Febrile Seizure: What Parents Should Know & How to Respond

What Is a Febrile Seizure?

A febrile seizure is a brief, fever-triggered burst of abnormal electrical activity in the brain that occurs in otherwise healthy, normally developing children with no prior seizure history. Most episodes happen within 24 hours of fever onset, last only a few minutes, and are generally harmless, with no long-term complications. They are relatively common, affecting about 2–5% of children worldwide, and reflect the temporary effect of high temperature on a developing brain, not a serious underlying brain disease.

Types of Febrile Seizures

Understanding febrile seizure types helps parents recognise what they're observing and communicate effectively with healthcare providers.

Simple Febrile Seizure

Simple febrile seizures represent the vast majority of cases, accounting for approximately 85% of all febrile seizures.

These seizures:

• Last from a few seconds to 15 minutes
• Affect the entire body (generalised)
• Don't recur within 24 hours
• Involve shaking or jerking of arms and legs
• Have no focal features confined to one body area

Complex Febrile Seizure

Complex febrile seizures are less common but require closer medical attention.

These seizures:

• Last longer than 15 minutes
• Occur more than once within 24 hours
• Are confined to one side of the body (focal)
• May involve periods of stiffness or unusual posturing

What Causes Febrile Seizures?

Understanding what causes febrile seizures helps parents recognise potential triggers:

• Fever: Usually above 38°C (100.4°F), often during a rapid temperature rise rather than at peak temperature.
• Viral infections: Especially flu and roseola.
• Bacterial infections: Such as tonsillitis and ear infections.
• Common childhood illnesses: Like chickenpox and respiratory infections.
• Post-vaccination fever: Rarely, fever following vaccines (especially MMR, DTP, or influenza) may trigger a febrile seizure.
• Rapid rise in temperature: The speed of fever increase often matters more than how high it gets.

As per the NHS, febrile seizures usually affect children between 6 months and 6 years, last around 2–3 minutes (rarely more than 10 minutes), and are unlikely to cause long-term harm, though urgent medical help is advised if it’s the first seizure, lasts over 5 minutes, or breathing and alertness don’t quickly return.

Who Is Most at Risk?

Several factors increase a child’s risk of febrile seizures:

• Age: Highest risk between 6 months and 3 years (can occur up to 5–6 years).
• Family history: Genetic predisposition makes seizures more likely.
• Previous febrile seizure: One episode raises the chance of another.
• Normal development: True febrile seizures occur in neurologically normal children.
• Gender: Slightly more common in boys than girls.
• Daycare exposure: More infections can mean more fevers and higher risk.

Symptoms of a Febrile Seizure

Recognising febrile seizure symptoms helps parents act quickly and describe events clearly to doctors:

• Shaking: Sudden, uncontrollable jerking of arms and legs
• Stiffness: Body goes rigid or takes an unusual posture
• Unresponsiveness: Child doesn’t respond to voice or touch
• Eye changes: Eyes roll back or stare fixedly
• Colour change: Lips/face may turn pale or bluish
• Loss of control: Possible vomiting or loss of urine/stool
• Fever: Temperature usually above 38°C (100.4°F)
• After-effects: Sleepiness, confusion, or irritability for up to an hour

How Febrile Seizures Are Diagnosed

Healthcare providers diagnose febrile seizures by:

• Taking a detailed history of the event and circumstances
• Confirming age (typically 6 months to 5 years)
• Documenting fever above 38°C during the seizure
• Ruling out CNS infections such as meningitis
• Ensuring there’s no history of afebrile seizures or epilepsy
• Checking that neurological development and exam are normal

Tests for Febrile Seizures

While febrile seizures are primarily diagnosed clinically, certain tests may be necessary:

• Lumbar puncture: May be performed to exclude meningitis, particularly in infants
• Blood tests: Help identify underlying infections causing fever
• Neuroimaging: Generally unnecessary for simple febrile seizures but may be considered in complex cases
• Electroencephalogram: Not routinely recommended for simple febrile seizures

How Long Do Febrile Seizures Last?

Most febrile seizures are brief, usually lasting 2–3 minutes and rarely more than 5 minutes. By definition, simple febrile seizures last under 15 minutes, and episodes over 10 minutes are uncommon. Very rarely, febrile status epilepticus can occur, with seizures lasting 30 minutes or more; these need immediate emergency medical care, even though long-term harm is still uncommon.

What To Do During a Febrile Seizure (First Aid)

When your child has a febrile seizure, follow these key steps:

• Stay calm and time it – note when the seizure starts.
• Keep them safe – move them away from hard objects or edges.
• Turn on their side – helps keep the airway clear and reduce choking risk.
• Loosen clothing – especially around the neck and chest.
• Don’t restrain them – let the movements happen without holding them down.
• Stay with your child – watch their breathing and movements.
• Call emergency services if the seizure lasts more than 5 minutes.

What NOT To Do During a Seizure

• Never put anything in the child's mouth: This can cause choking or dental injuries
• Don't give medications during seizure: Wait until child is fully conscious
• Avoid forceful restraint: This can cause injuries without stopping the seizure
• Don't panic: Your calm presence helps both child and emergency responders

Treatment for Febrile Seizures

Most febrile seizures don’t need specific seizure treatment. Supportive care and managing the fever are usually enough, with focus on treating the underlying infection. For prolonged seizures, emergency teams may use medicines to stop the episode, but long-term anti-seizure drugs are rarely advised for simple febrile seizures because they are generally benign.

Medications Used

• Paracetamol: Primary fever reducer, safe and effective for children
• Ibuprofen: Alternative fever reducer for children over 6 months
• Emergency seizure medications (like rectal diazepam or intranasal midazolam): May be used if a seizure lasts more than 5 minutes, either by trained caregivers or emergency professionals
• Antibiotics: Prescribed when bacterial infections are identified

Recovery: What Happens After the Seizure

After a febrile seizure, it’s normal for a child to be sleepy, confused, or irritable for up to an hour. This postictal phase does not mean brain damage. Most children return to their usual behaviour as the fever and underlying illness improve, with no lasting effects from the seizure itself. Parents should keep monitoring the temperature, treat the infection as advised, and offer calm, reassuring care to support recovery.

When to See a Doctor

Seek immediate medical attention if your child experiences:

• First febrile seizure: Always requires medical evaluation
• Seizures lasting over 5 minutes: Emergency medical care needed
• Multiple seizures within 24 hours: Indicates complex febrile seizure
• Focal seizures: Affecting only one body part requires assessment
• Signs of serious infection: Severe illness symptoms beyond fever
• Difficulty breathing: Respiratory distress during or after seizure
• Persistent altered consciousness: Confusion lasting beyond one hour

Can Febrile Seizures Be Prevented?

You can’t fully prevent febrile seizures, even in children who are prone to them. Seizures often occur during the initial rapid rise in temperature before fever is noticed, and studies show routine fever reduction doesn’t reliably stop them. It’s better to focus on treating the underlying infection and keeping your child comfortable rather than trying aggressive fever prevention.

Reducing Fever Safely

• Use appropriate medications: Paracetamol or ibuprofen as directed by healthcare providers
• Maintain hydration: Offer fluids frequently to prevent dehydration
• Dress appropriately: Light clothing helps body temperature regulation
• Monitor closely: Check temperature regularly during illness
• Seek prompt care: Early treatment of infections may reduce fever severity

Do Febrile Seizures Lead to Epilepsy?

Most children with simple febrile seizures do not develop epilepsy, and their risk is only slightly higher than other children. Even with complex febrile seizures, the vast majority grow and develop normally without long-term neurological problems. Regular follow-up with healthcare providers helps track development and address any concerns about future seizure risk.

Complications (Rare)

Serious complications from febrile seizures are extremely uncommon:

• Brain damage: Virtually never occurs from simple febrile seizures
• Learning difficulties: No increased risk associated with simple febrile seizures
• Future epilepsy: Slightly elevated risk, but most children remain seizure-free
• Physical injuries: May occur from falls during seizure onset
• Recurrent febrile seizures: About one-third of children experience additional episodes

Febrile Seizures vs Epileptic Seizures

Key differences between febrile and epileptic seizures:

• Fever: Febrile seizures always occur with fever; epileptic seizures don’t require fever.
• Age: Febrile seizures affect young children; epilepsy can occur at any age.
• Recurrence: Febrile seizures recur only with fever; epileptic seizures recur without it.
• Course & treatment: Febrile seizures usually resolve by school age and are managed by treating fever, while epilepsy typically needs long-term seizure medication and follow-up.

Febrile Seizures After Vaccination

Rarely, children may have a febrile seizure after vaccines like MMR or DTP due to the fever they cause, not the vaccine itself. The benefits of vaccination far outweigh this small risk, and a past febrile seizure usually doesn’t prevent future shots. If your child has a seizure history, discuss vaccine timing and fever management with your doctor.

Long-Term Outlook

The long-term outlook for children with febrile seizures is very good. Most outgrow them by 5–6 years as the brain matures, and simple febrile seizures do not affect intelligence, learning, or behaviour. Children can safely join regular activities, including school and sports; parents should simply inform teachers and caregivers about the seizure history so they can respond appropriately if the child develops a fever.

Conclusion

Febrile seizures are scary to watch but are usually brief, do not cause brain damage, and most children go on to live completely normal lives—what matters is staying calm, responding safely, and getting your child evaluated by a doctor as advised.

If your pediatrician recommends tests to find the cause of fever or monitor overall health, Metropolis Healthcare offers 4,000+ tests, specialised panels, and full body checkups with accurate results and quick turnaround times. You can book easily via website, call centre, app, or WhatsApp, and rely on their strong home sample collection network with 10,000+ touchpoints so your child can be tested safely and comfortably at home while you focus on their recovery.

FAQs

What triggers a febrile seizure?

High fever in children (usually above 38°C / 100.4°F) can trigger febrile seizures, most often due to viral infections like flu or roseola, bacterial infections such as tonsillitis, or other childhood illnesses that cause a rapid temperature rise.

How serious is a febrile seizure?

Simple febrile seizures are usually not serious, don’t cause brain damage, and most children recover fully without long-term problems, even though the episode can be very frightening for parents.

Can febrile seizures happen without fever?

No. By definition, febrile seizures only occur with fever; seizures without fever suggest another cause and need a different medical evaluation.

How do you stop a fever seizure fast?

You can’t stop a febrile seizure once it starts; focus on safety by turning your child on their side, clearing nearby hazards, and timing the episode; most stop on their own within a few minutes.

Should I call an ambulance for a febrile seizure?

Call emergency services if it’s your child’s first seizure, lasts longer than 5 minutes, or if there is breathing difficulty; for brief, familiar episodes, contact your doctor for further guidance.

Can adults have febrile seizures?

Febrile seizures are almost exclusive to children aged 6 months–5 years. Seizures associated with fever in adults usually indicate another underlying condition and require separate medical assessment.

Do febrile seizures cause brain damage?

Simple febrile seizures do not cause brain damage or affect intelligence, learning, or development, and even complex episodes rarely lead to permanent neurological problems.

How long does it take a child to recover?

Most children recover within 15–30 minutes, though they may be sleepy or irritable for up to an hour, and usually return to normal once the fever and illness improve.

Are febrile seizures genetic?

Yes, they often run in families; children with a parent or sibling who had febrile seizures have a higher chance of having them during fever.