Febrile Convulsion

Advice intended for parents/ carers taking their child home after seeing a doctor

If your child has any of the following:

  • Has a fit that lasts longer than 5 minutes
  • They have one fit after another without being awake in between
  • They are seriously injured during the fit
  • Remains drowsy or confused more than an hour after their fit
  • Has weakness of the arms or legs, visual difficulties (double vision) or difficulty speaking after the fit has stopped
  • They have trouble breathing after the fit has stopped
  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help.

Please phone 999 or go to the nearest Hospital Emergency (A&E) Department

If your child has any of the following:

  • Has another fit (less than 5 minutes) within the same illness
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Noisy breathing (stridor) only when upset
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Poor feeding in babies (less than half of their usual amount)
  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
  • A temperature 39°C or above in babies 3-6 months
  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
  • Getting worse or you are worried about them

You need to contact a doctor or nurse today

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

  • Seizure lasting less than 5 minutes with full recovery in a child with previous febrile convulsions or known epilepsy
  • Watch them closely for any change and look out for any red or amber symptoms
  • If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.

Self care

Using the advice below and overleaf you can provide the care your child needs at home

How can I look after my child?

  • For practical advice refer to ‘Fever advice sheet’ - download via Healthier Together website:
    www.what0-18.nhs.uk
  • If your child has a fever and is distressed, you can give them paracetamol (calpol) or ibuprofen. However, remember this might not stop them having a further febrile convulsion and fever is a natural response to infection. Always follow instructions on the bottle and do not exceed daily maximum doses. Never give your child aspirin.
  • Tepid sponging is not recommended – it does not reduce fever and may cause your child discomfort.

Febrile Convulsions (febrile seizures)

Febrile convulsions occurs in some children with a high temperature (fever). Although it can be extremely scary the first time you see your child have one, most of the time they are not serious. Most occur with common illnesses such as ear infections, colds and other viral infections. Full recovery with no permanent damage is usual. The main treatment is aimed at the illness that caused the fever.

Who gets them?

●       They occur in about 1 in 20 children, most commonly between 6 months and 6 years of age

●       They often occur on the first day of an illness associated with fever. There appears to be no connection between how high a child’s fever is and whether they have a fit.  They can occur even with mild fevers

●       Most children will not have another fit during the same illness

●       1 in 3 children who have a febrile convulsion may go on to have further febrile convulsions in the future. This is more likely if other members of the family have had febrile convulsions.

●       Febrile convulsions are not epilepsy. Regular treatment for prevention of future fits is usually not necessary. There is a small risk of your child developing epilepsy in the future and many parents worry about this, however, most children who have childhood simple febrile convulsions grow out of them and do not develop epilepsy

●       If your child has had a previous febrile convulsion, has a clear cause for their fever, their seizure stops quickly and they are back to normal soon after, they may be cared for at home. The first time your child has a fit, you should go to your local Emergency Department or call an ambulance

●       Once they have been examined, if a cause is found and your child is well, it may be appropriate that they are discharged to continue recovering at home

What should you do?

When the fit stops, you can give them Paracetamol or Ibuprofen. However, this might not stop them having another one. Always follow instructions on the container and do not exceed daily maximum doses

For more information on fever please see our page here.

How long will the symptoms last?

In most cases, children with simple febrile convulsions appear dazed and their eyes may roll back

Their bodies may go stiff, their arms and legs may twitch or shake and they will become unresponsive for a few seconds. It is unusual for the febrile convulsion to last for more than 5 minutes

Your child may be sleepy for a few minutes afterwards

  • Occur in about 1 in 20 children, most commonly between 6 months – 3 years of age.
  • They often occur on the first day of a febrile illness. There appears to be no connection between the extent of the fever and convulsions, so they can occur even with mild fevers.
  • Simple febrile convulsions generally last less than 5 minutes, involve the whole body becoming stiff then jerking of all 4 limbs (a tonic clonic seizure) and the child may be sleepy afterwards but should return to their normal self within a couple of hours.
  • 1 in 3 children who have febrile convulsions may have further convulsions with febrile illnesses in the future.
  • Regular treatment for prevention of future seizures is usually not necessary. Febrile convulsions are not epilepsy. There is a small risk of your child developing epilepsy in the future and many parents worry about this, however, most children who have childhood simple febrile convulsions grow out of them and do not develop epilepsy.
  • If your child has had a simple febrile convulsion, has a clear infection source that is causing their fever and you and the medical team are happy, they may be cared for at home.

What to do if your child has another convulsion:

  • Place them in the recovery position – on their side, on a soft surface with their face turned to one side. This will stop them swallowing any vomit and keep their airway protected.
  • Stay with your child and try to jot down what time their seizure starts and stops.
  • Do not put anything in your child’s mouth.
  • If the seizure lasts longer than 5 minutes seek immediate medical help – call 999 or go to the nearest A&E.
  • If the seizure lasts less than 5 minutes – phone your GP or NHS 111 for advice if you’re worried.
  • If you child appears to have a seizure(s) in the absence of fever, then please seek an urgent review with your GP. It is often extremely helpful if you or a family member are able to take a short video of your child when they are having their seizure.

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.

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