Febrile Seizures in Children

What is a Febrile Seizure?

A seizure is a temporary disturbance in the electrical connections in the brain. A Febrile Seizure is one caused by fever. These are also called a Febrile Seizure and/or a Febrile Convulsion (we’ll use the terms interchangeably here). While they can be frightening, they’re unlikely to cause any harm and it doesn’t mean that the child has a long-term problem.

Normal body temperature is 37C – although it can vary. Temperatures of 41C and above risk causing problems for the brain, which can include seizures. A fever seizure is commonest in children from 6 months to 6 years of age. Febrile seizures are often caused by other illnesses and are most likely to occur early on during an illness. They do not somehow wait until the fever is at its worst.

Healthy baby before a seizure

Perfectly healthy a week before!

Let’s tell you the story of James’ febrile convulsion and you’ll start to get the idea:

We’d been in England with James, our then young son. He’d got the usual cold that most people seem to get with international air travel. Somewhere along the way he must have rubbed his nose and then his eyes. Certainly by the time we came to board the plane back to Canada, he had a new eye infection. So now he has two infections, both of which could cause a fever. Aircraft are also hot places. Being unwell, he didn’t want to lie in his cot and wanted to spend the flight snuggled up with mum – which made him even hotter. Although he was stripped down to just a nappy/diaper, he still had a seizure in the middle of the flight.

Signs of a febrile seizure

  • Muscle contractions
  • Tremor or jerky movements
  • Noises like crying/moaning
  • Unresponsive
  • May vomit
  • Will fall over if they were sitting/standing
  • May urinate or have bowel movement

Expect some or all of these to happen quickly and to pass just as quickly. Febrile seizures can be from a few seconds to several minutes. Any seizure (including a fever seizure) lasting over 5 minutes requires an ambulance call.

When to call the ambulance for febrile seizures

  • More than 5 minutes of fever seizure
  • Seizure ends then another one happens
  • It’s not a fever seizure (eg: there was a head injury!)
  • They have a rash
  • They are unusually sleepy or confused. It’s normal for them to by a little sleepy or confused, but this should pass quickly.

What to do for a febrile seizure

  • Keep them safe.
  • Remove any objects that could harm them (eg: the scissors she was carrying)
  • Put a blanket/pillow/cushion under their head to protect it from the floor
  • Allow the fever seizure to happen. Do not move them unless they’re in danger
  • If they vomit, roll them to recovery position (come to class and practice!)

What not to do for febrile seizures

seizure

Don’t hold them down

  • Don’t hold them down or restrain them
  • Don’t put ‘stuff’ in their mouths including pencils, spoons, etc.
  • Don’t move them

After the febrile seizure

Make cooling them down your priority first. Use a cool wash-cloth or cool water (not cold, just cool). Once they can take it, give acetaminophen/paracetamol by mouth. Try to find the cause and if possible deal with it. Then, call or visit your doctor – any child having an unexpected seizure (even a febrile convulsion) should be checked out.

Way after the febrile seizure

That’s it. Sure a febrile convulsion may be scary, but there is no evidence to suggest they’re going to get anything else. No brain damage or epilepsy or whatever. Do keep a close eye on them when they have their next illness. Kids can have more than one febrile convulsion, but will usually outgrow them by age 6.

About Tony Howarth

Tony is a First Aid & CPR Instructor Trainer with Sea 2 Sky Safety Training Services and the company founder. Tony started with the British Red Cross in 1994. Has acted as first aid attendant for hundreds of events & treated many hundreds of people as a result. He is experienced in training a wide range of courses. He previously worked as an ambulance attendant with the British Red Cross. He is now in BC as a first aid instructor, and an instructor trainer (one who trains others to become instructors) Finally, Tony works at UBC Hospital as a pharmacist when not busy training safety
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