Febrile convulsions

Pre-referral guidelines for primary care providers

Febrile convulsions occur in 2-3% of normal children, with onset typical between 6 months and 6 years of age.

Afebrile seizures, i.e. convulsions with the absence of fever, can occur at any age. Please see the Seizures pre-referral page for further details.

For the assessment and management of febrile convulsions, please refer to the Royal Children’s Hospital clinical practice guidelines.

Practice points

  • Febrile convulsions are benign occurrences that do not increase the risk of epilepsy
  • The height of a fever is not related to the risk of a febrile convulsion
  • Giving antipyretics in febrile illnesses will generally not reduce the risk of febrile convulsions.
  • Infants under the age of 6 months do not typically have febrile convulsions, thus underlying causes and referral to an Emergency Department should be considered.

Referral pathways

Acute care of febrile convulsions should be undertaken in an Emergency Department if there is any difficulty with persistence of a convulsion, atypical features, persistently abnormal neurological state or if the child is unwell.

  • Paediatrician
    • Referral to paediatric outpatient services is not appropriate in the management of acute febrile convulsions.
    • Referral to paediatric outpatient services can be considered for further evaluation of atypical febrile convulsions.