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Brief febrile convulsions need no specific treatment; cool the child by removing excess clothing and give antipyretic medication, e.g. paracetamol is commonly used to reduce fever and prevent further convulsions but evidence to support this practice is lacking. Ibuprofen may be given in between doses of paracetamol, if the temperature is not controlled adequately with paracetamol alone.
Prolonged febrile convulsions (those lasting 5 minutes or longer), recurrent convulsions, or those occurring in a child at known risk must be treated more actively, as there is the possibility of resulting brain damage. Diazepam or buccal midazolam may be given:
Intermittent prophylaxis (i.e. the anticonvulsant administered at the onset of fever) is possible in only a small proportion of children.
Long-term anticonvulsant prophylaxis for febrile convulsions is rarely indicated. Anticonvulsant treatment needs to be considered only for children at risk from prolonged or complex febrile convulsions, including those whose first seizure occurred at under 14 months or who have neurological abnormalities or who have had previous prolonged or focal convulsions.