Quick answer: Watching your child have a seizure is one of the most frightening experiences a parent can have — even when the cause is benign.
Watching your child have a seizure is one of the most frightening experiences a parent can have — even when the cause is benign. Febrile seizures are common, they look terrifying, and the vast majority are completely harmless. Here’s what to do and what to know.
What a Febrile Seizure Is
A febrile seizure is a convulsion triggered by a rapidly rising fever in a child between 6 months and 5 years. They affect approximately 2–5% of children and are most common between 12–18 months. Simple febrile seizure (the most common type, ~85% of cases): generalised tonic-clonic convulsion (stiffening followed by rhythmic jerking of all limbs), lasts under 15 minutes, occurs only once in a 24-hour period, and the child returns to their normal self within an hour. Complex febrile seizure: lasts longer than 15 minutes, focal (affecting one part of the body), or occurs more than once in 24 hours. Complex febrile seizures warrant more thorough evaluation.
What to Do During a Febrile Seizure
Stay calm — it will end. Time the seizure from when it starts. Protect from injury — lay child on their side on a soft surface, move any hard objects away. Never restrain the movements or hold the child down. Never put anything in the mouth — this is dangerous and unnecessary. Do not give food, water, or medication during the seizure. Call 999/911 if: the seizure lasts more than 5 minutes; it’s a first seizure (call for 999/111 in UK for guidance); the child doesn’t recover consciousness after the seizure ends; there’s a second seizure; breathing is laboured after the seizure; or the child appears very unwell. After the seizure: The child will likely be confused, sleepy, and frightened (postictal phase). This is normal. Keep them safe, comfortable, and calm.
Does Having a Febrile Seizure Cause Brain Damage?
No — simple febrile seizures do not cause brain damage, intellectual disability, or cerebral palsy. The hippocampus (often cited as vulnerable) is not damaged by brief febrile seizures in studies. Complex febrile seizures of more than 30 minutes (febrile status epilepticus) are associated with a small risk of hippocampal injury — which is why seizures lasting more than 5 minutes are treated as emergencies (benzodiazepines to stop the seizure).
Risk of Recurrence and Epilepsy
Recurrence risk: approximately 30–50% of children who have one febrile seizure will have another. Risk is higher with: younger age at first seizure, lower temperature at time of seizure, family history of febrile seizures. Risk of developing epilepsy after a simple febrile seizure is approximately 1–2% — close to the general population rate. Complex febrile seizures carry slightly higher epilepsy risk (2–10% depending on features). Most children who have febrile seizures do not develop epilepsy.
Frequently Asked Questions
Should I rush to hospital after a febrile seizure that has stopped?
For a first febrile seizure, even if it’s stopped: yes, seek same-day medical evaluation. The purpose is to identify the source of the fever (ear infection, UTI, viral illness) and to establish that this was a typical febrile seizure and not a first seizure from another cause. For a child with known febrile seizures who has a typical recurrence that resolves within 5 minutes: contact your GP or call your health provider for advice — emergency attendance may not be necessary.
Can I prevent febrile seizures by giving paracetamol when my child has a fever?
No — multiple studies have found that prophylactic paracetamol or ibuprofen during fevers does not prevent febrile seizures. The seizures are triggered by the rapid rise in temperature, not by the peak temperature — by the time fever is detected and treated, the triggering moment has passed. Treat fever for comfort, not for seizure prevention.
My child had a febrile seizure — do they need anti-epileptic medication?
Generally no. Simple febrile seizures don’t require regular anti-epileptic medication. For children with frequent recurrences or complex febrile seizures, specialist discussion about intermittent rectal diazepam or buccal midazolam (for use during a prolonged seizure) may be appropriate. Discuss with your paediatrician.
Related Reading
- Baby fever: temperature chart, when to go to ER
- Can I give my baby paracetamol?
- Baby’s breathing: what’s normal, what’s not
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