Febrile convulsions/febrile fits

Febrile convulsions occur in young children when there is a rapid increase in their body temperature. It affects up to 1 in 20 children between the ages of one and four but can affect children between six months and about five years old. What is the risk of suffering a febrile convulsion?

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What is a febrile convulsion?

Febrile convulsions occur in young children when there is a rapid increase in their body temperature. It affects up to 1 in 20 children between the ages of one and four, but can affect children between six months and 5 years old.

What is the risk of suffering a febrile convulsion?

Children may inherit the tendency to suffer febrile convulsion from their parents.

  • If either parent suffered a febrile convulsion as a child, the risk of their child getting it rises by 10 to 20 per cent.
  • If both parents and a child have at some point suffered a febrile convulsion, the risk of a sibling child getting it rises by 20 to 30 per cent.

    Nevertheless, a child's susceptibility to febrile convulsions also depends on whether he or she frequently gets infections. Around 4 out of 10 children who have had febrile convulsions will get them again at some stage, although the risk differs greatly from child to child. The child's risk of febrile convulsion rises if:

    • they are genetically predisposed to it
    • they suffer frequent illnesses, which include high temperatures
    • the first attack of febrile convulsion was accompanied by a relatively low body temperature - below 39ºC.

      One in a thousand children may suffer a febrile convulsion after receiving the MMR (measles, mumps, rubella) vaccine. In these cases it occurs 8 to 10 days after the vaccination and is caused by the measles component of the vaccine.

      However, this causes only about one-tenth of cases of febrile convulsion compared with measles itself.

      Children who are prone to febrile convulsions should follow the same programme of vaccination as all other children.

      What are the symptoms of febrile convulsions?

      • The attack often begins with the child losing consciousness, and shortly afterwards the body, legs and arms go stiff.
      • The head is thrown backwards and the legs and arms begin to jerk.
      • The skin goes pale and may even turn blue around the lips briefly.
      • The attack ends after a few minutes and the shaking stops. The child goes limp, and then normal colour and consciousness slowly return.
      • Some children regain consciousness faster than others.

        What to do if your child suffers an attack of febrile convulsion

        Do not intervene while the attack is taking place except in the circumstance outlined below.

        Carefully turn the child's head to one side to prevent choking. In the past, it was common to place a stick in the child's mouth to prevent bites to the tongue or lips. This should never be attempted, as it may result in lasting damage to the teeth.

        When the fit subsides, keep the child in the recovery position, ie lying on their side. If fits are prolonged or follow each other rapidly, call an ambulance.

        The first time a child suffers a febrile convulsion they should be taken to hospital to be seen by a paediatrician. If the child has suffered attacks on earlier occasions, hospitalisation is not always necessary.

        However, it is always important to determine whether the convulsions are only due to a harmless viral infection, or something more sinister or that requires treatment. For this reason, a doctor should always be consulted following an attack.

        Has the child previously suffered febrile convulsions?

        • If the child has a history of febrile convulsions, parents are sometimes advised to have the medicine midazolam ready in case an attack takes place. It can be given into the side of the mouth and takes effect in a few minutes.
        • If the attack goes on for more than five minutes treatment, can be repeated, but an ambulance should always be called in any fit lasting more than 5 minutes. Dosage instructions must be carefully adhered to.

          Does the child have a temperature?

          • Make sure the child is not too hot by removing extra clothing or bedclothes. If the room temperature seems high, open a window, but bear in mind that the child should not get too cold either. Give the child plenty of cold drinks.
          • Some doctors giving the child mild painkillers such as paracetamol (eg Calpol) or ibuprofen (eg Nurofen for children). This lowers the temperature by between 1 and 1.5ºC. It is important to give the recommended dose only.

            Although febrile convulsions look like epileptic fits, they rarely have anything in common with this condition.

            Ninety-nine per cent of children who have had a febrile convulsion have no more fits after they reach school age.

            Future prospects

            Although febrile convulsion often seems frightening, it rarely results in any permanent injuries. If, however, the convulsions last a long time or the child suffers several attacks in quick succession, damage may rarely occur.

            • Half of all sufferers will have another febrile convulsion the next time they have a temperature. But the risk lessens with time and attacks should not occur after the age of about five.
            • If your child has had a febrile convulsion, consult your GP on the best way to deal with them.

              Is it possible to prevent febrile convulsion?

              Temperature-lowering medicines, such as paracetamol, can help lower body temperature, but may need to be repeated.

              Other people also read:

              MMR (measles, mumps, rubella) vaccine: How does it work?

              Fever in children: What is the normal temperature for a child?

              Food allergies in children: Children with food allergies often have several different symptoms.

              Based on a text by Dr Carl J Brandt, Dr Vibeke Manniche, paediatrician

              Last updated

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