Fever fits

Febrile convulsions are a common yet still frightening experience

My son had his first febrile fit when he was 18 months old. Unexpected and utterly terrifying, my first reaction was naturally panic, compounded by fears he may be suffering from something very, very serious. After rushing him to hospital, the relief of hearing it was a common condition made handling later episodes much easier, although I was left with a nagging worry over the long-term effects of these seizures.

‘Any fit or seizure in a young child, especially the first time it occurs, can be very alarming for parents,’ explains Sara Lane, nurse manager and emergency first aid instructor at Health Bay Polyclinic. ‘This is why it’s crucial that if a seizure occurs, especially the first time, parents take the child immediately to the hospital in order for doctors to make a diagnosis and rule out other more serious conditions such as epilepsy.’

So what causes these seizures? ‘The most common reason for such seizures is known as febrile convulsions,’ explains Sara. ‘Febrile fits occur when a child has a high fever of usually over 39°C (102.2°F) during the early stages of an infection, while the temperature is rising rapidly. The convulsion happens when the normal brain activity is disturbed by the fever,’ she says, adding that all children are susceptible.

Whether your child gets one depends upon the frequency they contract infections, as well as genetic influences. ‘In fact, research has found that febrile convulsions occur more in children whose parents also experienced them as a child, with around one in every 20 children having at least one experience,’ says Sara. ‘Some children can reach highs of 40-41°C without getting a convulsion, while more susceptible children may hit the brink of a high temperature (38°C) and they fit straight away.’

Sara says that around 40 per cent of children who have one febrile convulsion, with a temperature above 40°C, are likely to have another one the next time they get a fever. That said, the risk usually lessens as the child ages. ‘The usual peak period for febrile convulsions is between six months and three years, with the majority of children having outgrown them by age five.’

And though they are incredibly frightening, Sara is keen to emphasise that they’re generally not serious and rarely result in any permanent injury. ‘The most important thing is that parents know this is what’s happening and how to remedy it.’

Usual febrile convulsion symptoms start with the child becoming very flushed and sweaty. The body stiffens and the child’s back usually arches. They begin shaking and this often progresses into full jerking movements. Sometimes they have clenched fists and they can also appear slightly blue in colour as they’re effectively holding their breath.They may even become unconscious or unaware of their surroundings.

An attack will usually last just one or two minutes, after which kids typically go limp, their normal colour returning quite quickly. A prolonged fit of four minutes or more is much more serious and, in such cases, you should take your child to hospital or call an ambulance, advises Sara.

She strongly advises parents not to restrain the child as this could potentially cause more harm. ‘It’s important you protect them during the fit with cushioning around the head area. If you can safely turn your child on to his side, or at least with his head slightly to the side, this will protect the airway, helping to prevent choking in case he vomits,’ says Sara. ‘Always think about the airways and never put anything in the child’s mouth. Loosen any tight clothing and time how long the convulsion lasts and, of course, never leave them unattended.’

If your doctor does confirm febrile convulsions, says Sara, then there are ways of dealing with such fits should they happen again. In some cases, where fits occur regularly, they may prescribe medication such as Diazopam, to help stop the seizures. ‘If your child is prone to them, doctors will advise on the best ways to reduce a fever, such as the use of paracetamol and ibubrofen, to limit the possibility of a convulsion.’
Sara Lane is the nurse manager and emergency first aid instructor at Health Bay Polyclinic in Umm Suqeim, frequently running first-aid courses for parents. 04 348 7140; www.healthbaypolyclinic.com

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