Febrile convulsion

Data gathering

  • Red flags – previous convulsion in same febrile illness, rash, photophobia, drowsiness, floppy, vomiting, leg pains, cold hands/feet
  • Others – pregnancy/birth/immunisation/development history, post ictal phase, head injury
  • Examine – temp, HR, RR, abdo/cvs/resp/ENT


Clinical management

  • Refer
    • First febrile seizure
    • If not simple febrile convulsion (see below)
    • If recent antibiotics (can mask infection)
    • If no focus found
  • First aid during seizure
    • Note time seizure started
    • Lay child on side with head tilted back
    • Remove excess clothing
    • Call 999 if >5 minute duration
  • Explanation
    • A febrile convulsion is a fit that occurs with fever – between ages 6 months -> 5 years
    • They occur with common illness like colds, ear infections
    • Full recovery is usual
    • 1 in 25 kids have a febrile convulsion
    • 1 in 50 develop epilepsy (likely fit is due to epilepsy, not the fit causes epilepsy)