What to do if your child has a febrile seizure

May 2, 2017 Ednea A Simon, MD

portrait of a sick boy lying in bed


In this article:

  • Febrile seizures in children are caused by fevers, not an infection in the brain.

  • Some children may be more susceptible to febrile seizures due to family history or genetic influences.

  • While febrile seizures are not uncommon, a Swedish clinician cautions that children who experience one should be examined by a doctor.

Fever-related illnesses are a part of growing up and developing a healthy immune system. But what a frightening experience when a child has a seizure during a fever! Some parents might immediately think a brain infection is the cause. This possibility needs to be ruled out, and for this reason a child needs immediate medical attention. Fortunately, in many cases, the child has simply had a febrile seizure.

What is a febrile seizure?

A febrile seizure occurs with a fever but is not due to an infection in the brain or an associated metabolic condition. However, the increase in body temperature may not be evident until after the seizure.

Febrile seizures occur in normally developing children 6 months to 5 years old. They are not harmful or necessarily associated with an increased risk of epilepsy or future cognitive problems. The key factor is the peak temperature of the fever. Low-grade fevers are less likely to cause a seizure than a sudden peak in body temperature.

How do I know my child had only a febrile seizure and nothing more serious?

A simple febrile seizure, the most benign form, is defined as a generalized tonic clonic seizure, also known as grand mal seizure. These seizures last less than 15 minutes. Sometimes, however, a child has a complex febrile seizure, which involves only one part or one side of the body. This type involves multiple seizures over a short period of time or a seizure that lasts more than 15 minutes.

A physical exam and sometimes additional tests are done to determine the cause of the fever and seizure. Children under a year old will usually have a spinal tap because signs and symptoms of bacterial meningitis may be minimal or absent at this age. Children with a pre-existing neurologic condition may have an increased risk of seizures triggered by fever. These are called symptomatic febrile seizures.

Is my child at risk for more seizures in the future?

A family history of febrile seizures, a low peak temperature during a seizure and a seizure that occurs when a child is younger than 18 months can increase the risk of recurrence. Overall, about one-third of children will experience another seizure.

What should I do if my child has febrile seizures?

Seek immediate medical attention if it is your child’s first febrile seizure. Medications to control fever are recommended when a child is sick. These medications will prevent rapid increases in body temperature, but they won’t necessarily prevent a febrile seizure. This is because some children will have a seizure at the onset of a fever before any increase in body temperature.

It is very important to stay calm if your child has a seizure. Place your child on a flat, protected surface, and turn your child on his or her side to avoid respiratory difficulties. Time the seizure: if it lasts more than three to five minutes or if your child has breathing problems, call 911 for immediate help.

Does my child need to take anti-epileptic medication to avoid seizures?

Children with febrile seizures do not have epilepsy, so they do not need to take long-term antiepileptic medication. 
Your doctor may prescribe a medication to be used to stop a prolonged seizure. Most seizures last less than five minutes and do not require medication. Medication is particularly useful if you live in a remote area or if you are traveling and immediate medical assistance is not available. You can discuss this with your doctor.

Should my child see a neurologist after a febrile seizure?

It is very important to follow up with your pediatrician after your child has a fever-related seizure. If your child has a complex febrile seizure or any previous neurologic problems, a neurologic evaluation and additional investigations are advised to determine the risk of another seizure.

Could children be genetically predisposed to febrile seizures?

Genetic influences and a family history increase the risk of first-time and recurring febrile seizures. In particular, some families carry a mutation in the sodium channel gene that predisposes them to febrile seizures and epilepsy in the future. A neurologist can evaluate this possibility and order a test to diagnose this condition. 

A genetic cause should be considered, particularly for a child who has had:

  • Multiple febrile seizures that start before the child is 1 year old
  • Febrile seizures that affect only one side of the body
  • Prolonged febrile seizures, usually called status epilepticus
  • Prior febrile seizures and developmental regression

These findings may suggest a diagnosis of Dravet syndrome, which requires specific treatment.

Find a doctor

If you have questions about febrile seizures in children, contact the Pediatrics department or the Swedish Pediatric Neuroscience Center. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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