A febrile seizure is a seizure triggered by a fever, mostly in children aged 6 months to 5 years. It is frightening to watch, but it is usually over within a few minutes and does not cause lasting harm. Lay your child on their side, note the time and stay with them. Call 998 if it lasts more than 5 minutes, and have every first seizure checked by a doctor.

What is a febrile seizure?

A febrile seizure happens when a rising temperature affects a young child’s developing brain. The child may suddenly stiffen, shake or jerk their arms and legs, roll their eyes, lose awareness and not respond to you. Some children go limp or stare, and some turn pale or slightly blue around the lips for a short time.

About 2 to 5 in every 100 children have at least one, according to the American Academy of Pediatrics. They are most common between 12 and 18 months of age. They are linked to the speed of the rise in temperature, not just how high it goes, which is why a seizure can be the first sign that a child is ill.

What should I do during a febrile seizure?

Stay calm and do these things:

  1. Note the time it started.
  2. Lay your child on their side on a soft surface such as a bed or the floor, in the recovery position. This keeps the airway clear if they vomit.
  3. Clear the area of hard or sharp objects.
  4. Loosen tight clothing, especially around the neck.
  5. Stay with your child and watch them until the seizure stops and they wake up.

Do not:

  • put anything in your child’s mouth. Children do not swallow their tongues
  • hold them down or try to stop the movements
  • give food, drink or medicine by mouth during or straight after the seizure
  • put them in a bath or cold water to bring the temperature down

Most febrile seizures stop on their own within one to two minutes.

When should I call 998?

Call 998 or go to the nearest emergency department if:

  • the seizure lasts longer than 5 minutes
  • there is a second seizure straight after the first, or several within a day
  • your child has trouble breathing, or turns blue or grey
  • your child does not wake up properly, or is very drowsy or floppy for more than a few minutes afterwards
  • your child is under 6 months old
  • there is a stiff neck, a severe headache, or a rash that does not fade when you press it with a glass
  • your child is injured, or the seizure affected only one side of the body

If you are unsure, call. The call handler can advise you over the phone.

Does my child need to see a doctor after a first febrile seizure?

Yes. Every child who has a first seizure with a fever should be seen by a doctor the same day, even if they have fully recovered. The doctor will look for the cause of the fever, such as an ear infection, a throat infection or a viral illness, and check that the seizure was a simple febrile one and not a sign of something more serious.

Bring information to the visit: what time it started, how long it lasted, what your child’s body did, and what your child was like before and after. A phone video, if you can safely take one after the event, helps.

What is the difference between a simple and a complex seizure?

Doctors divide febrile seizures into two types:

Simple
lasts less than 15 minutes, affects the whole body, and happens once in 24 hours. Most febrile seizures are simple.
Complex
lasts longer than 15 minutes, affects one side or part of the body, or happens more than once in 24 hours.

A complex seizure, or a seizure in a very young baby, may need more tests or observation in hospital. A simple one usually needs only treatment of the illness causing the fever.

Does a febrile seizure damage my child’s brain?

No. Simple febrile seizures do not cause brain damage, learning problems or any lasting effect on development. Children recover fully and go back to normal play within an hour or so, though they may be sleepy.

Will my child develop epilepsy?

Most children who have a febrile seizure never develop epilepsy. The risk is a little higher than in other children, mainly after complex seizures, repeated seizures or when there is epilepsy in the family, but it remains low. Your doctor will tell you if your child needs follow-up or further tests.

Will it happen again?

About one in three children who have one febrile seizure will have another, usually in the next year. It is more likely if the first seizure happened before 12 months of age, at a lower temperature or soon after the fever started, or if a parent or sibling had febrile seizures. Most children outgrow them by age 5 or 6.

Can I prevent febrile seizures with fever medicine?

No. Paracetamol and ibuprofen make a child with a fever more comfortable, but they do not prevent febrile seizures. Giving them is fine for comfort, but do not give extra doses or rely on them to prevent a seizure. Do not use cold baths or alcohol rubs.

Our guides to dealing with a fever and fever treatment dos and don’ts explain what helps and what does not.

Do vaccines cause febrile seizures?

Rarely. Some vaccines, such as MMR, slightly raise the chance of a fever and, in a few children, a febrile seizure in the days after the injection. This is small, and the diseases the vaccines prevent are far more likely to cause serious harm. See our guide to fever after baby vaccines for what is normal. The NHS also has clear information about febrile seizures.

When to see a doctor

See a doctor on the same day if your child:

  • has had a seizure for the first time, even if it was short and they seem fine
  • has had a febrile seizure and now has another fever, especially with an ear ache, a sore throat, a cough or a rash
  • is very sleepy, will not drink, or is not passing urine
  • has a fever that is not coming down, or lasts more than 3 days
  • has had more than one seizure in a day

Call 998 for any seizure over 5 minutes, difficulty breathing, a stiff neck or a child who does not wake up properly. Our guide to when to go to the ER or the pediatrician can help you plan ahead.

How we can help at myPediaclinic

Dr. Medhat Abu-Shaaban, Consultant Pediatrician and Medical Director, and Dr. Tala Belbeissi, Consultant Pediatrician, see children with fever and after a seizure through our pediatric check-ups. We find the cause of the fever, examine your child and explain what to do if it happens again. If your child needs tests or specialist care, we arrange the referral. Both consult in English and Arabic at our clinic in Dubai Healthcare City.

A seizure is an emergency until proven otherwise, so call 998 first if your child is having one now.

Frequently asked questions

Should I give my child medicine after a seizure?

Only once your child is awake, alert and able to swallow. Paracetamol or ibuprofen can then be given for comfort at the dose on the label for their weight. Medicine does not stop a seizure that is already happening, so never try to give it during one.

Is it safe to let my child sleep after a seizure?

Yes. Children are often very sleepy for a while afterwards. Lay them on their side, and check that they are breathing normally and wake easily when you call their name. If they are very hard to wake, call 998.

Can I keep my child at home during a fever to prevent seizures?

You cannot prevent a febrile seizure, but you can keep your child comfortable and watch them closely. Offer fluids, dress them lightly and keep them cool. Having your doctor’s number to hand, and knowing what to do, helps you feel prepared.

Do febrile seizures run in families?

Often, yes. A child with a parent or sibling who had febrile seizures is more likely to have one. Tell your doctor about any family history, as it helps them assess the risk of recurrence.

Can my child go to nursery and play sports as normal?

Yes. After a simple febrile seizure, children can return to nursery, school and normal activity once they are well. A seizure does not mean your child must be wrapped in cotton wool. Tell the nursery staff what to do if it happens again.

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