Febrile convulsions

By on November 2, 2011
 

Febrile convulsions are fits or seizures which occur during a fever (raised temperature) in a child aged between 6 months and 5 years.  They affect about one child in 30.  The words convulsion, fit, and seizure have the same meaning. A febrile convulsion consists of loss of consciousness followed by rigidity of the muscles.  Sometimes breathing stops for up to half a minute.  This is followed by rhythmic jerking of the limbs or face.   The whole episode may last up to 15 minutes but often it stops after a few minutes.

It is caused by a temporary abnormal electrical activity in the brain, though why a fever should bring this about is unknown.  The fever is most commonly due to a viral infection.

It is very frightening for parents to witness such an event, and they may think the child will die.  Fortunately, in the vast majority of children who have a febrile convulsion no lasting harm results. About three out of 10 children with a febrile convulsion will have another one, but only 1%  develop epilepsy later.  Epilepsy is a different disorder and, put simply, means fits occurring for reasons other than fever.

A child who has a febrile convulsion should be seen by a doctor.  Often, parents call an ambulance and by the time they arrive at hospital the fit has stopped and the child appears well, apart from the fever.  The most important matter to be decided is whether the fit was due to the relatively rare condition of meningitis – a serious viral or bacterial infection of the outer lining of the brain.  An experienced paediatrician can usually make a judgement about this so in most cases a lumbar puncture (spinal tap) can be avoided.

Similarly, blood tests and an EEG (electro-encephalogram or brainwave test) do not assist in the diagnosis or treatment of febrile convulsions, and CT or MRI scans are unnecessary.

The important thing for parents confronted with this alarming situation is to place child on his or her front with the head turned to the side, so that if vomiting occurs it will not be inhaled.

One should not slap or shake the child nor attempt to force anything into the mouth.  It is reasonable to give a medicine to reduce the fever – paracetamol (‘Tylenol’) or ibuprofen – to make the child more comfortable but this probably does not help to prevent further seizures.

Immunisation can sometimes trigger fever which may result in a convulsion in susceptible children, and this should be discussed with the child’s doctor.

The above is for general information only and is not intended to replace medical advice.

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com