Febrile Convulsions
Febrile convulsions (seizures) occur in 3 percent of infants and toddlers between the ages of 6 months and 6 years. They occur usually during a viral illness and are associated with a temperature. They are frightening but not serious. There is no risk of brain damage, future epilepsy or other medical problems if a child has a febrile convulsion.
What happens ?
During an illness with a fever, a child will lose consciousness and have a generalised convulsion (seizure). This usually lasts a few minutes. The convulsion will stop and the child will have a short period of drowsiness. After about 30mins to half and hour the child will make a full recovery. An ambulance will transport the child to hospital for a period of observation and to confirm the diagnosis. Usually tests are not necessary.
However If the child is unwell, the seizure was prolonged (>15mins) or there are any unusual concerns in the history or assessment, further tests and admission to hospital may occur.
What can parents do ?
The initial experience is frightening for parents, particularly if this is the first occasion. During the convulsion an infant or toddler should be nursed, an older child made comfortable. Do not interfere with the mouth or tongue and do not attempt mouth to mouth as children will still breath whilst having a convulsion. Children generally do not vomit. There is no need evidence that reducing fever helps.
Can children be prevented from having convulsions ?
Contrary to what people believe – attempts at getting a temperature down by either the use of panadol, nurofen, or tepid baths or cool showers have no effect on whether a child has a convulsion. Those children that have lots of convulsions will sometimes be prescribed medication but this is rare.
What are the different types of febrile convulsions?
Simple febrile convulsions last for less than 15minutes and only occur once during a 24 hour period.
Complex febrile convulsions are defined as either lasting longer than 15minutes, having unusual features, or recurrent seizures within a 24 hour period.
What about recurrence ?
About 30% will have another febrile convulsion at some stage. If the first seizure is during infancy (<12months) there is a 50% chance of another episode in the future.
Are there long term problems ?
No. Febrile convulsions are not life threatening, and do not cause short or long term brain damage. Studies show no difference in scholastic or cognitive abilities compared to those who have never had convulsions. There is no increased risk of epilepsy. However some epilepsy syndromes are triggered by a fever. These children usually have an unusual type of seizure or other clues such as developmental delay.
- Febrile seizures are often genetic, ie one of the parents had an episode.
- Some viruses are more likely to trigger febrile seizures than others. Particularly the innocuous herpes virus 6 – which causes a mild illness and sometimes a rash called roseola infantum.
- Brain scans and further testing are not indicated in simple febrile convulsions.
- Medications such as drugs to treat epilepsy are not indicated unless the convulsions are recurrent or prolonged.
