • Stay with your child during the convulsion which is usually less than 2 minutes.
  • Do not give your child paracetamol or ibuprofen until your child is fully awake.
  • Try to cool your child by removing outer clothing and putting a fan on (if available). Do not use ice or put your child into a bath. If your child starts to shiver cover him with a light sheet to slow down cooling. Shivering is the body's way of trying to raise the body temperature when it is exposed to cold air or water.
  • 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.

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 will (25-30%).

How do you prevent your child having one?

There is no sure way of preventing febrile convulsions. 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.

  • Undress your child down to nappy/underpants.
  • Keep the child cool but do not allow shivering (cover your child's body with a sheet or light clothing if he starts to shiver). 
  • Give medicine to control fever.
  • Do not place your child in a bath to bring her temperature down.

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.

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.

Medicines to control fever

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 5 doses in 24 hours.
  • Some cough and 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. Do not use both paracetamol and ibuprofen at the same time.

  • 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 'Febrile convulsions – guidelines for parents and caregivers' November 2013

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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