Febrile seizures (also called febrile convulsions or febrile fits) are seizures associated with a fever in young children. They are common in kids younger than 5 years of age, and generally occur between the ages of 6 months and 6 years. They are most common around age 1-2 years and are rare after the age of 6 years.

Although frightening to witness, in general febrile seizures do not last long or cause any lasting effects. The majority of children who have had a febrile seizure do not have repeated febrile seizures.

What causes febrile seizures?

Viral infections are the most common cause of high fever in children who have had a febrile seizure. Common viral infections associated with febrile seizures include flu, ear infection (otitis media) and gastroenteritis.

Many children experience a febrile seizure before anyone has noticed that they have a temperature. They can also happen in children who are unwell (often with gastroenteritis) but have not had an obvious fever.

Among affected children, there is often a family history of the condition.

What happens during a febrile seizure?

Classically, a fit or seizure starts with a change in your child’s level of consciousness, often with their eyes rolling back in their head.

This may be followed by a general stiffening of their body and limbs, including clenching of the teeth, after which usually comes the repetitive, jerky movements commonly associated with fitting.

The fits usually last only a few minutes, although for people watching, it often seems to last much longer.

First aid for febrile seizures

It is important if you witness a child fitting that you don’t try to restrain them in the hope that you can stop the seizure.

If possible, turn the child on to their side to prevent any choking, especially in the event of vomiting. Do not try to force the child’s mouth open – contrary to popular belief, they will not swallow their tongue.

Make sure the child is safe by:

  • making space around them to prevent them injuring themselves;
  • removing any potential dangers from around them; and
  • loosening any clothing that could restrict their breathing.

Do not put your child in the bath to lower their temperature during or straight after a febrile seizure.

After the child stops fitting they may be drowsy, irritable or disoriented as they regain consciousness. It is important to provide reassurance and calm support at this time.

Call 000 for an ambulance if:

  • this is your child’s first seizure;
  • the seizure lasts more than 5 minutes;
  • your child has had more than one seizure in 24 hours; or
  • your child doesn’t wake up after the convulsion.

All children who have a febrile seizure should be seen by a doctor as soon as possible. You can take them to see your GP (general practitioner) or to the nearest hospital emergency department.

Tests and diagnosis

Your doctor will want to determine that a fever was the trigger for the seizure and rule out other possible causes.

The doctor will also want to work out the cause of the fever, which is often a simple viral infection. Ear infections and tonsillitis are 2 common infections associated with febrile seizures.

If the cause of the fever is obvious, tests may not be needed. In other cases, tests (such as blood or urine tests) may be needed to find the cause of the fever. Occasionally, a lumbar puncture may be recommended to rule out meningitis.

Treatment

Most febrile seizures last only a few minutes and do not need any specific treatment.

Some children need to be given a type of sedative or anti-seizure medicine to stop a febrile convulsion.

Self-care treatments for fever will make your child feel more comfortable. If your child is thought to have a bacterial infection, antibiotics will be prescribed.

Recovery after a febrile seizure

Children who have a febrile seizure almost always recover fully, with no long-term problems. Their learning and development will not be affected. Even very long seizures rarely cause lasting problems.

Will my child have another febrile seizure?

There are several risk factors affecting whether or not a child has another febrile seizure. Their age when the first seizure occurs is important — the younger they are, the more likely they are to have recurrences. About half of all children aged 12 months who have had a febrile seizure will have another febrile seizure in the future, while only about a third of 2-year-olds will have another fever-related seizure.

Children with a family history of febrile seizures may also have a higher risk of recurrence.

In general, the higher a child’s temperature, the higher the risk of another febrile seizure.

To prevent febrile seizures from recurring, many people advise treating children at the first sign of fever with paracetamol or ibuprofen. However, this has not been shown to reduce the risk of a febrile seizure.

Anticonvulsant medicines are rarely used to prevent further febrile seizures, as the side effects usually outweigh the benefits.

Risk of epilepsy after febrile seizures

Most children who have had a febrile seizure will not have seizures when they are older or develop epilepsy in the future. By far the majority of children who experience a febrile seizure will have no long-term consequences.

Last Reviewed: 21/09/2018

myDr



References

1. Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Febrile convulsion (updated April 2011). http://www.rch.org.au/clinicalguide/guideline_index/Febrile_Convulsion/# (accessed Feb 2013). 2. Febrile seizures (published November 2017). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2018 Jul. https://tgldcdp.tg.org.au/ (accessed Sep 2018). 3. BMJ Best Practice. Febrile seizure (updated May 2018). https://bestpractice.bmj.com (accessed Sep 2018). 4. Royal Children’s Hospital Melbourne. Kids Health Info: Febrile convulsions (reviewed March 2018). https://www.rch.org.au/kidsinfo/fact_sheets/Febrile_Convulsions/ (accessed Sep 2018). 5. BMJ Best Practice. Patient information from BMJ. Febrile seizures (published 9 Aug 2018). https://bestpractice.bmj.com (accessed Sep 2018).