Febrile convulstions and seizures explained

Childhood convulsions can be terrifying for parents, but they are a surprisingly common health worry

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As a parent, there is nothing worse than watching your child suffer, so seeing a previously healthy baby or toddler undergo an unexplained fit it both terrifying and distressing. It may not be a consolation at the time, but seizures are actually quite common, with an estimated one in 20 children having one at some point. Nor are they usually a sign of a more serious condition or leave lasting problems.

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What is it?

A febrile seizure (or convulsion) is a fit that occurs when a child has a fever – a temperature of 38C and over. They’re often called fever fits, the word febrile being Latin for feverish. They usually occur on the first day of the fever and last for less than five minutes. Children between the ages of 6 months and 3 years are most commonly affected, with the average age being 18 months, although they can occur up to 6 years old. Most children grow out of having seizures.

What are the signs?

Your child may become stiff, twitch, vomit, foam at the mouth and lose consciousness. He may also wet himself. After a fit, you may notice he is very sleepy. This will be distressing, but it’s important that you stay calm.

There are two main types:

  • Simple: Also known as a tonic clonic seizure. This does not last longer that 15 minutes and does not reoccur during your child’s illness. Four out of five febrile seizures are in this category.
  • Complex: These have one or more of the following features: lasts longer than 15 minutes, your child only has symptoms in one part of his body, another seizure occurs within 24 hours or during the period of the illness, your child does not recover fully within an hour.

What causes them?

When your child catches a bacterial or viral infection, such as chickenpox, it may stimulate the release of cytokines, a type of protein that affects the part of the brain and nervous system that controls temperature. As his temperature soars, your child’s brain signals may temporarily ‘scramble’, resulting in fitting. It is thought that children are affected rather than adults because their brains’ electrical systems are not yet mature enough to cope with the increase temperature. There may also be a genetic link, as around one in four children affected has a family history of the condition.

What to do if your child has a seizure

  • Lay your child on his side (or in the recovery position, if you know how), on a soft surface, with his face turned to the side to open the airways and stop him swallowing any vomit. Don’t put anything in his mouth to stop him biting his tongue. 
  • Loosen his clothes and cool down the temperature of the room he is in if you can. 
  • Move anything your child may injure himself on while fitting.
  • Call 999 and seek medical help immediately.
  • Monitor when the seizure starts and how long it lasts for, so you can inform your child’s doctor.

Tests

Your GP can usually diagnose febrile seizures from your description, but may ask your child for a urine sample or will suggest a blood test to rule out other more serious complications, such as meningitis and septicaemia. In more unusual circumstances, such as where there is no high temperature present, an electroencephalogram (EEG) test – this is where your child’s brain activity is monitored – or a lumbar puncture may be carried out, where a sample of the fluid surrounding your child’s brain is tested.

Plan ahead

In roughly 15% of cases, your child will have another seizure within the same illness and there is a one in three chance of fitting his he falls ill again. But you can look out for warning signs to reduce the risk, such as dehydration, which is recognisable by a dry mouth, sunken eyes, no tears when crying and a sunken fontanelle (a soft section of skin normally found on top of a young child’s head).

Your child may complain of feeling hot and flu-like symptoms. You may want to try infant ibuprofen or paracetamol to lower his temperature (be sure to follow the age-specific dosage instructions), but this doesn’t guarantee a seizure won’t occur. Don’t use wet sponges or cool baths, as they’re unlikely to have much effect and may make your child feel cold.

Medication

In a small number of cases, where the seizures occur regularly, your child may be prescribed medication, such as diazepam or lorazepam, to be taken when a fever starts.

Q&A:

Q: Are seizures linked to vaccinations?

A: Don’t worry – it is rare for a child to have a fit following a routine injection. Only one in 3,000 to 4,000 are at risk of a seizure following the Measles, Mumps and Rubella (MMR) vaccine, while just one in 11,000 to 16,000 have one after the DTaP/IPV/Hib immunisation.

Q: Does a convulsion mean epilepsy?

A: Parents whose child suffers one or more febrile convulsions sometimes worry their child will grow up to develop epilepsy, a condition where a person has repeated seizures without a fever. While it is true that there is an increased risk of epilepsy in children who have a history of febrile seizures, it should be stressed the risk is still small, with a one in 50 chance for sufferers of simple febrile seizures, compared to one in 100 for people who haven’t had one. See your GP if you’re worried.

Q: Could my child have meningitis?

A: In very rare cases febrile convulsions can be a sign of meningitis and symptoms can be similar, with a blotchy red rash sometimes apparent. You should seek urgent medical help if you are concerned.

Support for parents

Kerry Smith, from Kent, is mum to Charlie, 2. she set up an online support group after her son suffered repeated seizures. “Febrile convulsions are traumatic. It sounds heart-wrenching, but it feels like you’re losing your baby. You don’t know what’s wrong. Charlie has had 20 febrile convulsions – his first was when he was just 16 months and his last two were earlier this year. I didn’t feel like I was getting enough support, but I knew other mums were going through the same thing, so I set up a Facebook group. There’s about 130 of us from all around the world.”

Mums say…

  • “My son had a convulsion at 20 months, due to a high temperature while suffering from tonsillitis. It only happened that one time and my other two sons have been fine,” says Jennett Crawley via Facebook.
  • “It is heartbreaking. Those few minutes seem like hours, you’re just helpless seeing your child like that, with only the power to be by their side until they see their convulsion out. Two of my three children are prone to them, as was their father when he was younger,” says Lisa Grimm via Facebook.
  • “Both my babies suffered these at 18 months, very scary, but thankfully just down to high temperatures,” says Emma-Jayne Farrell.
  • “My son had several. He’s now a strapping 15-year-old and doesn’t remember them,” says Karen McClure via Facebook.

Read more…

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