Febrile convulsions are short lived tonic clonic seizures provoked by fever in otherwise normal children, they are the most common type of seizure in children. most commonly associated with viral illness

They typically occur between the ages of 6 months and 5 years and are seen in 3% of children.

The most common underlying cause in febrile seizures is roseola (human herpes virus 6).

Clinical features

• usually occur early in a viral infection as the temperature rises rapidly
• seizures are usually brief, lasting less than 5 minutes
• are most commonly tonic-clonic (focal seizures raise suspicion of meningitis)

Management following a seizure

• children who have had a first seizure OR any features of a complex seizure should be admitted to paediatrics
• if recurrences, try teaching parents how to use rectal diazepam or buccal midazolam. Parents should be advised to phone for an ambulance if the seizure lasts > 5 minutes
• regular antipyretics have NOT been shown to reduce the chance of a febrile seizure occurring

Prognosis

• 1 in 3 children will have at least one more febrile convulsion
• Simple febrile convulsions
  • Do not affect development
  • Do not hugely increase the child's likelihood of developing epilepsy. The general background risk for all children of developing epilepsy is around 1%, and for those who have a simple febrile convulsions, the risk is around 2%.
• Complex febrile convulsions last for a long time and/or occur multiple times in the same febrile illness. Complex febrile convulsions are associated with a significantly increased risk of epilepsy, around 4-12%.