Febrile convulsions/febrile fits

Health and Nutrition > Diseases > F Reviewed by Dr Stephen Greene, consultant paediatrician

What is a febrile convulsion?

Febrile convulsions occur in young children when there is a rapid increase in their body temperature. It affects up to 1 in 20 children between the ages of one and four but can affect children between six months and about five years old.

Children who are at risk may naturally have a lower resistance to febrile convulsion than others.

What is the risk of suffering a febrile convulsion?

Children may inherit the tendency to suffer febrile convulsion from their parents.

- If either parent suffered a febrile convulsion as a child, the risk of the child getting it rises 10 to 20 per cent.
- If both parents and their child have at some point suffered a febrile convulsion, the risk of another child getting it rises 20 to 30 per cent.

Nevertheless, the child's susceptibility also depends on whether the child frequently gets infections. About 4 out of 10 children who have had febrile convulsions will get them again at some stage, although the risk differs greatly from child to child. The child's risk of febrile convulsion rises if:

- they are genetically predisposed to it
- they suffer frequent illnesses, which include high temperatures
- the first attack of febrile convulsion was accompanied by a relatively low body temperature - below 39ºC.

One in a thousand children may suffer a febrile convulsion after receiving the MMR (measles, mumps, rubella) vaccine. In these cases it occurs 8 to 10 days after the vaccination and is caused by the the measles component of the vaccine. However, this causes only about one tenth of cases of febrile convulsion compared with measles itself.

Children who are prone to febrile convulsions should follow the same programme of vaccination as all other children.

What are the symptoms?

- The attack often begins with the child losing consciousness, and shortly afterwards the body, legs and arms go stiff.
- The head is thrown backwards and the legs and arms begins to jerk.
- The skin goes pale and may even turn blue briefly.
- The attack ends after a few minutes and the shaking stops. The child goes limp, and then normal colour and consciousness slowly return.
- Some children regain consciousness faster than others.

What to do if your child suffers an attack of febrile convulsion

Do not intervene while the attack is taking place except in the circumstance outlined below.

Carefully turn the child's head to one side to prevent choking. In the past, it was common to place a stick in the child's mouth to prevent bites to the tongue or lips. This should never be attempted, as it may result in lasting damage to the teeth.

When the fit subsides, keep the child in the recovery position, ie lying on its side.

If fits are prolonged or follow each other rapidly, call an ambulance.

The first time a child suffers febrile convulsions they should be admitted to hospital. If the child has suffered attacks on earlier occasions, hospitalisation is not always necessary. However, it is always important, for example, to determine whether the convulsions are only due to a harmless viral infection. For this reason, a doctor should always be consulted following an attack.

Has the child previously suffered febrile convulsions?

.

- If the child has a history of febrile convulsions, parents are sometimes advised to have the medicine diazepam ready in case an attack takes place. It can be given into the rectum from a specific rectal tube and takes effect in a few minutes.
- If the attack goes on for more than five minutes treatment can be repeated, but medical advice should always be sought in any prolonged fit. Dosage instructions must be carefully adhered to.

Does the child have a temperature?

- Make sure the child is not too hot by removing extra clothing or bedclothes. If the room temperature seems high, open a window, but bear in mind that the child should not get too cold either. Give the child plenty of cold drinks.
- Some doctors advise parents to give the child mild painkillers such as paracetamol or ibuprofen. This lowers the temperature by between 1 and 1.5ºC. It is important to give the recommended dose only.

Although febrile convulsions look like epileptic fits, they rarely have anything in common with this illness. Ninety-nine per cent of children who have had a febrile convulsion have no more fits after they reach school age.

Future prospects

Although febrile convulsion often seems frightening, it rarely results in any permanent injuries. If, however, the convulsions last a long time or the child suffers several attacks in quick succession, slight disturbances in the brain function may occur.

- If your child has had a febrile convulsion, consult your GP on the best way to deal with them.
- Half of all sufferers will have another attack the next time they have a temperature. But the risk lessens with time and attacks should not occur after the age of about five.

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