Febrile Convulsions and Seizures in Children

Why does it happen?

The exact cause of these seizures remains unknown. However, experts think that a rising body temperature triggers fits, usually due to an infection. Children cannot maintain their body temperature as efficiently as adults. A febrile convulsion in a child is often triggered if their temperature rises to over 38°. An extremely high temperature can also cause seizures in adults, but the levels at which this happens are considerably higher, usually over 40°. Febrile convulsions can happen to any child, but there is also a hereditary link. If one or both parents experienced seizures as children their child is likely to suffer from them too. An unusually hot day or hot environment will not lead your child to have a febrile convulsion. However if they are unwell, very hot weather can make it harder to reduce their core body temperature.

How to recognise a febrile convulsion

A seizure or convulsion may cause someone to thrash around violently as with a Grand Mal, tonic/clonic type of fit (this may start with a screaming sound as muscle spasm forces air out of their lungs). Alternatively, they may go rigid and experience uncontrollable spasms. Their arms and legs may jerk or twitch. Their eyes may roll back, and they may wet or soil themselves. They may or may not remain aware of what is happening.

How to help if someone is fitting

Seeing your child have a seizure is extremely frightening. If your child is unwell, try to lower their temperature. Take off any excess clothing, give them plenty to drink, open a window, or use a fan, but do not leave the child in a direct draught. If your child is feeling unwell and in distress, you can give Paediatric Paracetamol (Calpol) or Paediatric Ibuprofen, which will help them feel better and can reduce their temperature. If the fever is due to chicken pox, you should not give non steroidal anti-inflammatory medication such as Ibuprofen. If they are in distress, give Paracetamol.

A fit is not generally life-threatening. However, if the seizure continues for more than 5 minutes or a casualty has repeated seizures, it is vital to call an ambulance immediately. Whilst they are fitting they are unable to circulate oxygenated blood efficiently so it is important to stop the fit to prevent their vital organs being deprived of oxygen for too long. If someone starts fitting:

• Keep them safe. Move things away from them to avoid injury, cushion their head, but do not pick them up or restrain them.
• They might bite their lips or tongue during the seizure, but you cannot intervene whilst they are fitting. Do not let anyone put anything in their mouth.
• Look at your watch and time the fit. If the fit lasts more than 3 minutes, you should phone the emergency services. It also helps to note the progress of the seizure and which parts of the body are affected. Filming your child having the fit may help with diagnosis. You should only do this if it is your child or if you have parental permission.

How to help after the seizure

The fit can last from seconds to minutes. They may turn blue and could stop breathing for up to a minute. Once the fitting stops, they may remain unconscious and breathing, and you should roll them into the recovery position to keep the airway open. Following the convulsion, the person may feel confused and fractious. It is important to remain calm and reassuring. They will return to their normal selves. After a seizure, they will likely feel very sleepy. Following a first fit, doctors usually admit children to the hospital for observation and tests.

Once someone experiences one febrile convulsion, they become prone to having further ones. If your child has had a febrile convulsion, they will likely experience another one if they are ill and their core temperature rises again. They are highly unlikely to suffer any lasting damage from the seizures, and they will likely grow out of them by the time they are 5.

More Information can be found in the NICE guidance.