Febrile Seizures in Children: What to Do

A febrile seizure is a seizure that happens between 6 months and 5 years of age, during a fever, without a brain infection or another cause. According to the American Academy of Pediatrics, it occurs in 2–5% of children in this age group. For parents these are often the scariest minutes of their lives, but in most cases the seizure is safe for the child and leaves no lasting effects.

Simple and complex febrile seizures

Simple febrile seizure: involves the whole body, lasts less than 15 minutes, and happens once in 24 hours. The vast majority of febrile seizures are of this kind.

Complex febrile seizure: starts on one side of the body (focal), lasts longer than 15 minutes, or repeats within 24 hours. In this case the evaluation is more detailed.

What to do during a seizure

During the seizure, lay the child on their side, loosen their clothing, put nothing in their mouth, do not hold the movements down, and note the time. After the seizure stops, the child may be drowsy, which is normal. After every first febrile seizure the child should be examined by a doctor: the goal is to find the cause of the fever and rule out a dangerous cause such as meningitis.

Is an EEG, blood test or MRI needed?

According to the American Academy of Pediatrics, in a neurologically healthy child who has had a simple febrile seizure, an EEG, routine blood tests and imaging are not indicated: they neither change the outlook nor affect treatment. A spinal tap is done only when meningitis is suspected (especially in children younger than 12 months or those whose vaccinations are incomplete). After a complex febrile seizure, or when the exam shows changes, an EEG and, if needed, an MRI are ordered.

Recurrence and epilepsy risk

About a third of children who have had a febrile seizure have another one with later fevers; the risk is higher if the first seizure happened before age 1 and if there is a family history of febrile seizures.

Epilepsy risk: in a classic cohort study (1,706 children followed to age 7), epilepsy developed in 2% of children after a febrile seizure; after a simple febrile seizure in a previously healthy child the figure was about 1%, which differs very little from the general population. The risk is higher after a complex seizure and in children who already had a neurological problem.

Treatment and prevention

Continuous antiepileptic treatment is not recommended after a simple febrile seizure: the side effects of the medicines outweigh the expected benefit. Fever-reducing medicines are given to make the child comfortable, but they have not been shown to prevent seizures. For children who have long or repeated seizures, the doctor may prescribe an emergency medicine for use at home and teach the parents how to give it.

Frequently asked questions

Does a febrile seizure damage the brain?

A simple febrile seizure does not damage the brain and does not affect intelligence or learning.

If I bring the fever down quickly, will I prevent a seizure?

Bringing the fever down is the right thing to do for your child's comfort, but it has not been shown to prevent a seizure. Please do not blame yourself.

Can a febrile seizure happen after a vaccine?

Vaccines can cause a fever, so in rare cases a febrile seizure may follow; this is not a reason to skip vaccines. Discuss the decision with your pediatrician.

What if seizures continue after age 5?

If seizures with fever continue after age 5–6, or the child has had a seizure without fever, a pediatric neurologist should examine the child in detail. Seizures and epilepsy

The information on this page is for education only and does not replace an examination by a doctor. If you are worried about your child, book an appointment. In an emergency, call 103.

Febrile seizures in children (seizures with fever)