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Febrile seizures

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 4 minutes read

A febrile seizure (sometimes called a febrile convulsion or febrile fit) happens when some babies and toddlers have a high temperature (a fever.) It can be alarming and scary to see, but it's usually harmless, and most children make a complete recovery. It’s best to get your child checked out the first time this happens, so take them to the nearest hospital or call an ambulance if your child is having a seizure.

Children aged between 6 months and 3 years are most commonly affected, and around 5% of children have a febrile seizure before the age of 6. It doesn’t affect every child, but once they’ve one febrile convulsion, they have a higher chance of having a seizure with the next feverish illness – the chance is about 1 in 3. They are rare under the age of 3 months and after the age of 6.

What causes febrile seizures?

There is no clear cause for febrile seizures. We know that is it is linked to the start of a high temperature which can be caused by any viral or bacterial infection. There is also a genetic link, so there’s a slightly higher risk if a parent of sibling had them. On very rare occasions a seizure may occur after a vaccination.

What are the signs of a febrile seizure?

This depends on the type of febrile seizure – there are three types but a febrile seizure is usually obvious to spot – you may get one or all of the possible signs.

Simple febrile seizure. This is the commonest type, affecting around three quarters of children who have a febrile fit. In this type, the symptoms are usually triggered as the child’s body temperature starts to rise and it causes them to look hot and flushed initially. Their eyes may then roll back in their eyes before they become unconscious and twitch (sometimes violently). They may also wet themselves before the fit ends, usually only lasting a few seconds although it may take a few minutes to settle in some cases. They’re then often very sleepy afterwards but after an hour or so are usually much better, often because their temperature has started to come down.

Complex febrile seizures are less common – affecting around 4 in 20 cases - and are recognised as lasting longer than 15 minutes and possibly just affecting one area of the body. They may look similar to simple febrile fits but can reoccur within 24 hours and it can take longer than one hour for the child to recover fully.

Febrile status epilepticus is the least common of all – affecting 1 in 20 cases – and simply means the convulsion lasts longer than 30 minutes.

What do I do if my child has a febrile seizure?

  1. Place them in the recovery position on the floor or bed, to keep them safe and allow saliva to drain from their mouth.
  2. Do not leave your child alone, and make a note of how long the seizure lasts.
  3. Do not put anything into your child’s mouth during a seizure as they may choke on it.
  4. Once the seizure has stopped, try to lower your child’s temperature by taking off their clothes and giving them paracetamol or ibuprofen.

Although it's unlikely to be anything serious, you should take your child to the nearest hospital or call 999 and ask for an ambulance if this is your child’s first seizure, if it lasts more than 5 minutes, if your child has difficulty breathing or if you’re concerned there’s something more worrying going on.

Are there any complications of a febrile seizures?

Normally there is full recovery, with no after-effects. However, febrile seizures have been linked to a small increased risk of a condition called epilepsy, where people have repeated seizures without a fever. The risk is about 1 in 50 with simple febrile seizures, and a little higher (about 1 in 20) if the seizures are the complex type. This is compared to a 1 in 100 chance of developing epilepsy without any history of febrile seizures.

It can be distressing to see a febrile seizure, and you’ll want to do everything to keep your child safe and prevent them happening in future. Unfortunately, you can't prevent them, you can only keep your child feeling secure and calm when they occur. It's not really understood why, but keeping a tight control over a fever with medications doesn't seem to prevent febrile seizures if your child has a tendency towards them. But you can use paracetamol or ibuprofen, as you usually would, if your child has a high fever.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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