Febrile fits (also called febrile seizures or convulsions) are seizures associated with a fever in small children. They affect about 2-4 per cent of children, and generally occur between the ages of 3 months and 6 years.
Although frightening to witness, in general these febrile fits do not last long and the risk of the fit causing any serious damage is minimal.
Febrile fits are related to how quickly your child’s temperature rises or falls, rather than how high their temperature is. Consequently, many children experience a febrile fit before anyone has noticed that they have a temperature.
Among affected children, there is often a family history of the condition.
Symptoms of febrile seizures
Classically, a fit or seizure starts with a change in your child’s level of consciousness, often with their eyes rolling back in their head.
This may be followed by a general stiffening of their body and limbs, including clenching of the teeth, after which comes the repetitive, jerky movements commonly associated with fitting.
The fits usually last less than 15 minutes, although for people watching it, a fit often seems to last much longer.
First aid for febrile seizures
It is important if you witness a child fitting that you don’t try to restrain them.
Make sure they are safe by removing any potential dangers from around them and putting something soft under their head. Loosen any clothing that could restrict their breathing.
If possible, turn the fitting child on to their side to prevent any choking, especially in the event of vomiting. Do not try to force a fitting person’s mouth open. Contrary to popular belief, they will not swallow their tongue.
After the child stops fitting they may be drowsy and disorientated as they regain consciousness. It is important to provide reassurance and calm support at this time.
Call an ambulance if the seizure lasts more than 5 minutes or your child doesn’t wake up after the convulsion.
All children who have a febrile fit should be seen by a doctor to determine that a fever was in fact the trigger for the fit, to rule out other causes, and to assess the illness that has caused the fever (often a simple viral infection).
The majority of children who have a febrile fit will recover fully. Even very long seizures rarely cause lasting problems.
The biggest factor affecting whether or not a child has another febrile fit is their age when the first fit occurs — the younger they are, the more likely they are to have recurrences. Among children aged 12 months who have a febrile convulsion, about 50 per cent will have a febrile fit in the future, while approximately one-third of 2-year-olds will have another fever-related seizure.
To prevent febrile fits from recurring, many people advise treating children at the first sign of fever with paracetamol or ibuprofen. However, this has not been shown to reduce the risk of a febrile fit.
Anticonvulsant medicines are rarely used in the treatment of febrile seizures.
Risk of epilepsy
Most children who have had a febrile fit will not develop epilepsy in the future. By far the majority of children who experience a febrile fit will have no long-term consequences.
2. Royal Childrenâ€™s Hospital Melbourne. Clinical Practice Guidelines: Febrile convulsion (updated April 2011). http://www.rch.org.au/clinicalguide/guideline_index/Febrile_Convulsion/# (accessed Feb 2013).
3. Royal Childrenâ€™s Hospital Melbourne. Kids Health Info: Febrile convulsions (reviewed Aug 2008). http://www.rch.org.au/kidsinfo/fact_sheets/Febrile_Convulsions/# (accessed Feb 2013).
4. National Institute of Neurological Disorders and Stroke. Febrile seizures fact sheet (updated 21 Feb 2013). http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm (accessed Feb 2013).