Clinical Reference Systems: Pediatric Advisor 10.0
Convulsions Without Fever
During a convulsion (seizure), a child becomes unconscious
and falls, the eyes roll backward, the body stiffens, and
the arms and legs jerk. Most seizures last less than 5
minutes. Convulsions without fever occur in 0.4 percent of
children. If they become recurrent, the child is said to
have epilepsy. While the causes are many, the usual cause
is a small scar in the brain tissue that triggers seizures.
Recurrent seizures can usually be controlled with special
- Leave your child on the floor or ground.
During a seizure your child should be left on the floor
or ground. Move him only if he is in a dangerous place.
- Protect your child's airway.
If your child has anything 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 by placing two fingers
behind the corner of the jaw on each side (this will
automatically bring the tongue forward).
- Common mistakes in first aid for 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.
- Treatment for previously diagnosed convulsions
After the seizure is over, let your child sleep if he
wishes. The brain is temporarily exhausted, and there
is no point in trying to keep your child awake. There
is no need to bring your child to an emergency room for
When you discuss your child's treatment with your
physician, ask if you should give your child an extra
dose of anticonvulsant medicine right after a seizure to
prevent another seizure. If your child has recently
missed a dose of anticonvulsant medicine, twice the
usual dose may be in order.
While most sports are safe, be certain your child avoids
activities that would be unsafe if he suddenly had a
seizure. These include activities at heights (for
example, climbing a tree or rope), cycling on a highway,
or swimming alone. Wind surfing, scuba diving, and hang
gliding must also be avoided. Have him take showers
instead of baths and only when someone else is in the
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF (for children
with diagnosed epilepsy):
John M. Freeman et al, Seizures and Epilepsy in Childhood: A
Guide for Parents (Baltimore, Md.: Johns Hopkins
University Press, 1990).