Fever - febrile convulsions

What is a febrile convulsion?

A febrile convulsion is a fit or seizure that occurs in children when they have a high fever. This can happen in children aged 6 months to 6 years.

The fit can last a few seconds or up to 15 minutes and is followed by drowsiness. Most fits last less than 2 to 3 minutes.

One in every 20 children will have one or more febrile convulsion. A febrile convulsion is not epilepsy and does not cause brain damage. Around 30% of babies and children who have had one febrile convulsion will have another. There is no way to predict who will be affected or when this will happen.

Symptoms of febrile convulsions

The symptoms of febrile convulsions include:

• loss of consciousness (black out)
• twitching or jerking of arms and legs
• breathing difficulty
• foaming at the mouth
• going pale or bluish in skin colour
• eye rolling, so only the whites of their eyes are visible
• your child may take 10 to 15 minutes to wake up properly afterwards. They may be irritable during this time and appear not to recognise you.

Reassurance for parents about febrile convulsions

The signs and symptoms of a febrile convulsion can be very frightening to parents. Important things to remember include:

• Children suffer no pain or discomfort during a fit.
• A febrile convulsion is not epilepsy. No regular drugs are needed.
• A short-lived fit will not cause brain damage. 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 medication called Midazolam that is sometimes recommended for children who have a history of febrile convulsions lasting longer than 5 minutes. Most children do not require this medication. If you would like more information about this treatment, you should talk with your doctor.

Causes of 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.

The growing brain of a child is more sensitive to fever than an adult brain. Febrile convulsions tend to run in families, although the reason for this is unknown.

Treatment for a fever

Fever is a normal response to infection and is usually harmless. If your child has a fever, suggestions include:

• Keep them cool by not overdressing them or having their room too hot.
• Give them plenty to drink. It is best to give small, frequent drinks of water.
• Give liquid paracetamol 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 febrile convulsions

If your child experiences a fit, suggestions include:

• Try to stay calm and don't panic.
• Make sure your child is safe by placing them on the floor. Remove any object that they could knock themselves against.
• Don't force anything into your child's mouth.
• Don't shake or slap your child.
• Don't restrain your child.
• Once the convulsion has stopped, roll your child onto their side, also known as 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 that the fit started and stopped to tell the doctor.
• Have your child checked by your doctor or nearest hospital emergency department as soon as possible after the fit stops.
• Call an ambulance if the fit lasts longer than 5 minutes, as medications may be needed to stop the fit.

Where to get help

• In an emergency always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• Maternal and Child Health Line Tel. 13 22 29 (24 hours, 7 days)
• NURSE-ON-CALL Tel. 1300 606 024 - for expert health information and advice (24 hours, 7 days)
• The Royal Children's Hospital Melbourne Tel. (03) 9345 5522