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Medical Advice >> Pediatric Advisor
Related Topic: Fever
Febrile Convulsions
(Convulsions with Fever)
What are febrile convulsions?
Convulsions are also called seizures. Febrile convulsions
are seizures triggered by high fever. They are the most
common type of convulsion and are usually harmless. The
average body temperature at which they occur is 104°F
(40°C). The fever itself can be caused by an infection in
any part of the body.
Children who have febrile convulsions are usually 6 months
to 4 years old. A child's first febrile convulsion usually
occurs by 2 years of age.
During a convulsion, your child may:
- become stiff
- become unconscious or not know where they are
- have jerking or twitching movements
- have the eyes roll backward
- have breathing problems.
How long will the effects last?
Each convulsion usually lasts 1 to 10 minutes without any
treatment. Febrile convulsions do not cause any brain
damage. However, a few children (3%) will have convulsions
without fever sometime in the future.
Febrile convulsions occur in 4% of children. Most of these
children have just one febrile convulsion in a lifetime.
The other 40% of children who have had a febrile convulsion
have 1 to 3 recurrences over the next few years. Febrile
convulsions usually stop happening by the time a child is 5
or 6 years old.
What should I do when my child has a convulsion?
- Reduce the fever.
Bring your child's fever down as quickly as possible to
shorten the seizure. Remove your child's clothing and
apply cold washcloths to the face and neck. Sponge the
rest of the body with cool water. As the water
evaporates, your child's temperature will fall. When the
convulsion is over and your child is awake, give the
usual dose of acetaminophen or ibuprofen for your child's
weight and age, and encourage your child to drink cool
fluids.
- Protect your child's airway.
If your child has anything visible in the mouth, clear it
with a finger to prevent choking. Place your child on
the side or stomach (face down) to help drain secretions.
If the child vomits, help clear the mouth. Use a suction
bulb if available. If your child's breathing becomes
noisy, pull the jaw and chin forward.
Call a rescue squad (911) IMMEDIATELY if the febrile
convulsion continues more than 5 minutes.
- Driving to a medical facility.
If you are told to drive to a medical facility, keep the
fever down during the drive. Dress your child lightly
and continue putting a cold washcloth on the forehead.
(Warning: Prolonged seizures due to persistent fever
have been caused by bundling up sick infants during a
long drive.)
- Common mistakes in first aid of convulsions.
During the convulsion, don't try to restrain your child
or stop the seizure movements. Once started, the seizure
will run its course no matter what you do. Don't try to
resuscitate your child just because breathing stops
momentarily for 5 to 10 seconds. Instead, try to clear
the airway. Don't try to force anything into your
child's mouth. This is unnecessary and can cut the
mouth, injure a tooth, cause vomiting, or result in a
serious bite of your finger. Don't try to hold the
tongue. Children may rarely bite the tongue during a
convulsion, but they can't swallow the tongue.
How can I take care of my child?
- Oral fever-reducing medicines
Febrile convulsions usually occur during the first day of
an illness. Begin acetaminophen (Tylenol) or ibuprofen
(Advil) at the first sign of any fever (a temperature over
100°F, or 37.8°C) and give it continuously for the first
48 hours of the illness. If your child has a fever at
bedtime, awaken him once during the night to give the fever
medicine.
Because fever is common after DTP immunizations, begin
acetaminophen or ibuprofen in the physician's office when
your child is immunized and continue it for at least
24 hours.
- Fever-reducing suppositories
Have some acetaminophen suppositories on hand in case
your child ever has another febrile seizure (same dosage
as oral medicine). These suppositories may be kept in a
refrigerator at the pharmacy, so you may have to ask for
them.
- Light covers or clothing
Avoid covering your child with more than one blanket.
Bundling during sleep can push the temperature up 1 or 2
extra degrees.
- Lots of fluids
Keep your child well hydrated by offering plenty of
fluids.
How can I help prevent convulsions?
The only way to prevent future febrile convulsions
completely is for your child to take an anticonvulsant
medicine on a daily basis until the age of 3 or 4 years.
Because anticonvulsants have side effects and febrile
seizures are generally harmless, anticonvulsants are rarely
prescribed unless your child has other neurologic problems.
Your physician will discuss this decision with you.
When should I call my child's health care provider?
Call your doctor's office IMMEDIATELY after the seizure is
over.
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