I consulted a book by Dr. Robert S. Mendelsohn, M.D. ( a leading American Pediatrician) regarding his view on fevers and convulsions. He writes, "High fevers do not cause convulsions. They result when the temperature rises at an extremely rapid rate." He goes on to say, "Many parents are fearful of fevers because they have witnessed a convulsive seizure and believe that their child may experience one if his temperature is allowed to rise "too high". I empathize with those who have this concern, for a child in the throes of a convulsion is a frightening spectacle. If you have seen one occur, you may find it hard to believe that this condition is rarely serious. It is also relatively uncommon; it is estimated that only 4 % of children with high fever experience fever-related convulsions. There is no evidence that those who do have them suffer any serious aftereffects as a result. One study of 1,706 children who had suffered febrile convulsions failed to disclose a single death or motor defect. There is no convincing evidence that febrile seizures in childhood increase susceptibility to epilepsy later in life."  Dr. Mendelsohn goes on to say, " Treatment to prevent febrile convulsions is almost always given too late to do any good. Medication and sponging are a useless exercise because, by the time you become aware that your child has a temperature, the probability is that any resulting convulsion would already have occurred. That’s because the convulsion is not related to the height of your child’s temperature but to how rapidly the temperature rose to whatever level it reached.   The possibility of febrile convulsions is limited primarily to children under five years of age, and even those children who experience them prior to that age rarely have them after the age of five".

I will have to check with my son’s endo to see if this advice also pertains to children who have CAH. This is the advice I’ve always used (so far) with my non-CAH 6 yr old daughter and my 4 yr old SWCAH son.