Febrile Convulsions

My 25-month-old daughter has been in hospital for the second time with a febrile convulsion. I have been told that it is not epilepsy but they look like an epileptic convulsion that I saw on a video once. What is the difference?

The convulsion of febrile convulsion and that of the commonest form of epilepsy (generalised tonic-clonic or Grand Mal) are identical in appearance. The difference is that febrile convulsions only occur in young children (usually under 3 but sometimes up to 6 years). Commonly there is a family history of febrile convulsions. If a father, mother, sister or brother had febrile convulsions there is a 16 times greater chance that a young child will have one compared to a child with no family history. Because you and her father would not recall having had them at such a young age, it is worth checking with your parents or an older relative about the chance that you did.

Because an epileptic convulsion may be triggered by a febrile illness in a child, who has epilepsy and they look identical to febrile convulsions it is usual to wait until a second one occurs. In 60% of children with febrile convulsions there is only 1 episode but in 40% they are repeated. If a second episode of convulsing happens an electroencephalogram (E.E.G.) may be performed. This is a painless procedure in which the brain’s electrical activity is recorded while not fitting. If this is normal it is very unlikely (although not impossible) that the child has epilepsy.

A reassuring fact is that febrile convulsions are much commoner than epilepsy at your child’s age.