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Clinical Reference Systems: Pediatric Advisor 10.0
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Convulsions with Fever


Febrile convulsions are seizures triggered by high fever. They are the most common type of convulsion and are usually harmless. The average body temperature at which they occur is 104ƒF (40ƒC). The fever itself can be caused by an infection in any part of the body. Each febrile seizure usually lasts 1 to 10 minutes without any treatment. Febrile seizures do not cause any brain damage; however, a few children (3%) will later have seizures without fever.

Febrile convulsions occur in 4% of children. Most of these children have just one febrile seizure in a lifetime. The other 40% of children who have had febrile seizures have one to three recurrences over the next few years.

Children who have febrile seizures are usually 6 months to 4 years old. A child's first febrile seizure usually occurs by 2 years of age. Febrile seizures usually stop occurring by the time a child is 5 or 6 years old.


  1. Reduce the fever.

    Bringing your child's fever down as quickly as possible will shorten the seizure. Remove your child's clothing and apply cold washcloths to the face and neck. Sponge the rest of the body with cool water. As the water evaporates, your child's temperature will fall. When the seizure is over and your child is awake, give the usual dose of acetaminophen or ibuprofen for your child's weight and age, and encourage your child to drink cool fluids.

  2. Protect your child's airway.

    If your child has anything visible in the mouth, clear it with a finger to prevent choking. Place your child on the side or abdomen (face down) to help drain secretions. If the child vomits, help clear the mouth. Use a suction bulb if available. If your child's breathing becomes noisy, pull the jaw and chin forward.

  3. Common mistakes in first aid of convulsions.

    During the seizure, don't try to restrain your child or stop the seizure movements. Once started, the seizure will run its course no matter what you do. Don't try to resuscitate your child just because breathing stops momentarily for 5 to 10 seconds. Instead, try to clear the airway. Don't try to force anything into your child's mouth. This is unnecessary and can cut the mouth, injure a tooth, cause vomiting, or result in a serious bite of your finger. Don't try to hold the tongue. Children may rarely bite the tongue during a convulsion, but they can't swallow the tongue.

  4. Emergencies.

    Call a rescue squad (911) IMMEDIATELY if the febrile convulsion continues more than 5 minutes.

  5. Driving your child to a medical facility.

    If you are told to drive to a medical facility, keep the fever down during the drive. Dress your child lightly and continue putting a cold washcloth on the forehead. (Warning: Prolonged seizures due to persistent fever have been caused by bundling up sick infants during a long drive.)


  1. Oral fever-reducing medicines

    Febrile convulsions usually occur during the first day of an illness. Try to control fever more closely than is necessary for children who do not have febrile seizures. Begin acetaminophen or ibuprofen at the first sign of any fever (a temperature over 100ƒF, or 37.8ƒC) and give it continuously for the first 48 hours of the illness. If your child has a fever at bedtime, awaken him once during the night to give the fever medicine.

    Because fever is common after DTP immunizations, begin acetaminophen or ibuprofen in the physician's office when your child is immunized and continue it for at least 24 hours.

  2. Fever-reducing suppositories

    Have some acetaminophen suppositories on hand in case your child ever has another febrile seizure (same dosage as oral medicine). These suppositories may be kept in a refrigerator at the pharmacy, so you may have to ask for them.

  3. Light covers or clothing

    Avoid covering your child with more than one blanket. Bundling during sleep can push the temperature up 1 or 2 extra degrees.

  4. Lots of fluids

    Keep your child well hydrated by offering plenty of fluids.


The only way to prevent future febrile convulsions completely is for your child to take an anticonvulsant medicine on a daily basis until the age of 3 or 4 years. Because anticonvulsants have side effects and febrile seizures are generally harmless, anticonvulsants are rarely prescribed unless your child has other neurologic problems. Your physician will discuss this decision with you.


  • Your child has a febrile convulsion.
  • The neck becomes stiff.
  • Your child becomes confused or delirious.
  • Your child becomes difficult to awaken.
  • Your child starts to act very sick.



Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems