Febrile Seizures: Understanding This Common Cause of Seizures in Kids
Key takeaways:
A febrile seizure is a convulsion caused by a fever in a child. They are common in children under 6 years of age.
In most cases, febrile seizures are harmless and last only a few minutes. And they usually do not mean there’s a serious health problem.
Simple febrile seizures do not cause brain damage or long-standing complications. In rare cases, febrile seizures can lead to an increased risk of epilepsy.
Few things are more frightening to a parent than a seizure. The seizure may even be the first sign your child is sick. Yet as frightening as they are, seizures caused by fever are usually harmless. Most children who have a febrile seizure will never have another one. And there’s no risk of permanent damage.
What is a febrile seizure?
Febrile seizures are convulsions in a child that are caused by fever. They tend to happen in 5% of healthy children. The typical age range for febrile seizures is between 6 months and 5 years old. Febrile seizures most often affect children around 18 months of age.
There are two types of febrile seizures: simple and complex. A simple febrile seizure:
Involves shaking or jerking of the whole body
Lasts from a few seconds to 15 minutes
Happens only once in 24 hours
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A complex febrile seizure needs a medical evaluation. It typically:
Involves only one part of the body
Lasts longer than 15 minutes
Happens more than once in 24 hours
What causes febrile seizures?
Experts aren’t entirely sure why a fever can cause a seizure in some children. A seizure happens when the brain “short-circuits” and sends abnormal signals throughout the body. This causes the body to convulse.
Most febrile seizures happen within 24 hours of the start of a fever. How high the fever gets doesn’t make a seizure more likely. Any temperature above 100.4°F (38°C) can cause a seizure. And it appears that children with a family history of febrile seizures may be more at risk.
Febrile seizures can happen with any common illness that causes a fever. This can include:
Cold
Ear infection
RSV (respiratory syncytial virus)
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It’s important to know that vaccines rarely cause febrile seizures. In fact, vaccines can prevent some febrile seizures by protecting your child from common illnesses.
What are the symptoms of a febrile seizure?
During a febrile seizure, a child loses consciousness and shakes all over. Other common symptoms include:
A brief cry or moan
Sudden stiffness
Collapse
Shaking or jerking all over
Irregular breathing (it may seem like they stop breathing or turn blue)
A short period of sleepiness or confusion after the seizure
How do you treat febrile seizures?
There is no specific treatment for febrile seizures. It may seem like forever, but most febrile seizures stop in a few seconds to minutes. Febrile seizures are a symptom of a child’s fever. And fever is not a bad thing. It’s the body’s normal response to an illness or vaccine.
The important thing is to stay calm and treat the underlying illness that’s causing the fever. You can keep your child safe during a febrile seizure by following these tips:
Turn your child on their side so saliva can drain from their mouth.
Place them on a safe surface so they won’t fall.
Time the seizure and stay with your child.
Don't try to hold your child still or stop their movements.
Don't put anything in their mouth. They will not swallow their tongue.
Are febrile seizures in children serious?
A short (simple) febrile seizure is not an emergency. But you’ll need to seek medical attention to figure out the cause of the fever and treat it. Most children do not need to be hospitalized unless the seizure lasts a long time or a serious infection causes the fever.
You may need to seek emergency treatment if:
The seizure lasts more than 5 minutes.
There is more than 1 seizure in a 24-hour period.
Your child does not return to normal after several minutes.
Here’s the good news: Febrile seizures don’t cause any long-term complications. They don’t lead to brain damage, autism, or learning disabilities. And they do not affect a child’s intelligence, behavior, or school achievement.
In rare cases, there may be an increased risk of epilepsy. A very small number of children may have prolonged febrile seizures that last more than 30 minutes. In these children, there can be a 1 in 40 risk of developing epilepsy later.
How can you prevent febrile seizures?
It’s not necessary to prevent a febrile seizure in most cases. Fever reducers such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) have not been shown to prevent febrile seizures. But they will help lower a fever and make your child feel more comfortable.
Antiseizure medication for febrile seizures is not recommended for most people. The side effects of these medications are greater than the risk of a simple febrile seizure. But, if a child has frequent or severe febrile seizures, a healthcare provider may recommend oral diazepam (Valium) at the start of a fever. In rare cases, this may be helpful in preventing a febrile seizure.
The bottom line
Febrile seizures are a common, frightening event to witness as a parent or caregiver. But the good news is that they don’t hurt your child or cause complications. The most important things are to keep your child safe during a seizure and to treat the cause of the fever.
If you think your child has had a febrile seizure, make sure to contact a healthcare provider right away. They can help you figure out the next steps to keep your child safe.
Why trust our experts?
References
Centers for Disease Control and Prevention. (2020). Febrile seizure and childhood vaccines.
National Institute of Neurological Disorders and Stroke. (2022). Febrile seizures fact sheet.
Steering Committee on Quality Improvement and Management. (2008). Febrile seizures: Clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics.
Xixis, K. L., et al. (2022). Febrile seizure. StatPearls.
