Key points to remember

• febrile convulsions are a common childhood problem
• they are usually caused by a fever with a viral infection
• they look scary, but very rarely cause long-term problems
• the most important thing is to try to keep calm, and lie your child down on their side, in the recovery position, until the convulsion is finished
• dial 111 and ask for urgent medical help if the convulsion lasts more than five minutes, or if your child has trouble breathing, or you are worried (see Emergencies - dialling 111 on this website)
• you should get your child checked by a doctor afterwards to find the cause of the fever
• when your child is having a convulsion do not put anything in their mouth and do not put them into a bath or shower to cool down

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What is a febrile convulsion?

A febrile convulsion is a convulsion that occurs with a fever. 

 

Many infections in children cause fevers. In some children the fever triggers a convulsion.

 

Febrile convulsions are also called fever fits, or febrile seizures.

 

Febrile convulsions are common. They are not the same as epilepsy.

 

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What puts my child at risk of getting febrile convulsions?

• about one in 25 children will have a febrile convulsion
• febrile convulsions occur between the ages of six months and five years. They are uncommon after the age of five years
• there is an increased chance of your child having a febrile convulsion if a close relative had febrile convulsions as a child. The tendency to febrile convulsions runs in families

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What happens during a febrile convulsion?

Your child becomes unresponsive. They may become stiff or their arms and legs may start to twitch or jerk. Their eyes may roll back. Sometimes they are floppy. 

 

This is the convulsion, fit or seizure. It usually lasts a minute or two and stops by itself. At the time, it will usually seem to last much longer.

 

After the jerking or stiffness stops, your child will usually sleep for a while (up to an hour). Some children appear to be very upset, and then become sleepy.

 

Seeing a febrile convulsion can be very frightening. This is especially so if it is the first time that you see one.

 

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What do I do if my child has a febrile convulsion?

Most febrile convulsions stop by themselves. They do not need any treatment. 

 

The most important thing to do is to keep your child safe while they are having a convulsion.  

• lie your child down on their side, in the recovery position
• do not put anything in their mouth
• do not put your child in the bath or shower to cool them down
• loosen their clothes around their face and neck
• wait a few minutes for the convulsion to stop. Check the time if you can to see how long the convulsion goes for

Dial 111 and ask for urgent medical help if:

• the convulsion does not stop after five minutes
• your child is having trouble breathing
• your child looks very unwell
• your child is not waking up and responding after the convulsion

See Emergencies - dialling 111 on this website.

 

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Will a febrile convulsion harm my child?

The good news is that a febrile convulsion in a healthy child will not cause any long-term harm.

 

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If my child has had one febrile convulsion will they have another?

About one in three children have more than one febrile convulsion. The second one usually happens during a different febrile illness.

 

By the age of five years, children have usually grown out of febrile convulsions.

 

One in five children have more than one febrile convulsion in the same illness. This second seizure may be a sign that a serious illness is causing the fever so it is very important to get your child checked by a doctor.

 

If your child starts a second convulsion before waking from the first one you should dial 111 for urgent medical help.

 

See Emergencies - dialling 111 on this website.

 

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Will my child develop epilepsy?

Febrile convulsions do not cause epilepsy, but a small number of children who have a febrile convulsion also develop epilepsy (about one in 50). 

 

Epilepsy:

• affects about one in a hundred of the whole population
• is the medical name for repeated convulsions or seizures that are not caused by infections or fevers
• is a different condition to febrile convulsion

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What causes febrile convulsions?

Most febrile convulsions occur during a viral infection such as a cold with a fever. 

 

A small number (one in ten) of febrile convulsions are caused by bacterial infections, such as pneumonia, urine infection, ear infection or meningitis. Bacterial infections can be serious, so your child should be checked by a doctor after every febrile convulsion.

 

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How are febrile convulsions treated?

Most febrile convulsions stop by themselves in one or two minutes. They do not need any treatment. The most important thing to do is to keep your child safe while they are having a convulsion.

 

Some febrile convulsions can last a longer than ten minutes. There are special medicines (such as diazepam) that are used to stop the convulsion if it does not stop by itself. Doctors and emergency services have these medicines and can use them. 

 

Parents of children who have more than two febrile convulsions are sometimes given a supply of diazepam to use at home if necessary.

 

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Does my child need to stay in hospital?

If your child recovers completely from the febrile convulsion, and they do not have a serious infection, they do not need to stay in hospital.

 

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How can I prevent my child having a febrile convulsion?

There is no easy way to prevent a febrile convulsion. Keep your child cool and comfortable when they have a fever. The best ways to bring your child's temperature down are by:

• undressing your child so that they are just wearing a single layer (for example a singlet and pants)
• making sure the room is not too hot or too cold

Remember:

• don't put anything in your child's mouth when they are having a convulsion and
• don't put your child into a bath or shower to cool down

If your child is miserable because of the fever, you can give paracetamol to make them more comfortable. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose. 

 

Paracetamol may reduce the effectiveness of childhood vaccinations to stimulate lasting immunity (infection-fighting ability). For this reason it is not recommended for routine use before or after vaccination.

 

See Fever on this website.

 

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When should I see the doctor?

You should take your child to see a doctor after the convulsion finishes. The doctor will check to see what is causing the fever. 

 

Most children are sleepy after a convulsion, but if they are hard to rouse, or if you are worried about them for other reasons, see a doctor urgently.

 

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How are febrile convulsions diagnosed?

The doctor will ask you to describe what happened and will ask questions. They will also thoroughly examine your child. This is to make sure there are no signs of a serious infection, and to make sure your child has fully recovered from the convulsion.

 

Most children do not need special tests after a febrile convulsion unless the convulsion lasts a long time, your child looks very unwell, or there is something unusual about the convulsion.

 

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Where to go for more information

On this website

Fever

 

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Endorsement

This fact sheet was endorsed by PSNZ - 28/04/2010

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Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2010

The Paediatric Society of New Zealand http://www.paediatrics.org.nz

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