Febrile convulsion

Question 1

Counselling for parents for what to do during a convulsion?

Answer 1

• The most important thing is to stay calm - don’t panic.
• Place your child on a soft surface, lying on his or her side or back.
• Do not restrain your child.
• Do not put anything in their mouth, including your fingers. Your child will not choke or swallow their tongue.
• Try to watch exactly what happens, so that you can describe it to the doctor later.
• Time how long the convulsion lasts.
• Do not put a child who is having a convulsion in the bath.

Call the ambulance

Question 2

Typical age for febrile convulsion?

Answer 2

6 months to 6 years of age

Question 3

What is a simple febrile convulsion?

Answer 3

These are generalised, tonic-clonic seizures lasting less than 15 minutes that do not recur within the same febrile illness

Question 4

What is a copmlex febrile convulsion?

Answer 4

These have one or more of the following:

• focal features at onset or during the seizure
• Duration of more than 15 minutes
• Recurrence within the same febrile illness
• Incomplete recovery within 1 hour.

Question 5

What is febrile status epilepticus?

Answer 5

This is a febrile convulsion lasting for longer than 30 minutes

Question 6

Does paracetamol help reduce the risk of having a febrile convulsion?

Answer 6

Paracetamol has NOT been shown to reduce the risk of further febrile convulsions.
It may be used for pain / discomfort associated with febrile illnesses such as otitis media. The parents should understand the reasons for its use and be discouraged from using it solely to reduce their child’s fever.

Question 7

What is the recurrence rate?

Answer 7

depends on the age of the child; the younger the child at the time of the initial convulsion, the greater the risk a further febrile convulsion

1 year old 50%; 2 years old 30%

Question 8

What is the risk that the child will develop epilepsy?

Answer 8

Risk of future afebrile convulsions (epilepsy) is increased by family history of epilepsy, any neurodevelopmental problem, atypical febrile convulsions (prolonged or focal).

• No risk factors: risk of subsequent epilepsy approx. 1% (similar to population risk).
• 1 risk factor: 2%.
• More than 1 risk factor: 10%.