seizure with fever

Overview

A febrile seizure is a convulsion (fit) that happens in a young child when they have a high temperature (fever). It is not epilepsy and usually stops on its own within a few minutes.

Yes, febrile seizures are common. About 1 in 30 children will have at least one febrile seizure. They are most common between 12 and 18 months of age.

They affect young children, typically between 6 months and 5 years old, especially during a fever. Children with a family history of febrile seizures are more likely to have them.

Symptoms

Common symptoms

• Sudden stiffening of the body
• Jerking or twitching movements in the arms, legs, or face
• Loss of consciousness (child may not respond)
• Eyes rolling back or staring blankly
• Breathing may become shallow or irregular

Symptoms in children

• The same symptoms as above, but in young children the seizure often lasts 1–3 minutes and stops on its own.
• After the seizure, the child may be drowsy, confused, or irritable for a short time (postictal state).

Symptoms in older adults

• Febrile seizures are very rare in adults. If an older adult has a seizure with fever, it may be due to a different underlying condition such as a brain infection or electrolyte imbalance – a doctor should evaluate it urgently.

Causes

Main causes

• A sudden spike in body temperature due to an infection – common infections include ear infections, tonsillitis, colds, flu, or roseola.
• The exact trigger is the rapid rise in temperature, not necessarily how high the fever gets.

Risk factors

• Age between 6 months and 5 years
• Family history of febrile seizures (parents or siblings who had them)
• Certain viral infections like human herpesvirus 6 (roseola) or influenza
• Children who attend daycare (more exposure to infections)

When to see a doctor

See a doctor urgently if:

• First febrile seizure – always get medical help immediately.
• Seizure lasting more than 5 minutes (call emergency services).
• Child has a seizure and is under 6 months old.
• Child has a seizure and does not regain normal behavior within 10–15 minutes.

Book a routine appointment if:

• After a simple febrile seizure that has stopped, see your GP or paediatrician within 24 hours to find the cause of the fever.
• If your child has repeated febrile seizures, discuss with a doctor about future management.

Diagnosis

The doctor will ask you to describe exactly what happened during the seizure, how long it lasted, and any other symptoms. They will also examine the child to find the source of the fever.

Tests that may be done

• A urine test to check for a urinary tract infection
• A blood test to look for signs of infection or electrolyte imbalance
• If meningitis is suspected, a lumbar puncture (spinal tap) may be done – this is more common in children under 12 months
• In some cases, a EEG (brain wave test) may be ordered, but this is not routine for simple febrile seizures

What to expect at your appointment

The doctor will first make sure the child is stable. They may give medicine to lower the fever. They will explain the type of seizure and what to watch for. Most children do not need any special treatment beyond treating the infection.

Treatment

The main treatment is to manage the fever and treat the underlying infection. The seizure itself usually stops on its own and does not require medication.

Self-care at home

• Stay calm and place the child on a soft flat surface (floor or bed) on their side to help breathing.
• Do not put anything in the child’s mouth (they will not swallow their tongue).
• Remove tight clothing and cool the child with a damp cloth or tepid sponge – never use cold water or ice.
• After the seizure, give fever-reducing medicine like paracetamol or ibuprofen (follow the dose for age and weight) – but never give medicine while the child is seizing.
• Encourage fluids once the child is awake and alert.

Medical treatments

If the fever is high, doctors may recommend antipyretics (fever reducers) to lower temperature and make the child more comfortable. In rare cases when a seizure lasts a long time (prolonged febrile seizure), doctors may use a rectal gel or breathing mask medicine to stop it. This is not for simple febrile seizures.

When is surgery considered?

Surgery is not relevant for febrile seizures.

Living with this condition

Most children who have had a febrile seizure live completely normal lives. The key is to manage fevers quickly during illnesses. Learn what to do if a seizure happens again – stay calm and keep the child safe.

Lifestyle tips

• Keep a thermometer at home and check temperature when your child seems unwell.
• Know the signs of a fever and have child-safe fever medicine on hand.
• If your child has a fever, dress them lightly, keep the room cool, and offer plenty of fluids.

Diet and exercise

No special diet or exercise changes are needed. Children can play and eat normally. During a fever, offer small, light meals and lots of fluids.

Mental health and emotional wellbeing

Having a child with a febrile seizure can be very scary for parents. It is normal to worry and feel anxious. Talk to your doctor about your concerns. For older children who remember the seizure, reassure them that it was not their fault and they are safe.

Prevention

Febrile seizures cannot always be prevented because they can happen suddenly with a rising fever. However, controlling a high fever early with medicine and cool methods may reduce the risk. It is important to vaccinate your child against infections that cause fever.

Vaccines

Routine childhood vaccines (such as MMR, pneumococcal, and flu vaccine) help prevent infections that can trigger febrile seizures. There is a slightly increased risk of fever after some vaccines (like MMR), but the benefit of protection is greater.

Screening programmes

There is no routine screening test to predict who will have a febrile seizure because they are common and usually harmless.

Complications

If left untreated

• If the underlying infection (like bacterial meningitis) is not treated, it can lead to serious brain infection or sepsis.
• Prolonged seizures (lasting more than 15 minutes) are rare but can sometimes cause low oxygen levels – this needs emergency care.
• Repeated very long seizures may slightly increase the risk of later epilepsy, but the vast majority of children with simple febrile seizures have no complications.

Long-term outlook

The outlook is excellent. Most children stop having febrile seizures by age 5. Having a febrile seizure does not mean your child has epilepsy. Your child can go on to lead a healthy, active life. If you follow the fever management advice and vaccination schedule, you are doing everything right.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.