A child having a convulsion might stiffen, jerk around and fall unconscious. Her eyes might roll back in her head. See your GP if your child has convulsions, and call an ambulance if a convulsion lasts longer than five minutes. Convulsions are also called fits, seizures or epileptic attacks.
Causes of convulsions or seizures
Convulsions happen because of sudden, abnormal electrical activity in the brain. This produces changes in a child’s consciousness.
Febrile convulsions are seizures that happen because of fever, which is a temperature higher than 38°C. We don’t know why, but the rapid rise in temperature causes an abnormal electrical discharge in the brain.
Febrile convulsions are pretty common. About 4% of children aged between six months and five years have them.
Two-thirds of these children only ever have one fit. Most happen when children are younger than three years old.
Children who have their first febrile convulsion before the age of one year have a higher risk of having more febrile convulsions. This type of convulsion tends to run in families and affects boys more than girls.
It can be very frightening to see your child having a febrile convulsion, but children don’t die from convulsions. Most febrile convulsions don’t cause long-term consequences or brain damage either.
There are many other causes for convulsions – for example, epilepsy and brain tissue scarring, which might occur after head injury. Convulsions in some children might be triggered by flashing lights – like a strobe light – or by looking at patterns on a TV or cinema screen.
There’s usually a family tendency towards having convulsions.
is when a child has more than one seizure, which isn’t triggered by fever, and the child also has an abnormal EEG
. About 3% of children with febrile convulsions go on to develop epilepsy, compared with 0.5% of all children.
Symptoms of convulsions or seizures
There are several different types of convulsions, but they’re usually characterised by:
- your child’s body suddenly stiffening
- your child becoming unconscious
- your child jerking, and his eyes possibly rolling back in his head
- your child usually sleeping deeply for an hour or so afterwards.
Most convulsions don’t last longer than several minutes.
Convulsions can be partial, affecting only one part of the body (and one part of the brain), or generalised, involving the whole body (and spreading throughout the brain).
Some convulsions don’t involve jerking body movements, but simply appear as an ‘absence’ from activities. Your child might stare for a few seconds, then continue with what she was doing as if nothing has happened. These are called petit mal convulsions.
The symptoms of a febrile convulsion are like those of a general convulsion. The seizure is usually brief, lasting less than five minutes. Your child will make a complete recovery afterwards – but he might be drowsy for an hour or so. Your child will also have symptoms of the condition that caused the fever, like a runny nose, earache or cough.
Occasionally a febrile convulsion will be associated with a more serious condition like meningitis, so it’s important to see a doctor in all cases.
When to see your doctor about convulsions
You should take your child to your GP if:
- it’s your child’s first convulsion
- your child has several convulsions
- your child has convulsions often.
Phone 000 and ask for an ambulance if the seizure lasts longer than five minutes.
Tests after a convulsion or seizure
A child who’s had a febrile convulsion probably won’t need tests.
Sometimes doctors might order blood or urine tests, or a chest X-ray, to work out what condition caused the fever. Your child might be sent for an EEG if she’s having repeated febrile convulsions, but this won’t usually happen after a single seizure.
Convulsions with other causes
If your child has a convulsion that isn’t caused by fever, your doctor will suggest sending your child for an EEG, and occasionally a CT scan of the brain.
Treatment for convulsions or seizures
The long-term treatment of general convulsions depends on what’s causing them and how bad they are.
A febrile convulsion usually lasts only a few minutes, and almost always stops by itself before you get the chance to do anything about it.
During a convulsion
Place your child on a soft surface, lying on his side or back.
Watch exactly what happens, so you can describe it later. If you have a smartphone or camera, take a video of the convulsion.
Time the convulsion. If the seizure goes on for longer than five minutes, call an ambulance or take your child to the doctor or hospital.
After a convulsion
Children don’t usually need to be admitted to hospital after a febrile convulsion, unless your doctor is concerned about the condition that caused the fever – for example, pneumonia or meningitis. If you take your child to hospital, medical staff will check your child out, treat the underlying condition, and send your child home.
Prevention of convulsions or seizures
There’s no guaranteed way to prevent febrile convulsions.
You can lower your child’s fever and make her more comfortable by using paracetamol and taking off extra clothing. Sometimes the seizure will be the first sign of a fever.
There’s no point in giving your child anticonvulsant medication whenever he develops a fever, because it takes several days for this medication to build up enough to prevent seizures.
If your child has a lot of febrile seizures, your doctor might rarely consider prescribing anticonvulsant medications to be taken on continually for several years to prevent the seizures. But this is a rare treatment, which a paediatrician or paediatric neurologist would prescribe and supervise.
Prevention of non-febrile convulsions depends on the diagnosed cause of the seizures.