Mixing within sessile drops can be enhanced by generating internal flow patterns using ac electrowetting. While for low ac frequencies, the flow patterns have been attributed to oscillations of the drop surface, we provide here the driving mechanism of the hitherto unexplained high-frequency flows. We show that: (1) the electric field in the liquid bulk becomes important, leading to energy dissipation due to Joule heating and a temperature increase of several degrees Celsius, and (2) the fluid flow at these frequencies is generated by electrothermal effect, i.e., gradients in temperature give rise to gradients in conductivity and permittivity, the electric field acting on these inhomogeneities induces an electrical body force that generates the flow. We solved numerically the equations for the electric, temperature and flow fields. The temperature is obtained from a convection-diffusion equation where Joule heating is introduced as a source term. From the solution of the electric field and the temperature, we compute the electrical force that acts as a body force in Stokes equations. Our numerical results agree with previous experimental observations.