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Treatment of a Febrile Convulsion (Seizure)

Violet

What should I do if my child has a febrile convulsion (seizure)?

Firstly, don't panic. A febrile seizure (convulsion) looks very scary but your child will recover.

Put your child in the recovery position. Lie her on her side with her top knee bent over the bottom leg. This will protect her airway. You don't need to put anything in her mouth.

The pictures below show the recovery position.

Lewis Recovery position Lewis Recovery position from above Lewis Recovery position from feet


If you can, remove some clothes to cool her.

If this is the first time your child has had a febrile seizure (convulsion), you will want to call for medical help (call an ambulance).

If your child has had a convulsion before, look at your watch and if she is still convulsing at 5 minutes, call an ambulance.

Should I put my child in the bath when she has a convulsion?

No, that is not necessary. That was recommended years ago but we don't recommend it as a treatment now.

Should I keep my child's temperature down to stop her having a convulsion?

No. There is no need to do that. If your child is miserable with a convulsion, give her some Paracetamol (Acetominophen) or Ibuprofen to make her more comfortable.

Giving routine Paracetamol (Acetaminophen) or Ibuprofen to keep the fever down does not prevent a child having a febrile convulsion (seizure). Some children will have a convulsion before a fever is even registered.

Will my child need anticonvulsant medication after a febrile convulsion (seizure)?

No. Anticonvulsant medication may stop a further convulsion but there are side effects to having any medication. The side effects of anticonvulsant medication outweigh the possible benefit they may provide in this condition. That is because most children will not get another convulsion regardless of medication and we know that there is little harm in a child having a further convulsion.

Is there anything I can do to prevent a further febrile seizure (convulsion)?

Not really. Trying to prevent a fever by giving regular Paracetamol (Acetaminophen) or Ibuprofen will not help. No other treatments have been proven to prevent further episodes either. Remember that febrile convulsions (seizures) are not dangerous in themselves.

If your child has a further convulsion and it lasts 5 minutes or more, call an ambulance. This will give plenty of time for your child to get any help she needs.

What if I live a long way from a medical facility?

There are medications that can be given at home to stop seizures if they are lasting a long time. I usually advise giving the medication if the seizure has lasted 5 minutes or more. The most commonly used medications for this are:
  • Diazepam given rectally
  • Midazolam placed on the inside of the cheek
You can ask your doctor about these. If you live close to a medical facility, you will not usually need to have these medications at home.


References

  • Mewasingh L. Febrile seizures. Clinical Evidence. BMJ Publishing Group. April 2006; 15 : 1-2
  • Offringa M. Seizures associated with fever. Chap 28 in "How to practice evidence-based pediatrics and child health" 2nd. ed. BMJ Publishing Group. 2004. Pp 277-284


To read more about a febrile convulsion (seizure), click here

To go to the Fever page, click here

To return to the Home page, click here


Last reviewed 8 January 2007

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