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Understand more about febrile convulsions

1 in 50 children will have had a febrile convulsion by the time they are five years old, according to Great Ormond Street Hospital. They occur most frequently in babies and young children who are unwell and have a rising body temperature which triggers a seizure. They are most common between the ages of 6 months and 3 years. Most children grow out of these seizures by the age of about 6. It is extremely rare for febrile convulsions to be life-threatening or cause long-term problems – but nonetheless they are frightening in the moment for the carer of the child.

This blog will explain febrile seizures, outline the symptoms and provide some guidance for how to help a child having a seizure.

What is a Seizure?

Seizure is the medical term for a fit or convulsion that occurs when there is a sudden burst of electrical activity in the brain which temporarily interferes with the normal messaging processes. With a febrile convulsion, this occurs due to a raising body temperature. If adults have a raised temperature, then they too can experience seizures, however the threshold for adults is considerably higher than with small children.

Signs of a febrile seizure include:

  • The seizure may start with a sound like a scream, as their muscles contract, forcing air out of their lungs. It sounds like they are in pain, but they aren’t.
  • Their body may become rigid, with possible twitching of the arms and legs.
  • They may lose consciousness or be unresponsive.
  • They might wet or soil themselves.
  • The child’s eyes may roll back.
  • They could appear to stop breathing for up to a minute (if it is longer than this, then alert the emergency services immediately)

After the seizure, the child will often be exhausted and sleepy for quite some time.

If the seizure lasts for longer than 5 minutes, or they suffer from multiple seizures; alert the emergency services immediately. Whilst someone is experiencing a seizure they are not as efficient at circulating oxygen to their brain. Therefore it is vital that the emergency services are alerted immediately in order to stop the seizure using medication. They are also likely to give them oxygen.

To try and prevent a convulsion in unwell children with a history of febrile convulsions:

Try to reduce the child’s temperature, however, be extremely careful that you do not cause them any distress in cooling them and that you do not over-cool them.

To reduce their temperature:

  • Take off excess clothing, if possible.
  • Use a damp tepid flannel to gently sponge the child under the arms, on their wrists and on their forehead, ensure it doesn’t cause them any distress and doesn’t over-cool them.
  • Give them plenty of cool water to drink.

If they are feeling unwell, give them paediatric paracetamol or paediatric ibuprofen to relieve their symptoms – as well as helping them feel better, it will also help to reduce their temperature.

If the child in your care starts fitting:

  • Maintain their safety – remove any objects from around them to prevent injury
  • Protect their dignity and talk to them calmly
  • Cushion their head using a blanket or pillow, but do not restrain them
  • Time how long the seizure lasts
  • Loosen any tight clothes/blankets and remove any excess clothing if it is possible to do so.
  • When the seizure has finished, check their breathing and if unconscious and breathing, put them into the recovery position.

If they are unresponsive and do not appear to be breathing – start CPR immediately.

Do not try to pick them up or restrain them and do not be tempted to put anything in their mouth whilst they are fitting. It is possible that they may bite their lips or tongue during the seizure but there is nothing you can do until after the seizure has finished. The seizure can last from seconds to minutes. During the seizure it is possible that they could go blue and appear to stop breathing (for less than a minute). However, they should start breathing again extremely quickly and spontaneously, but ensure you are checking continually and are ready to give CPR if necessary.

When the seizure has finished it is likely the casualty will feel confused and drowsy. If they are unresponsive, put them into the recovery position.

Unfortunately, once a child or baby has had a seizure, they have shown they have a pre-disposition and therefore are likely to have further seizures if they experience a raised temperature again. Fortunately, there is no evidence to suggest that febrile convulsions cause any long-term damage and children usually grow out of them by the time they are 5 or 6 years old.

Phone for an ambulance if:

  • It is their first seizure. (Or if you are in any doubt about this)
  • The seizure lasts more than 5 minutes.
  • They have another seizure soon after the first.
  • They are injured.
  • Their breathing does not appear ‘normal’ after the seizure.
  • They regularly have seizures and this one is different.
  • They are unresponsive for more than 5 minutes after the seizure.
  • You are worried for any reason.

Never:

  • Put your fingers or anything in their mouth to try and prevent them biting their tongue – this could cause serious injury to yourself or the child.
  • Try and move them (unless they are in immediate danger).
  • Restrain their movements whilst they are fitting.
  • Give them anything to eat or drink until fully recovered.
  • Try and ‘bring them round’.
  • If the casualty is conscious during the seizure, it is most important to ensure their safety, and to reassure them.

Febrile convulsions are frightening and can be extremely distressing to watch.

The most important things to remember are to protect the child during the seizure and to phone an ambulance if this is their first seizure, it lasts more than 5 minutes, or you have any other concerns or worries.

About the author

Written by Emma Hammett CEO of First Aid for Life

First Aid for Life and onlinefirstaid.com provide this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made or actions taken based on this information. The best way to be prepared for action in an emergency is to attend a practical first aid course or do one online.

Please contact emma@firstaidforlife.org.uk , visit our website www.firstaidforlife.org.uk or call us on 02086754036.

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