Fever - febrile convulsions

What is a febrile convulsion?#

A febrile convulsion is a fit or seizure that happens in children when they have a high fever. It can occur in children aged between 6 months and 6 years. About one in every 20 children will have one or more febrile convulsions.

The fit can last from a few seconds up to about 15 minutes and is followed by drowsiness, although most fits last less than 2 to 3 minutes. A febrile convulsion is not epilepsy and does not cause brain damage.

Around 30% of children who have had one febrile convulsion will have another. There is no way to predict who will be affected or when it will happen.

Symptoms#

The signs and symptoms of a febrile convulsion can include:

• loss of consciousness (blacking out)
• twitching or jerking of the arms and legs
• breathing difficulty
• foaming at the mouth
• going pale or bluish in skin colour
• eye rolling, so only the whites of the eyes are visible

After the fit, your child may take 10 to 15 minutes to wake up properly. During this time they may be irritable and appear not to recognise you.

Reassurance for parents#

The signs of a febrile convulsion can be very frightening to watch, but it helps to remember that:

• Children feel no pain or discomfort during a fit.
• A febrile convulsion is not epilepsy.
• No regular medicines are needed.
• A short-lived fit will not cause brain damage, and even a long fit almost never causes harm.
• Children who have had a febrile convulsion grow up healthy.

If you have concerns or questions, contact your doctor. In an emergency, take your child to the nearest hospital emergency department.

There is a medicine called midazolam that is sometimes recommended for children who have a history of febrile convulsions lasting longer than 5 minutes. Most children do not need this medicine. If you would like more information about it, talk with your doctor.

What causes febrile convulsions#

Febrile convulsions only happen when there is a rise in body temperature. The fever is usually due to a viral illness or, sometimes, a bacterial infection. A child’s growing brain is more sensitive to fever than an adult’s. Febrile convulsions tend to run in families, although the reason for this is not known.

Fever itself is a normal response to infection and is usually harmless.

Treating a fever in your child#

If your child has a fever, suggestions include:

• Keep them cool by not overdressing them and by not keeping their room too hot.
• Give them plenty to drink. It is best to offer small, frequent drinks of water.
• Give liquid paracetamol (acetaminophen) or ibuprofen if your child has pain or is miserable. Check the label for how much to give and how often.

Paracetamol does not protect against febrile convulsions.

First aid for a febrile convulsion#

If your child has a fit:

• Try to stay calm and don’t panic.
• Make sure your child is safe by placing them on the floor, and remove any objects they could knock against.
• Don’t force anything into your child’s mouth.
• Don’t shake, slap or try to restrain your child.
• Once the convulsion has stopped, roll your child onto their side into the recovery position.
• If there is food in their mouth, turn their head to the side and do not try to remove it.
• Note the times the fit started and stopped, so you can tell the doctor.

Have your child checked by your doctor or the nearest hospital emergency department as soon as possible after the fit stops. Call an ambulance if the fit lasts longer than 5 minutes, as medicines may be needed to stop it.

Key points#

• A febrile convulsion is a fit that occurs in children aged 6 months to 6 years when they have a high fever.
• About one in every 20 children will have one or more febrile convulsions.
• A febrile convulsion is not epilepsy and does not cause brain damage.
• Children feel no pain during a fit, and most fits last only a few minutes.
• Stay calm, keep your child safe, and call an ambulance if the fit lasts longer than 5 minutes.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).