Febrile Seizures

A febrile seizure is a fit (convulsion) that happens when a young child has a fever, usually from a common infection such as a cold, ear infection or other viral illness. During the seizure a child may become stiff, their arms and legs may jerk or twitch, they may lose consciousness, and sometimes they wet themselves. Febrile seizures are also called febrile convulsions.

They most often happen in children between 6 months and 6 years of age. Although they can be very frightening to watch, the large majority are brief and harmless, and the child recovers fully afterwards. A febrile seizure is not the same as epilepsy.

A typical febrile seizure comes on while a child has a fever. The child usually loses consciousness, the body goes stiff, and the arms and legs twitch or jerk. The eyes may roll back, breathing can become irregular for a short time, and the child may look pale or slightly blue around the lips during the fit. Most seizures last 2 to 3 minutes and stop on their own.

Afterwards, children are often sleepy, confused or irritable for a short while before returning to their usual selves. A simple febrile seizure is short, affects the whole body and happens only once in a 24-hour period. Seizures that last longer, affect one side of the body, or happen more than once in 24 hours are less common and need closer assessment.

Febrile seizures are linked to a fever, often during the early part of an infection when the temperature is rising. It is the fever itself, rather than any one illness, that is the trigger, and the infections involved are usually ordinary childhood ones. It is not the height of the fever alone but how a young, developing brain responds to it that matters.

A tendency to febrile seizures can run in families. Importantly, febrile seizures are not caused by anything a parent did or failed to do, and giving fever medicines does not reliably prevent them.

A doctor will ask exactly what happened during the seizure, how long it lasted, and about your child's fever and recent illness. The main aim is to find and treat the cause of the fever, so an examination focuses on looking for the underlying infection.

For a typical, short febrile seizure in a well-recovered child, special tests such as brain scans or EEGs are usually not needed. Further tests may be considered if the seizure was unusual, prolonged or repeated, if the child is very young, or if the doctor is concerned about a more serious infection.

Stay as calm as you can and protect your child from injury. Note the time the seizure starts, move away any hard or sharp objects, and gently lay your child on their side (the recovery position) so any fluid can drain from the mouth. Do not try to hold them still, and never put anything, including your fingers or medicine, into their mouth during a seizure.

Stay with your child until the seizure ends and they recover. Most seizures stop within a few minutes. Once it is over, comfort your child and let them rest. After a first febrile seizure, your child should be seen by a doctor to check the cause of the fever, even if they seem fully recovered.

Call emergency services or go to the nearest emergency department straight away if the seizure lasts longer than 5 minutes, if your child has another seizure soon afterwards or more than once in 24 hours, if your child is having trouble breathing or their lips or face look blue, or if they do not wake up or are very difficult to rouse after the seizure stops.

Also seek urgent help if it is your child's first seizure, if you are worried they may have a serious infection (for example a stiff neck, a rash that does not fade when pressed, or severe drowsiness), or if you are simply unsure. Routine fever medicines treat discomfort but are not a reliable way to prevent seizures, so the priority is keeping your child safe and getting them checked.

There is no reliable way to prevent febrile seizures. While paracetamol or ibuprofen can help a feverish child feel more comfortable, studies show that giving fever medicines does not dependably stop a febrile seizure from happening, so they should be used for comfort rather than as prevention.

Keeping up with routine childhood vaccinations helps protect against some of the infections that cause high fevers. If your child has had febrile seizures before, your doctor can talk you through what to do if one happens again.

The outlook is very reassuring. Simple febrile seizures do not cause brain damage and do not affect a child's development or intelligence. Most children stop having them by around the age of 6 as their brain matures.

Some children who have had one febrile seizure will have another, especially with future fevers, but each episode is usually short and harmless. Having febrile seizures only slightly raises the chance of developing epilepsy later, and for most children that risk remains low.