What is a febrile convulsion?
A febrile convulsion, or fit, is a common medical condition in young children and in most cases is triggered off by a rapidly rising temperature or fever (to over 38xC). It affects up to one in 20 children between the ages of one and four.
The good news is that for the vast majority of children with simple febrile convulsions, the outcome is excellent, with no evidence of brain damage.
Although febrile convulsions appear like epileptic fits, they rarely have anything in common with epilepsy. The risk of developing epilepsy in the future is no higher than for children who have never had a febrile convulsion.
What causes them?
Febrile convulsions are usually caused by a rapid rise in the child's body temperature at the start of an illness. Some children are more susceptible to having a convulsion if they have a lower resistance and keep catching infections. However, this is usually something they will grow out of. In around nine out of ten cases, a viral infection is the most common cause of fever.
Genetic factors also appear to play a part, with children being four times more likely to experience a febrile convulsion if either parent had them as a child. Children of parents with epilepsy are also at higher risk.
How common are they?
Around one in 50 children will have had a febrile convulsion by the age of five. Children from the ages of six months to five years are in the vulnerable age group, with most cases being in the younger age range. Boys are more likely to be affected than girls, for unexplained reasons. Around six out of ten children who have had one febrile condition will never experience another.
What are the symptoms?
When normal brain activity is disturbed, a fit or seizure will usually happen, generally without warning.
* The child loses consciousness.
* The head is thrown backwards, the limbs become either floppy or stiff and the child may stop breathing for a very short period of time.
* The child's body may then jerk and the eyes could roll back.
* Skin may briefly turn pale or blue.
This tends to last for no more then two minutes until the child regains consciousness. At first they may seem irritable or confused and will then sleep for several hours.
Associated risks
In a minority of children, a febrile convulsion can be a sign of an underlying neurological problem. The child may need to be treated in hospital to rule out other problems, especially if this is their first seizure.
What to do when a child has a febrile convulsion
* Stay calm and time the convulsion.
* Hold the child in your arms and place them in a lying-down position on a soft surface.
* Stay with the child and lie them on one side with the head lower than the body (recovery position). Remove any objects such as a dummy.
* Loosen any tight or warm clothing without restraining the child.
* Do not give the child anything to eat or drink during a convulsion.
* Once the child is fully conscious, try giving them paracetamol in liquid form to reduce the body temperature.
* Prop the child into a sleeping position and stop them rolling backwards.
Important: Call a doctor when it is over (unless you have already consulted one for advice). If the child has difficulty breathing or if the convulsion lasts beyond five minutes, you can dial 999 for emergency help.
Prevention
Beyond trying to keep a child's temperature down, there is really no effective way of preventing further convulsions. For those who suffer them frequently, anti-convulsant medication is available, but this is usually given in association with epilepsy, not fever.
Treatment
Temperature-lowering medication such as paracetamol can help to lower the child's body temperature. Diazepam is sometimes recommended for children with regular febrile convulsions or fits lasing beyond five minutes.
However, most children do not require this medication. If parents are worried, they should consult with the child's doctor.
