Febrile Seizures | National Institute of Neurological Disorders and Stroke

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What are febrile seizures?

Febrile seizures are seizures or convulsions that occur in young children. They are triggered by fever typically above 101 degrees Fahrenheit (38.3 degrees Celsius). Seizures may happen during illnesses such as a cold, the flu, or an ear infection. In some cases, a child may not have a fever at the time of the seizure but will develop one a few hours later.

Having a febrile seizure does not mean a child has epilepsy. Epilepsy involves repeat seizures that are not triggered by fever.  

Symptoms may include:

• Loss of consciousness or passing out
• Uncontrollable shaking
• Eye rolling
• Rigid (stiff) limbs

Less commonly, a child can become rigid or have twitches in only part of the body.

Most febrile seizures last a minute or two. Yet some may only last a few seconds and others may last for more than 15 minutes.

Febrile seizures that last less than 15 minutes do not cause any long-term health problems. However, if another one happens, it is more likely to be prolonged or longer than 15 minutes. A first febrile seizure that is prolonged does not boost the risk of having more. Even prolonged seizures are generally harmless on their own, but they do carry an increased risk of developing epilepsy.

Who is more likely to get febrile seizures?

About 40 percent of children who have one febrile seizure will have another. Certain things increase the risk for more febrile seizures, including:

• Young age—Children who have their first febrile seizure when they are younger than 18 months are at an increased risk of having another one. 
• Family history—Children whose family members had febrile seizures are more likely to have more than one seizure.   
• First sign of illness—Children who have febrile seizures before exhibiting other symptoms of an illness are at greater risk of having multiple seizures.
• Low temperature—Children are more likely to have another febrile seizure if the first one was accompanied by a relatively low temperature.

How are febrile seizures diagnosed and treated?

Diagnosing febrile seizures

To diagnose febrile seizures in infants and children, healthcare providers will review a child’s medical history and perform a physical exam. They often test blood and urine to help pinpoint the cause of the fever. Keep in mind that dehydration from severe diarrhea or vomiting can cause seizures. 

Meningitis, an infection of the membranes surrounding the brain, can cause both fever and seizures that can look like febrile seizures but are much more serious. If meningitis is suspected, health care providers may remove and test a small amount of the fluid that surrounds the brain and spinal cord.  

Most of the time, children who have febrile seizures will not need to be in the hospital. Healthcare providers may recommend hospitalization if:

• The seizure is prolonged
• The child has a serious infection
• The child is younger than 6 months of age

Treating febrile seizures

Parents and caregivers should remain calm, take first aid measures, and carefully watch the child. During a febrile seizure, parents and caregivers should:

• Note the start time of the seizure. If it lasts longer than five minutes, call an ambulance. The child should be taken right away to the nearest medical facility.
• Call an ambulance if the seizure is less than five minutes but the child does not seem to be recovering quickly.
• Gradually place the child on a protected surface such as the floor to prevent injury. Do not restrain or hold a child during a convulsion.
• Put the child on his or her side or stomach to prevent choking. When possible, gently remove any objects from the child’s mouth. Nothing should ever be placed in the child’s mouth during a seizure. These objects can block airway and make it hard to breathe.
• Seek immediate medical attention if this is the child’s first febrile seizure. Once it is over, take the child to the doctor to check for the cause of the fever. This is especially urgent if the child shows these symptoms of meningitis, an infection over the brain surface, which can include stiff neck, extreme lethargy, or a lot of vomiting.

Drugs that lower fevers such as acetaminophen or ibuprofen may provide comfort yet studies show that treating a fever does not lower the risk of febrile seizure. Healthcare providers may recommend other medications to control seizures if needed.

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Learn About Clinical Trials

Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with febrile seizures?

Consider participating in a clinical trial so clinicians and scientists can learn more about febrile seizures and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with febrile seizures at Clinicaltrials.gov.

Where can I find more information about febrile seizures?

Information may be available from the following resources:

Centers for Disease Control and Prevention (CDC)
Phone: 800-232-4636

Citizens United for Research in Epilepsy (CURE)
Phone: 312-225-1801 or 844-231-2873

Epilepsy Foundation
Phone: 301-459-3700 or 800-332-1000

Learn about related topics

• Epilepsy and Seizures

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Order publications from the NINDS Catalog

The NINDS Publication Catalog offers printed materials on neurological disorders for patients, health professionals, and the general public. All materials are free of charge, and a downloadable PDF version is also available for most publications.

Febrile Seizures (for Parents) – Nemours KidsHealth

en español: Convulsiones febriles

Medically reviewed by: Yamini Durani, MD

Primary Care Pediatrics at Nemours Children’s Health

What Are Febrile Seizures?

Febrile seizures are convulsions that can happen when a young child has a fever above 100.4°F (38°C). (Febrile means “feverish.”) The seizures usually last for a few minutes and stop on their own. The fever may continue for some time.

Most febrile seizures stop without treatment and don’t cause other health problems. Some kids might feel sleepy after a seizure, while others feel no lasting effects.

Who Gets Febrile Seizures?

Febrile (FEH-bryle) seizures happen in kids 6 months to 5 years old. They’re most common in toddlers 12–18 months old.

Kids are more likely to have a febrile seizure if:

• There’s a family history of febrile seizures.
• They’ve already had one. About 1 in every 3 kids who have had one febrile seizure will have another, usually within 1–2 years of the first.
• They had a first febrile seizure when they were younger than 15 months old.

Most children outgrow having febrile seizures by the time they are 5 years old.

Febrile seizures are not considered epilepsy (seizure disorder). Kids who have a febrile seizure have only a slightly increased risk for developing epilepsy.

What Are the Signs & Symptoms of Febrile Seizures?

There are two types of febrile seizures:

• Simple febrile seizures are most common. They’re usually over in a few minutes, but in rare cases can last up to 15 minutes. During this type of seizure, a child may:
  • convulse, shake, and twitch all over
  • roll the eyes
  • moan
  • become unconscious (pass out)
  • vomit or urinate (pee) during the convulsions
• Complex febrile seizures last longer than 15 minutes, happen more than once in 24 hours, and involve movement or twitching of only one part or one side of the body.

What Causes Febrile Seizures?

No one knows why febrile seizures happen. But evidence suggests that they’re linked to some
virusesand the way that a child’s developing brain reacts to high fevers.

What to Do if Your Child Has a Febrile Seizure

If your child has a febrile seizure, stay calm and:

1. Gently place your child on the floor or the ground.
2. Remove any nearby objects.
3. Place your child on their side to prevent choking.
4. Loosen any clothing around their head and neck.
5. Watch for signs of breathing problems, including a bluish color in the face.
6. Try to keep track of how long the seizure lasts.

If the seizure lasts more than 5 minutes, or your child turns blue, it may be a more serious type of seizure — call 911 right away.

It’s also important to know what you should not do during a febrile seizure:

• Do not try to hold or restrain your child.
• Do not put anything in your child’s mouth.
• Do not try to give your child fever-reducing medicine.
• Do not try to put your child into cool or lukewarm water to cool off.

When the seizure is over, call your doctor for an appointment to find the cause of the fever. The doctor will examine your child and ask you to describe the seizure. In most cases, no other treatment is needed. The doctor might order tests if your child is under 1 year old and had other symptoms, like vomiting or diarrhea.

The doctor may recommend the standard treatment for fevers, which is acetaminophen or ibuprofen. Giving these medicines around the clock is not recommended and won’t prevent febrile seizures.

The doctor might prescribe an anti-seizure medicine to give at home if your child has more than one or two febrile seizures that last more than 5 minutes.

When Should I Call 911?

Get emergency medical care if your child:

• has a febrile seizure that lasts longer than 5 minutes
• has a seizure that involves only some parts of the body instead of the whole body
• has trouble breathing or turns blue
• isn’t responding normally
• has another seizure within 24 hours
• had to take an anti-seizure medicine to make the seizure stop

A child who has missed getting some vaccines and has a febrile seizure could have a higher risk for meningitis. Get medical care right away if your child has any signs of meningitis, such as:

• a stiff neck
• a lot of vomiting
• sensitivity to light
• in babies, a bulging soft spot on the head

Febrile seizures can be scary to see. But they’re fairly common and not usually a symptom of serious illness. If you have questions or concerns, talk with your doctor.

Medically reviewed by: Yamini Durani, MD

Date reviewed: March 2023

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Convulsions at high temperature in children. What Parents Need to Know

Hyperthermia or febrile seizures in children are seizures at high temperatures. The most common so-called convulsive syndrome of childhood. It has been established that this type of seizures are more often observed in winter and spring. It is assumed that this is due to a higher frequency of infectious diseases in the winter-spring period.

When children have febrile convulsions (high temperature)

Febrile seizures can develop in children with various infections, pneumonia, otitis, which are accompanied by fever.

Hyperthermic convulsions are an age-dependent pathology and debut mainly at the age of 18-24 months.

At what age do convulsions appear in children with a high temperature? Studies have shown that in the presence of a family burden, febrile convulsions can occur at a lower temperature in children.

Parents who first encounter a seizure in a child with a high temperature, as a rule, are psychologically unprepared, confused and do not know what to do first.

What to do if a child has seizures with a high temperature

Recommendations of a pediatric neurologist to parents on providing first aid to a child with febrile seizures:
• behave calmly, do not panic;
• unfasten the collar of clothing, free the chest from tight clothing;
• lay the child down with their head turned to one side;
• do not try to open the jaws with any object;
• measure temperature;
• do not give drugs by mouth;
• closely monitor the course of the attack.

Although febrile convulsions are triggered by high fever, excessive exposure of the child to cold should be avoided.

Clinical experience shows that cold wraps, rubbing with alcohol or a solution of vinegar, the use of fans do not give a significant beneficial effect and sometimes cause discomfort that negatively affects the course of an attack.

It is important to know and remember that in most cases the course of febrile seizures is benign, the probability of their transformation into severe forms of epilepsy is generally low (2-5%).

With the development of hyperthermic seizures, it is necessary to call an ambulance.

This is especially important in the following cases:

• the duration of the seizure is more than 10 minutes;
• repeated convulsions, with impaired consciousness;
• manifestation of the first episode before the age of 6 months;
• the presence of neurological symptoms (prolonged impairment of consciousness, post-attack paralysis, etc. ).

Children who have had a febrile seizure should be observed by a pediatric neurologist:

• 1 month after the seizure,
• then 2 times a year.
• In terms of examination, a pediatric neurologist prescribes electroencephalography (EEG) after an attack, then once a year.

Prevention in children to avoid recurrence of convulsions at high temperature

The likelihood of recurrence of febrile seizures is quite high. Therefore, preventive measures are of particular importance. The question of the advisability of prescribing anticonvulsant drugs is decided by a specialist – a pediatric neurologist.

Parents, on the other hand, can prevent convulsions with fever by keeping the temperature from rising. It should be remembered that a child who may have febrile convulsions should use antipyretics when the temperature rises to 37.5 ° C.

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Febrile convulsions in children | Rassvet Clinic

Febrile convulsions (attacks) are episodes of convulsions in children accompanied by high fever.

Seizure may occur with a probability of up to 4%:

• in a child aged 6 months to 5 years who did not have any previous neurological problems;
• when the temperature rises above 38 ⁰C.

What can cause an attack?

Infections that cause fever. Infection can be caused by bacteria, but febrile seizures are more common with viral illnesses (eg, roseola and influenza).

Vaccinations followed by fever. There is a small chance of febrile seizures after vaccination against measles, rubella and mumps, as well as diphtheria, tetanus and whooping cough. But the risks from incomplete vaccination are higher than the risk from a febrile seizure after vaccination.

Heredity. If either parent has had a febrile seizure, the child is more likely to have a fever seizure.

A febrile seizure, especially when it occurs for the first time in life, is very frightening for parents. In fact, most of these attacks are not dangerous, do not lead to complications and damage to the brain. A child with a simple febrile seizure is only marginally more likely to develop epilepsy than a child who has never experienced a febrile seizure.

What does a simple febrile seizure look like?

• The child loses consciousness, does not respond, may roll his eyes up.
• The arms and legs twitch rhythmically, this happens symmetrically on both sides.
• The attack usually lasts less than a minute, but in some cases – up to 5 minutes.
• After an attack, the child may be drowsy for an hour, but does not feel weakness in the arm or leg and gradually returns to normal.

What are complex febrile seizures? How are they different from normal ones?

In this type of febrile seizure, the seizure may begin with a twitch of one arm (leg) or with a turn of the head to one side (asymmetry).

• An attack may last longer than 15 minutes, or attacks may recur several times a day.
• An attack can occur at a relatively low temperature, below 38 ⁰C.
• After an attack, there may be prolonged drowsiness, weakness in one arm or leg.

How to help a child during an attack?

1. Lay the baby on its side, on a flat surface, and make sure that the child does not fall or hit anything during a cramp (eg, crib bars).
2. Time yourself and tell your doctor when the attack started and how long it lasted.

Attention! Do not try to open the jaw, do not put anything in the child’s mouth during an attack, this can lead to injuries (broken teeth of the child and injured fingers of the caregiver).
Do not try to restrict the movement of the child during convulsions, do not restrain him.

The child may be even more afraid of an attack than the parents. Try to calm him down, support him.

If a seizure occurs for the first time in life, lasts longer than 5 minutes, the child is unusually sleepy and lethargic before or after the seizure, call an ambulance.

In other cases, take the child to the pediatrician without delay. The doctor should examine the child after the attack and make sure that he does not have signs of a central nervous system infection (meningitis or encephalitis).

What tests are done after a febrile seizure?

In most cases, a doctor’s examination is sufficient to make this diagnosis. If meningitis is suspected, a lumbar puncture is performed. Sometimes the doctor may order urine and blood tests if the cause of the high fever is not clear.

In case of complex seizures, electroencephalography and MRI are scheduled. These studies are necessary because this type of febrile seizure may be a manifestation of rare epileptic syndromes that require anticonvulsant treatment.

How to treat a fever in a child who has previously had a febrile seizure?

If the child does not have a fever during illness or after vaccination, it is not recommended to give antipyretics! It does not reduce the risk of an attack.

If the fever is high, drugs to reduce it make you feel better, but do not help the attacks.

The harm of anticonvulsants for the prevention of febrile seizures outweighs the benefits, they are almost never prescribed.

If the child has a prolonged febrile seizure, it is recommended to administer a benzodiazepine enema, nasal spray, or cheek gel at the onset of the seizure. Such forms have only recently been registered in Russia, but, unfortunately, they have not yet entered the market. Therefore, if the attack lasts longer than 5 minutes, the emergency doctor can give an injection of such a medicine.

For antipyretics, children can be given ibuprofen 10 mg/kg every 8 hours or paracetamol 15 mg/kg every 6 hours. Do not give children aspirin!

Probability of recurrence of febrile seizures

After the first simple febrile seizure in life, recurrent seizures occur in ⅓ of children. A second attack usually occurs within 2 years after the first.