Febrile Seizure (Febrile Convulsion)

febrile seizure

A febrile seizure is sometimes called a febrile convulsion. Any illness that causes a fever (high temperature) can cause a febrile seizure. Most occur with common illnesses such as ear infections, coughs, colds, flu and other viral infections.

About 3 in 100 children have a febrile seizure sometime before their sixth birthday. They most commonly occur between the ages of 18 months and three years. They are rare in children aged under six months and over the age of six years.

Febrile seizures are classified into three types:

Simple febrile seizure: the most common type - occurs in about 15 in 20 cases

The child may look hot and flushed and their eyes may appear to roll backwards. They may appear dazed and then become unconscious. The body may go stiff, then generally twitch or shake (convulse). It may only be a few seconds and is unusual for it to last more than five minutes. The child may be sleepy for some minutes afterwards but within an hour or so the child will usually appear a lot better when their temperature has come down. Another feature of a simple febrile seizure is that it does not recur within 24 hours or within the same febrile illness.

Complex febrile seizure - This is similar to a simple febrile seizure but has one or more of the following features:

  • The seizure lasts more than 15 minutes and/or ...
  • The seizure recurs within 24 hours or within the same febrile illness and/or ...
  • The child is not fully recovered within one hour. This does not mean the seizure lasts more than an hour but that it takes more than an hour for the child to look and behave more like their normal self and/or ...
  • The seizure has partial or focal features. This means that rather than a generalised shaking, only a part of the body may shake. For example, just one arm or just one leg.

Febrile status epilepticus - This means the febrile seizure lasts for longer than 30 minutes.

What first aid should I do for a febrile seizure?

Note the time it started. Lay the child on their side with their head in line with the body or slightly lower (the recovery position). Do not put anything into their mouth or shake the child. When the seizure stops, try to lower the child's temperature to make them more comfortable.

What should happen after immediate first aid?

Call an ambulance if a seizure lasts more than five minutes (this includes small twitching movements, even if large jerking movements have stopped).
You should also contact a doctor urgently or ring for an ambulance if:

  • The child does not improve quickly once a short seizure is over.
  • Another seizure starts soon after the first one stop.
  • The child has difficulty breathing.
  • The child was not fully conscious before the seizure or one hour afterwards.
  • You suspect a serious illness is the cause of the fever.

No treatment is usually needed for the seizure itself if it stops within a few minutes.

In all cases, the child should be seen by a doctor as soon as possible after a seizure for a check over to rule out serious illness.

Is a febrile seizure dangerous?

Although alarming, a febrile seizure in itself is not usually dangerous. Full recovery is usual.

Can febrile seizures be prevented?

It may seem logical that if you keep a child's temperature down during a feverish illness it may prevent a febrile seizure. However, there is little scientific evidence to prove that this is so. However, it is common practice to keep a child cool when they have a feverish illness. This will make them feel more comfortable.

  • Keep the child very lightly dressed, or take all their clothes off if the room is warm.
  • Give paracetamol or ibuprofen.
  • Give lots of cool drinks.

Will it happen again?

Only one seizure occurs in most cases. In about 3 in 10 children who have a febrile seizure, a second seizure occurs with a future feverish illness. Once the child is past three years old, the chance of a recurrence (getting more than one seizure) becomes much less likely.

Does a febrile seizure cause any permanent damage?

Usually not. Full recovery is usual with no after-effects. Rarely, a seizure which lasts 30 minutes or more may cause some injury to the brain.

Is a febrile seizure a type of epilepsy?

No. Febrile seizures and epilepsy are two different conditions. The cause of a febrile seizure is related to the feverish illness and is not due to epilepsy or any brain abnormality. Epilepsy causes seizures without a fever.

Should a child who has had a febrile seizure have immunisations?

Yes. Some children develop a fever following immunisation. A very small number of children develop a febrile seizure following an immunisation. However, this is very unlikely to cause any permanent harm, or to happen again after a future immunisation.

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