A parent has asked me to write as a GP about febrile convulsions. This followed a worrying experience with her child. As a general practitioner previously working in rural communities it was not uncommon to care for children experiencing such convulsions. Medically they are almost always benign and without long-term consequences for the child. They almost always resolve without treatment.
For parents however, the experience can be difficult and intimidating. This is particularly true of the first experience.
Quick summary
Febrile convulsions – a worrying experience for parents.
Febrile convulsions are most common in children between the ages of six months and up to 6 years. They are precipitated by a high temperature or possibly a rapid rise in temperature. Simple febrile convulsions do not cause long-term problems for children. A child experiencing a febrile convulsion should always be reviewed by a health care provider to both confirm the diagnosis and exclude other less common possible diagnoses.
What happens during a febrile convulsion? Almost universally there will have been a preceding illness and an associated elevated temperature. The child will lose consciousness and begin to convulse. The convulsions are usually generalised and affect both arms and both legs. There may be urinary incontinence and breathing is often irregular. The child’s eyes do not focus and may look around in a most unusual manner or twitch to a particular side. The child’s colour will often remain pink but occasionally there will be duskiness if the breathing rate has fallen. Excessive salivation or drooling is common.
Simple febrile convulsions are generally short, lasting less than 15 minutes.
Generalised or complex convulsions last longer, for example, longer than 15 minutes or occur in multiple episodes within a 24 hour period.
As a parent it is recommended that an ambulance be called if the convulsion lasts longer than five minutes.
Treatment
The large majority of children experiencing febrile convulsions do not require treatment.
The following material is taken directly from the resources of the Royal Children’s Hospital Melbourne.
- There is nothing you can do to make the convulsion stop.
- The most important thing is to stay calm.
- Place your child on a soft surface, lying on his or her side or back.
- Do not restrain your child.
- Do not put anything in their mouth, including your fingers. Your child will not choke or swallow their tongue.
- Try to watch exactly what happens, so that you can describe it to the doctor later.
- Time how long the convulsion lasts.
- Do not put a child who is having a convulsion in the bath.
Prevention
Preventing febrile convulsions is not possible. Giving Panadol or Nurofen can help with discomfort from high temperatures, but appears to be ineffective in preventing a convulsion.
Prognosis
Simple febrile convulsions do not damage your child’s brain. Children will always outgrow them in the absence of epilepsy
Other resources
There is a section of the Royal Children’s Hospital Melbourne’s website with more information about febrile convulsions:
Sleep well
Dr Brian Symon
The Babysleep Doctor
