Febrile Seizures
Also known as: Fever fits, Febrile convulsions
A febrile seizure is a fit or convulsion triggered by a fever in a young child, most commonly between six months and five years of age. It typically happens early in an illness as the temperature rises quickly, and the child may stiffen, jerk their arms and legs, lose consciousness, and sometimes go blue around the lips. Watching one is extremely frightening for parents, but simple febrile seizures last less than 15 minutes, usually under five, and cause no lasting harm, brain damage, or learning problems. They are not epilepsy, although a very small proportion of children who have them go on to develop it. Around one in three children who have had a febrile seizure will have another with a future fever, and most children grow out of them by age six.
At a Glance
- Common symptoms
- A sudden loss of consciousness during a fever, Stiffening of the body followed by rhythmic jerking of the arms and legs, Eyes rolling back, foaming at the mouth, or a blue tinge to the lips
- Main treatments
- During the seizure: place the child on their side on a soft surface, remove nearby objects, and time it; do not restrain them or put anything in their mouth, Call emergency services if the seizure lasts more than 5 minutes, or if it is the child's first, Emergency medication (such as rectal diazepam or buccal midazolam) given by paramedics or, for children with recurrent prolonged seizures, by trained parents
- Category
- Pediatric · Common; affects roughly 2 to 5 percent of children under five in Western countries
- See a doctor if
- Any first febrile seizure: the child should be assessed the same day
Symptoms
Causes
- A rapid rise in body temperature, usually from a common viral infection
- Viral illnesses such as roseola, flu, colds, and gastroenteritis
- Ear infections, tonsillitis, or other bacterial infections
- Fever following some childhood vaccinations (the seizure is caused by the fever, not the vaccine itself, and is rare)
- An immature brain that is more sensitive to temperature changes
Risk Factors
- Age 6 months to 5 years, peaking at 12 to 18 months
- A family history of febrile seizures in a parent or sibling
- A previous febrile seizure
- Very high or very rapidly rising fever
- Prematurity or developmental delay (slightly higher risk)
Diagnosis
- A description of the seizure from whoever witnessed it, and examination of the child
- Identification and treatment of the cause of the fever
- Tests such as blood, urine, or a lumbar puncture only if meningitis or another serious infection is suspected, or in very young babies
- EEG or brain imaging are not needed for simple febrile seizures and are reserved for complex or recurrent cases
Treatment
- During the seizure: place the child on their side on a soft surface, remove nearby objects, and time it; do not restrain them or put anything in their mouth
- Call emergency services if the seizure lasts more than 5 minutes, or if it is the child's first
- Emergency medication (such as rectal diazepam or buccal midazolam) given by paramedics or, for children with recurrent prolonged seizures, by trained parents
- Treating the underlying infection, including antibiotics if a bacterial cause is found
- Paracetamol or ibuprofen to keep the child comfortable, though these do not prevent seizures
- Daily anti-seizure medication is not usually recommended because the risks outweigh the benefits for simple febrile seizures
- Supportive: reassurance and a written plan for parents on what to do if it happens again
Prevention
- Febrile seizures cannot be reliably prevented; fever-reducing medicines make the child more comfortable but have not been shown to prevent seizures
- Keep children's vaccinations up to date, which prevents many fever-causing illnesses
- Offer plenty of fluids and light clothing during a fever
- Learn seizure first aid so you can respond calmly
- Discuss a rescue medication plan with your doctor if your child has had prolonged seizures
When to See a Doctor
- Any first febrile seizure: the child should be assessed the same day
- A seizure lasting longer than 5 minutes, or repeated seizures: call emergency services
- Breathing difficulty, or the child not waking up or returning to normal within an hour
- A stiff neck, non-blanching rash, vomiting, or extreme drowsiness, which may suggest meningitis
- A seizure in a child under 6 months or over 6 years, or without a fever
Frequently Asked Questions
Related Conditions
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