Febrile Seizures

Febrile seizures are convulsions triggered by fever in young children, most common between six months and five years of age. While frightening to witness, most febrile seizures are brief, do not cause lasting harm, and do not indicate epilepsy.

• A convulsion (jerking or stiffening movements, loss of consciousness) occurring during a fever, typically as the temperature is rising rapidly
• Most last only a few minutes and stop on their own
• The child is usually previously healthy, with the seizure occurring in the context of a feverish illness such as a viral infection
• A brief period of sleepiness or confusion after the seizure is common and expected
• A more complex or prolonged seizure, or one with features on only one side of the body, is assessed differently and may need further evaluation

• Triggered by fever, most often from a common viral infection, in a child with an underlying tendency toward febrile seizures, which is not fully understood but has a genetic component in many cases.
• Most common in children aged six months to five years, an age range during which the developing brain is thought to be more susceptible to seizures triggered by fever.
• Family history of febrile seizures is common.

• Diagnosed clinically based on the characteristic occurrence of a seizure during a fever in a child of typical age, with the child otherwise well between episodes.
• It is important to identify and treat the source of the fever, and to exclude more serious causes of both the fever and the seizure, such as meningitis, particularly if the child seems unusually unwell, has a stiff neck, or does not return to their normal alert self after the seizure.
• A simple febrile seizure (brief, generalised, and not recurring within the same illness) generally does not need extensive investigation once other serious causes have been reasonably excluded.

During a seizure, the priority is keeping the child safe — placing them on their side, away from hard or sharp objects, and not restraining their movements or putting anything in their mouth.

Most febrile seizures stop on their own within a few minutes; a seizure lasting more than five minutes requires emergency medicine to stop it and urgent medical care.

After the seizure, identifying and treating the underlying cause of the fever is important, and the child is monitored until fully recovered.

Simple febrile seizures generally do not require preventive antiseizure medicine, since the risk of them evolving into epilepsy is low and the seizures themselves, while frightening, are not typically harmful.

Parents are given clear guidance on what to do if another seizure occurs and when to seek emergency care.

• Treat fever with paracetamol for the child's comfort, though this does not reliably prevent febrile seizures from occurring.
• Keep the child safe during a seizure by placing them on their side and removing nearby hazards, without restraining them or putting anything in their mouth.
• Seek emergency care immediately if a seizure lasts more than five minutes, recurs within the same illness, or the child does not return to their normal state afterward.
• Seek reassurance and information from a health worker after a first febrile seizure, since understanding what to expect reduces anxiety for future episodes.