Febrile Convulsions is defined as a crisis that occurs during an episode of fever, in absence of infection in the central nervous system.

Febrile convulsions are classified as follows:


Febrile convulsions frighten and worry parents.  The vast majority of febrile convulsions are harmless, there is no evidence that they can damage the brain or that they can result in mental retardation.  During a convulsion there is a possibility (low) that the child may suffer damage if he/she falls or chokes with food or saliva.  
    Almost 95 to 98% of children that have experienced febrile convulsions do not develop epilepsy.  It has not been demonstrated that the treatment available for febrile convulsions with anticonvulsant medicine, can prevent a future presence of epilepsy.  Studies have found that children with simple or complex febrile convulsions do not differ from other children regarding their academic or intellectual abilities or achievements.  The majority of the children with prolonged febrile convulsions make complete recoveries.
    When evaluating a child with convulsions it is important that parents or caregivers give as much clinical information as possible as well as a detailed description of the convulsive crisis to allow a proper confirmation that it is in fact a real febrile convulsion, be able to classify it, detect risk factors, find the cause that is originating the fever episode and especially, eliminate the possibility of the episode being meningitis.
    There is no need for periodic testing of children that have one febrile convulsion.  A child with febrile convulsions usually does not need to be hospitalized.  If the convulsion is prolonged or if it is accompanied by a severe infection, or if the origin of the infection cannot be determined, the child should be hospitalized for observation.
    Prevention: Parents resort to medicines such as acetaminophen or ibuprofen to reduce fever and to make the child more comfortable, even though there is no study that proves this to reduce the risk of a convulsion.
Children that are especially prone to febrile convulsions can be treated by the medical professional when they present a fever, with a specific anticonvulsant medicine.  The majority of the children with febrile convulsions do not need medications.  No treatment with anticonvulsant medications is recommended, neither daily nor intermittent to prevent the recurrence of the simple or complex febrile convulsions, due to the potential side effects of them and also because the effectiveness to prevent such convulsions is questionable.
Handling febrile convulsions at home.
    Parents should remain calm and carefully observe the child.  To prevent accidental injuries, the child must be taken to a flat surface such as a bed or floor.  This is especially urgent if the child presents neck rigidity, lethargy or vomit.

Position the child on his/her side to avoid obstruction of the aerial         tract with saliva or food.
Do not put anything on his/her mouth and carefully remove any         object that might be present in the mouth to avoid obstruction of the     upper air tract.
Do not try to restrict the movements of the child during a convulsion. Most of the convulsions cease after few minutes therefore keep track of time.
Once the convulsion has passed, take the child to a doctor so the origin of the fever can be determined.
In case of long convulsions, go to the closest medical center.

A febrile convulsion is an event that produces anxiety in parents, therefore it is necessary to establish an educational system since during the first visit to the emergency room is hard to assimilate all the information that should be issued regarding the nature of the crisis, its prevalence, the recurrence risk, the prognosis, the handling of the fever and of the crisis when both of these are going on.  Parents should be reassured that the child is not going to die nor is he/she going to suffer brain damage.  
    Scientists are exploring the environmental and genetic risk factors that make children susceptible to febrile convulsions.  Some studies suggest that women that smoke or drink alcohol during pregnancy are more prone to have children that will suffer from febrile convulsions, but it is necessary to investigate more in order to establish a definite connection.  Scientists try to identity the factors that can help in predicting which children are more predisposed to have recurrent or long febrile convulsions and continue to observe the impact that these may have in the long term over intelligence, behavior, academic performance and the development of epilepsy, as well as the medicines that can prevent them.

Lisandro Brito Solano
M.D. Pediatrician