Febrile Seizure in Children: What Every Parent Should Know

Seeing your child have a seizure during a fever can be frightening, even if it lasts only a short time. Many parents describe those moments as overwhelming, filled with worry and uncertainty about what is happening and what they should do next.

In most cases, febrile seizures are a temporary reaction to a sudden rise in body temperature and are not linked to epilepsy or long-term problems in otherwise healthy children. 

Understanding how to keep your child safe during a seizure, recognising warning signs that need urgent medical attention, and knowing when to seek medical advice can help you feel calmer and more prepared should it happen again.

What is a febrile seizure?

A febrile seizure is a convulsion that happens when your child has a fever, usually above 38°C. While not extremely common, they do occur in some young children between 6 months and 5 years, particularly between 12 and 18 months of age.

Learning the difference between the two types can help you feel more prepared and know when your child needs additional medical support. Doctors generally describe febrile seizures as either simple or complex, based on how long they last and how they affect the body.

• Simple febrile seizures account for the majority of cases. They last less than 15 minutes (usually just a few minutes), affect the whole body, and don't repeat within 24 hours.
• Complex febrile seizures last longer than 15 minutes, may affect only one part of the body, or happen more than once within 24 hours. These need closer medical attention.

The distinction between these two types is important – simple febrile seizures can be assessed at urgent care after they stop, while complex febrile seizures require immediate A&E evaluation.

Febrile seizures don't mean your child has epilepsy or a serious brain condition. What's actually happening is that your child's developing brain is simply more sensitive to sudden changes in body temperature. 

Most children who experience febrile seizures go on to develop normally, with no lasting effects. Knowing this can help ease some of the fear you might be feeling right now.

Febrile seizure symptoms

Recognising the signs of a febrile seizure can help you respond quickly and calmly when it matters most. The seizure often begins without warning, usually when the fever spikes.

During a febrile seizure, your child may:

• Lose consciousness or become unresponsive to your voice

• Shake or jerk their arms and legs on both sides of the body

• Roll their eyes back or stare blankly

• Stiffen their body or arch their back

• Have difficulty breathing or briefly appear bluish around the mouth

• Drool or foam at the mouth

Most febrile seizures last between one and two minutes. Simple febrile seizures stop on their own within 15 minutes.

Once the seizure ends, your child may seem drowsy, confused, or a bit irritable for a short while. This can be unsettling to watch, but it's a normal part of their body recovering and usually passes within an hour or two. Your child's brain has just been through something intense, and they need time to rest and resettle. 

Stay close, speak softly, and let them recover at their own pace. If the drowsiness continues beyond a couple of hours, or if you notice anything else that doesn't feel right, trust your instincts and contact your doctor for guidance.

Febrile seizure cause

Febrile seizures are triggered by a rapid rise in body temperature, usually during the early stages of an illness. The exact reason why some children have febrile seizures while others don’t isn't fully understood, but it's thought to be related to how a young child's developing brain responds to fever.

Common illnesses that can trigger febrile seizures include:

• Viral infections, such as flu, cold, roseola, or ear and throat infections

• Urinary tract infections

• Gastroenteritis (stomach bug)

• Post-vaccination fever (though this is rare and usually mild)

The seizure is caused by your child’s fever itself, not the underlying illness. In most cases, the fever needs to reach at least 38°C, though some children may have seizures at lower temperatures.

Risk factors of febrile seizure

While any child with a fever can have a febrile seizure, there are certain factors that increase the likelihood, such as:

• Your child is between 6 months and 5 years old (the brain is still developing during this period).

• Your child has a family history of febrile seizures in parents or siblings.

• Your child’s first febrile seizure occurs before 18 months of age.

Having one or more of these risk factors doesn't mean your child is guaranteed to have a febrile seizure. But it does help to be informed, so you can watch for fever a bit more closely and feel less caught off guard if it does occur.

What to do if your child has a febrile seizure

Staying calm and knowing what to do during a febrile seizure can help you focus on keeping your child safe. Most febrile seizures stop on their own within a few minutes and don't require emergency treatment if your child recovers quickly and fully.

First aid for febrile seizures

If your child is having a febrile seizure, follow these steps:

• Stay calm and time the seizure:

  • Note when it starts and stay with your child throughout. Use your phone timer if possible.

• Keep your child safe:

  • Place them on their side on a soft surface like a carpet or bed. This position helps prevent choking if they vomit or drool. 

  • Remove any nearby objects that could cause injury.

• Loosen tight clothing:

  • Gently loosen any clothing around their neck to help them breathe more easily.

• Do not restrain your child:

  • Let the seizure run its course. Don't try to hold them still or stop the shaking movements.

• Never put anything in their mouth:

  • Don't insert your fingers, food, or any objects, as putting something in their mouth could cause choking or injury.

After the seizure stops, keep your child comfortable and let them rest. Offer comfort and reassurance once they regain consciousness.

Situations requiring immediate emergency care

Most febrile seizures stop on their own within a few minutes. 

However, you must call 995 or head straight to A&E immediately if you notice any of the following:

• The seizure lasts longer than 5 minutes

• Your child has difficulty breathing, turns blue or has another seizure within 24 hours

• Your child doesn't regain consciousness after the seizure

• Your child is under 6 months old

• Your child has a stiff neck or persistent vomiting

Trust your instincts in these moments – seeking emergency care quickly ensures your child gets the support they need when it matters most.

Visit urgent care or your GP after the seizure stops

If the seizure has ended and your child is beginning to settle, it's still important to seek medical attention within 24 hours. 

You can visit your GP or an Urgent Care Centre (UCC) for:

• An examination to understand what triggered the fever

• Guidance on managing the fever and keeping your child comfortable

• Reassurance and practical advice on what to watch for going forward

• A care plan to help you feel prepared if another seizure happens

• Referral to a paediatrician if there are any concerns that need further attention

Your doctor will examine your child, work out what caused the fever, and talk you through what to watch for going forward. It's also a chance for you to ask the questions that are likely weighing on you and get clearer about what happens next.

Do febrile seizures cause brain damage?

The good news is that febrile seizures usually do not cause brain damage, developmental delays, cerebral palsy, or intellectual disability. 

However, it’s important to note that children who have had febrile seizures do have a slightly higher chance of developing epilepsy later in life, though the vast majority never develop this condition. The risk is higher if your child has complex febrile seizures or a family history of epilepsy.

It's natural to worry about your child's development after experiencing something like a seizure. Your paediatrician is there to support you and address any concerns that arise during follow-up appointments.

Can febrile seizures be prevented?

There's no guaranteed way to prevent febrile seizures. They often occur during the initial rapid rise in temperature, sometimes before you're even aware your child is unwell.

Fever-reducing medications like paracetamol or ibuprofen can make your child more comfortable but don't prevent seizures from happening.

While you can't prevent febrile seizures entirely, you can take steps to care for your child when they're unwell:

• Monitor your child's temperature when they're not feeling well

• Give fever-reducing medication as directed by your doctor

• Ensure your child stays well-hydrated

• Dress them in light clothing

• Keep the room at a comfortable temperature

Most children naturally grow out of febrile seizures by age 5. If your child has had multiple febrile seizures, your doctor may discuss whether to prescribe standby medication for home use during prolonged seizures. However, this is not routinely recommended for all children. 

What matters most is knowing how to respond safely and confidently if a seizure does occur. Being prepared can help you feel more in control during an unsettling moment. These steps cannot prevent all febrile seizures, but they help support your child’s comfort and recovery during illness.

FAQ

Can a child have a febrile seizure without a fever?

No, febrile seizures by definition occur with a fever. However, the seizure may happen before you notice the fever, as it's often triggered by a rapid rise in temperature at the start of an illness.

Will my child have another febrile seizure?

About one in three children who have had a febrile seizure will have another one. The risk is higher if the first seizure occurred before 18 months of age or if there's a family history of febrile seizures.

Are febrile seizures genetic?

Yes, febrile seizures can run in families. If a parent or sibling has had febrile seizures, your child has a higher risk of experiencing them.

Do febrile seizures lead to epilepsy?

Most children who have febrile seizures do not develop epilepsy. While there is a slightly increased risk compared to children who haven't had febrile seizures, the vast majority of children grow out of them completely without any long-term effects.

Can teething cause febrile seizures?

Teething alone doesn't cause febrile seizures. While teething may cause a slight rise in temperature, it normally doesn't reach the level needed to trigger a seizure (38°C or higher). If your teething child has a seizure, it's more likely due to an underlying infection.

Is it safe for my child to have vaccinations after a febrile seizure?

Yes, vaccinations are generally safe and recommended. While some vaccines can cause a mild fever, the benefits of vaccination far outweigh the small risk of triggering another febrile seizure. Discuss any concerns with your paediatrician before scheduled vaccinations.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations based on your medical conditions, request an appointment with Thomson Medical.