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A febrile seizure can be a frightening experience for parents and caregivers, but most are brief, do not cause permanent brain damage, and have an excellent long-term prognosis. These seizures are triggered by fever rather than by an underlying neurological disorder.

HISTORY / OVERVIEW

Febrile seizure typically occurs in children between 6 months and 5 years of age, with the highest incidence between 12 and 18 months. The seizure usually happens during a fever caused by a viral or bacterial infection, often as the temperature rises rapidly.

Febrile seizures are relatively common, affecting approximately 2–5% of children in many populations.

TYPES OF FEBRILE SEIZURES

Simple Febrile Seizures

• Last less than 15 minutes

• Generalized (involving the whole body)

• Occur only once within a 24-hour period

• Account for the majority of febrile seizures

Complex Febrile Seizures

• Last 15 minutes or longer

• May affect only one part of the body (focal seizure)

• May occur more than once within 24 hours

• May require additional medical evaluation

COMMON CAUSES

Fever associated with:

• Viral respiratory infections

• Ear infections

• Roseola

• Influenza

• Gastrointestinal infections

• Other common childhood illnesses

Rarely, certain vaccinations may be associated with a small temporary increase in the risk of febrile seizures, usually because they can cause fever. The benefits of routine childhood vaccination continue to greatly outweigh this small risk.

COMMON SYMPTOMS

During a febrile seizure, a child may experience:

• Loss of consciousness

• Whole-body shaking or stiffening

• Eye rolling

• Limb jerking

• Brief breathing irregularities

• Sleepiness or confusion after the seizure

DIAGNOSIS

Healthcare providers evaluate:

• Medical history

• Description of the seizure

• Physical and neurological examination

• Source of the fever

Additional tests, such as blood tests, imaging, or an electroencephalogram (EEG), are not routinely required for a simple febrile seizure but may be considered in selected cases based on the child's age, symptoms, or examination findings.

TREATMENT

Treatment focuses primarily on the illness causing the fever.

During a Seizure

• Place the child on their side on a safe surface.

• Remove nearby objects that could cause injury.

• Do not place anything in the child's mouth.

• Do not try to restrain the child's movements.

• Time the seizure if possible.

Medical Care

• Treat the underlying infection if necessary.

• Fever-reducing medications may improve comfort but have not been shown to reliably prevent future febrile seizures.

• Most children do not require long-term anti-seizure medication after a simple febrile seizure.

WHEN TO SEEK EMERGENCY CARE

Seek immediate medical attention if:

• The seizure lasts more than 5 minutes

• It is the child's first seizure

• The child has difficulty breathing after the seizure

• The seizure is focal or repeats within 24 hours

• The child does not recover as expected

• There are signs of a serious infection, such as a stiff neck, persistent lethargy, or severe illness

PROGNOSIS

Most children recover completely without lasting neurological problems.

• Simple febrile seizures generally do not affect intelligence or development.

• Some children may experience another febrile seizure during future illnesses.

• The risk of developing epilepsy later in life is only slightly higher than average after a simple febrile seizure, though it may be higher in children with certain risk factors, such as complex febrile seizures or pre-existing neurological abnormalities.

FUTURE RESEARCH

Current research is exploring:

• Genetic factors influencing susceptibility

• Improved methods for identifying children at higher risk of recurrence

• Better understanding of the mechanisms linking fever and seizures

• Personalized approaches to prevention and management

ENGAGEMENT QUESTION

If you were learning about febrile seizures for the first time, what information would you find most reassuring: understanding that most are harmless, knowing the correct first-aid steps, recognizing when emergency care is needed, or learning about the long-term outlook?