How to manage febrile convulsion

How to manage febrile convulsion

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A two-year-old boy was rushed to the consulting room with a history of high fever and a fit.

The mother had managed to rush him through a congested traffic to the hospital. She thought he was dying. But within an hour after first aid support was given to lower the temperature, the child was playing normally again.

The mother then requested that the intravenous canula be removed from his hand, as the child was now fully in control of his movement.

What are febrile convulsions? How common are they? Are they really harmless?

Febrile convulsions are convulsions that are associated with a significant rise in body temperature in children aged six months to five years. Most children will outgrow these episodes before they reach the age of five.

It was discovered that an overwhelming majority of parents have gross misconceptions about febrile convulsions, and usually take inappropriate or even harmful actions in an attempt to control it.

There is a genetic link, as having a parent or siblings who suffered from febrile convulsions predisposes a child to it.


The child suddenly goes stiff, the limbs start twitching and the eyes roll back in the head. A typical episode lasts for less than a minute, during which the child may poop or pee, he may breathe irregularly, and turn blue or darker with a temperature reaching 40ºC or more.


Malaria, viral infections, bacterial sepsis, respiratory tract infections, urinary tract infections, ear infections, genetics, etc., are some of the causes of febrile convulsions. And, sad to say, there are children who are exceptionally prone to these.

Laboratory test

A thorough septic screening (tests for infections) of blood, urine and sputum culture is necessary. You can also have a lumbar puncture (also called a spinal tap, a medical procedure where a needle is inserted into the lower part of the spine); as well as test for malaria.


Immediate response: Stay calm but yell for help and remain with your child throughout the convulsion episode. Turn the child’s head to the left side to prevent choking as a result of rolled tongue blocking the air passage or excessive saliva.

Also, keep the child lying on his/her side even after the convulsion has subsided. More important, note the time the convulsion starts and ends,

Remove all surrounding harmful objects from the child, and make efforts to reduce the child’s temperature by taking off extra clothing and ensuring good ventilation. You can also use tepid sponging, or give him oral doses of paracetamol or ibuprofen syrup.

Treatment courses include the use of anti-malaria, antipyretics, antibiotics and anticonvulsants in some cases.

The don’ts of febrile convulsions

Do not rub palm kernel oil all over the child, as it will cause a rise in temperature and worsen things.
Do not put the child’s feet in the fire. It will give the child burns and it may lead to permanent deformity.
Do not put scarification marks on the child’s face. One sign in African adults who suffered febrile seizures as children are the fever marks (small facial scarifications).
Do not cover the child with thick clothing or warm blankets: this will further increase the temperature and therefore increase the risk of reoccurrence.
Do not place foreign objects such as a stick or a spoon in the child’s mouth. This is obviously of no help in any way, but it will rather cause more harm/injury in the mouth.
Do not rub pepper or onions on the child’s eyes – it’s an unnecessary punishment for a sick child.
Do not turn the child upside down – it may lead to suffocation.

In conclusion, the first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage.

However, simple febrile seizures are harmless if properly handled. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or result in learning difficulties.

Give a tepid sponge bath to a child with fever if the child’s temperature is 38ºC or higher; acetaminophen or ibuprofen may also be given.

Other materials that may be needed to keep a child with febrile convulsion include bath basin, tepid water 37ºC, washcloth, bath thermometer, bath blanket, and patient thermometer.

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