Febrile convulsion: a threatening, but usually harmless specter

Febrile convulsion: a threatening, but usually “harmless” specter

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Happiness and sorrow of the parent:

To have a child and to be able to accompany it in his life and to grow up, is a great happiness. There are endless situations where the parent is flooded with pure, high-concentration happiness hormones.

In addition, there are also situations in which a pure, highly concentrated adrenaline shoots through the veins, the breath stops and the heart stops feeling.

One such event is the first-time occurrence of a febrile convulsion in one’s own child. And so that as many parents as possible at some point in such a situation, are a bit “forewarned”, I had already reported in a guest post on daddycoolsblog about it. By the way, Matthi is the “Daddy among the Mama bloggers” and regularly writes texts that go to their hearts. He conquered my heart for his lyrics and for the pictures of his adorable family in a flash and I am very happy that I got to meet him (and many others) live at # digitalwirdreal3 in Hamburg at the end of May. What a great idea to connect the virtual world with the real one. My heart beats for that, too.

But back to the current topic, which I find so important that I would like to introduce it here.

Febrile convulsion in the child:

Fever and infections are among the most common symptoms and illnesses, especially in the first years of a child’s life. Why this is so, you can read here and here.

Summing up just this much: for the development of a healthy immune system, the examination of the child’s body with various pathogens is extremely important and almost inevitable. Unfortunately, this process is also nerve-wracking, but there is almost no way around this fact over. Small “consolation” in advance: at the latest in school age, many of these things have “grown” (what luck).

Of course, schoolchildren (and even adults) get sick every now and then and take one or the other cold in the winter infectious period. As a rule, however, their immune system gets the symptoms quite well and quickly under control again.

Fever in the child: why so often, so fast, so high ?

That children often fever, is because their immune system is still immature and must first learn to deal properly with the various pathogens. Therefore, many first contacts with pathogens, which the child’s body has not met before, lead to an infection. And in order to properly “heat up” the pathogens, to prevent them from multiplying and thus rendering them harmless, the body has a small miracle weapon, namely the fever. Fever in itself is not harmful per se, as it serves to fight the pathogens. So far so good.

An immature “measuring method”:

However, it is true that the body temperature regulation system in children is not yet fully developed. It can get confused quickly and e.g. even in case of strong thirst or too warm a blanket lead to a measurable increase in body temperature. Occasionally, it may overreact or inappropriate.

Like the immune system, this system has to learn over the years and refine the method of measuring the body. In addition, there are (as in adults) individual differences: one child feverish even in a “banal” infection quickly and high, while another has only a slightly elevated temperature even in a severe infection.

So there are many things that can affect the body temperature measurement system.

In a febrile convulsion, the “control center” gets mixed up:

The control center, which is responsible for maintaining a normal body temperature, is located in a special area of ​​the brain called the hypothalamus. The target value, ie the target normal temperature, is mediated by the distribution and the interaction of certain messenger substances. In the event of an infection, this setpoint is “adjusted” and the body feels that the normal temperature of 37 ° C is too cold. It reacts with chills and raises the temperature to speed up and mobilize defenses, etc..

In children, this control center is very sensitive and can e.g. be irritated by virus infections.

Definition fever spasm:

A fever convulsion is a seizure that by definition occurs in children and in conjunction with fever. This is only the shortened version. The definition also includes other criteria that are irrelevant to this contribution.

Important is:

  • For the occurrence of a febrile convulsion is not primarily the height of the fever is crucial, but the speed of fever rise!
  • The faster the temperature rises, the sooner a potential febrile convulsion occurs.
  • Many febrile seizures occur thus even at a – for children – still relatively low temperature (38-zone).
  • Sometimes the temperature rises so fast that it is only through the fever convulsion that the child has a fever at all.

As a rule, you can not anticipate a febrile convulsion. Therefore, self / reproaches after a febrile convulsion are definitely unnecessary or inappropriate.

For further assessment and prognosis, the distinction between simple and complicated febrile convulsion is important:

  • The most common form is the simple / uncomplicated Febrile seizure. He usually stops by himself and usually needs no further medication.
  • At the complicated Febrile convulsion lasts longer than 15 minutes and there are other abnormalities. It plays u.a. The age of the child also plays a role, but if necessary your pediatrician will tell you more about it.

Frequency Febrile convulsion:

Febrile convulsions occur with a frequency of 3-5%, that is: 3-5 out of 100 children suffer from a fever spasm in the first years of life. Typically, children aged 6 months to 5 years are affected. Febrile convulsions are particularly common at the age of 1-3 years.

Cause fever spasm:

The exact reason why some children get a febrile convulsion and others do not, is still unclear. The most common causes are:

  • most common: virus infections! For example, at the so-called three-day fever
  • may also be part of a vaccine response associated with fever, e.g. after measles / whooping cough vaccination occur
  • heaped family

In some families, febrile seizures occur frequently, which means that a certain predisposition can also be inherited. However, it does not mean that if one of the parents had a febrile spell as a child, the child also gets it. However, informing yourself in such a case about febrile convulsions, but certainly not harm.

Symptoms Febrile convulsion:

  • fever
  • sudden loss of consciousness
  • possibly very shallow / missing breathing with blue color of the lips
  • Abnormalities in the muscular area:
  • – usually rhythmic muscle twitching (especially of the arms and legs)
  • – occasionally also general muscle tension or also
  • – complete relaxation of the muscles
  • often accompanying: smacking or gurgling sounds
  • – twisting the eyes
  • often after the seizure: tiredness / deep sleep

Usually, the seizure stops within a few minutes (which, of course, seem endless!) On its own again! Even a (usually short-term) respiratory failure is interrupted by the – especially in children pronounced respiratory irritation – by itself. To witness and to see this is without question unbearable for every parent / family member and is accompanied by an extreme feeling of worry and helplessness.

What can you do in an acute attack??

You can not and must not do much at first, except:

  • keep calm (even if it’s hard!)
  • Secure the environment: no sharp edges or objects near the child
  • look at the clock: when did the seizure begin and how long did it last??
  • Pay attention to the symptoms: both arms and both legs were twitching rhythmically or the convulsions affected only one half of the body?
  • Call emergency doctor, v.a. on the first seizure and / or if the seizure lasts more than 10 minutes
  • only after seizure: measure temperature

The emergency doctor or pediatrician will ask you about it, so try to pay attention to these things.

Diagnosis febrile convulsion:

The diagnosis is made on the basis of the symptoms and the medical history. In most cases the febrile convulsion is already over when the emergency doctor arrives. Whether after the seizure a further diagnosis or a stationary admission must take place, the physician will decide on the spot. In most cases (simple febrile convulsion) this will not be necessary.

Therapy febrile convulsion:

If your child has a febrile convulsion for the first time, you should first, as described above, first keep calm, secure the environment around the child, look at the clock and inform the ambulance or a pediatrician.

Presumably, the seizure on the arrival of the emergency doctor will already be over. It is even more important that you can describe the symptoms and the duration of the condition as accurately as possible. Medications are usually unnecessary.

The further procedure then depends on the assessment of the doctor on site. If the seizure does not stop by itself, the doctor will give a medication to stop the seizure. You will probably also get an emergency drug for the home. Everything else to the therapy and the further measures the pediatrician will discuss with you.

Can you prevent a febrile convulsion:

Not in principle, since you can not usually foresee it.

A reduction in fever feverish fever and febrile convulsion is suitable for improving the general condition of the child; However, according to the current level of knowledge, measures to reduce the risk of recurrence do not lead to a reduction in the risk of recurrence. Whether a therapy with antiepileptic drugs is required, your pediatrician will clarify in each case.


The prognosis of febrile seizures is altogether favorable despite the threatening symptoms. This means that as a rule no consequential damage is to be expected. However, about one third of the children experience renewed febrile seizures.


Febrile seizure is the so-called occasional spasm, the most common form of seizure in childhood. Even if he usually stops by himself and has a very good prognosis, he is perceived by the affected family as absolutely life threatening. The child unconscious, twitching and possibly no longer breathing, is an absolute horror scenario. But luckily, the horror stops by itself after a few minutes.

I hope I could “warn you” a bit with this post, so that in case of a case, you know that to keep calm and in case of doubt immediately to inform a doctor, the most important thing is.

annotation: Of course I wrote this article with the best of my knowledge and belief. However, it is for information only and does not replace the doctor’s visit in any way.

I wish you all the best from my heart and hope that you will never see this specter.

Or have you possibly already experienced a fever spasm in your child? If so, how did he go and what did you do? I am happy if you share your experiences in the comments and maybe help other parents.

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Christina Cherry
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