When your child spikes a fever, it’s only natural to worry. They’re cranky, clingy and not acting like themselves. You try to comfort them, but suddenly their arms and legs start jerking. Their eyes roll back and they lose consciousness for a moment.
It’s terrifying. You feel helpless. Every second feels like forever.
This is a febrile seizure. While most are harmless, knowing what’s happening and how to respond can help you stay calm and keep your child safe.
Chandler Sparks, DO, a family medicine physician with Banner Health, explains what febrile seizures are, what to do and when to follow up with your child’s provider.
What is a febrile seizure?
A febrile seizure is triggered by a fever. It happens most often in children between 6 months and 5 years old, when the brain is still developing. These seizures can happen early in an illness, even before you know your child has a fever.
“Febrile seizures are usually not related to any underlying seizure disorder,” Dr. Sparks said. “They usually don’t cause any lasting damage to your child’s brain and body. Spooky for sure, but they are generally harmless.”
Febrile seizures can be simple or complex:
- Simple febrile seizures last less than 15 minutes and don’t occur more than once in 24 hours. The vast majority of febrile seizures are simple.
- Complex febrile seizures last longer than 15 minutes and occur more than once in 24 hours.
“A simple febrile seizure often needs no medical attention or intervention aside from lowering the fever that caused it,” Dr. Sparks said. “A complex febrile seizure needs further tests and likely a short stay in the hospital while that happens.”
Why do febrile seizures happen?
“We think some children are just born more susceptible to febrile seizures,” Dr. Sparks said. “And anything that fires up the immune system, like a viral illness or a vaccine, can lead to a seizure in these kids when a fever is high.”
A family history of febrile seizures can also increase a child’s chances. In about half of cases, there is a family history, mostly in a parent or sibling. Children who have known epilepsy or another neurologic disorder may also be at higher risk.
Anything that raises the body temperature quickly, like the flu, ear infections or viruses, can set the stage. Rarely, vaccines like measles, mumps and rubella (MMR) can cause a fever that leads to a seizure in susceptible kids. It’s important to note that the vaccines themselves do not cause the seizures; the fever does.
What a febrile seizure looks like
Parents often describe the moment as terrifying because it starts suddenly. You may notice:
- Your child looks “out of it”
- Jerking movements of the arms, legs or face
- A brief loss of consciousness
- Eyes rolling or the body stiffening
“A child might pass out briefly but they will continue to breathe on their own and have a pulse,” Dr. Sparks said.
Most febrile seizures last less than five minutes and often less than one minute, though “a minute feels like forever when it’s your child,” Dr. Sparks said.
Afterward, your child may experience a brief period of confusion or sleepiness that lasts 30 minutes to an hour before returning to normal.
The dos and don’ts of febrile seizures
Even though it’s scary, your child needs calm, simple actions from you. Dr. Sparks offers a clear plan for parents:
DO
- Start a timer on your phone: The length of the seizure helps your child’s provider determine next steps.
- Roll your child onto their side: This helps keep their airway clear.
- Move them to a soft, safe surface: Keep them away from furniture or objects they could hit.
- After the seizure ends, treat the fever with children’s acetaminophen (Tylenol) or ibuprofen (Motrin), following the instructions on the bottle.
DON’T
- Don’t try to stop the jerking or hold your child down.
- Don’t put anything in your child’s mouth (no food, drink or objects).
- Don’t give medications during the seizure.
When to call 911
Call for emergency help if:
- The seizure lasts more than five minutes (your child may need medicine to stop the seizure)
- Your child turns blue or has trouble breathing
- You cannot find a pulse
- Your child is not waking up or improving after the seizure
- The seizure seems different from a previous one
How to reduce the risk of a future seizure
There is no guaranteed way to prevent febrile seizures but you can lower the chances of one happening during an illness.
“Beyond keeping your child’s fever below 103°F (39.4°C) with medication, there is nothing else to do,” Dr. Sparks said. “You can alternate ibuprofen and Tylenol doses every three hours when your child is sick to keep fever down, but don’t wake your child up to treat a fever.”
If your child has had a simple febrile seizure in the past, lowering the fever early in an illness can be helpful. But it does not prevent every seizure.
Do febrile seizures cause long-term problems?
Here’s the reassuring part: Simple febrile seizures do not cause brain damage, developmental delays or learning problems.
“Even though febrile seizures are scary to watch, they are harmless and do not cause brain damage,” Dr. Sparks said. “As long as they don’t last more than five minutes, your child doesn’t need a trip to the emergency room.”
Most children never have another one. For kids who do, the next seizure is typically similar to the first.
When your child needs follow-up care
If your child has a febrile seizure, Dr. Sparks recommends follow-up with their health care provider.
“Seizures of any kind in a child deserve the attention of a board-certified physician at follow-up, due to the risk involved and decision-making that may be required,” he said. “They may recommend a referral to a pediatric neurologist for further evaluation.”
A pediatric neurologist (brain and nervous system doctor that looks after children) may order tests if the seizure is complex, prolonged or has unusual features.
Takeaway
Watching your child have a seizure is scary. You might feel fear, guilt, confusion or a rush of protective instinct. You may second guess yourself or replay the event in your head. Those feelings are normal.
Take a moment to breathe, get your child in a safe position and call your child’s provider or a Banner Children’s specialist. They can help you understand what happened and what to expect going forward.
