Febrile Seizures: What is it, Causes, Symptoms & Treatment

What are febrile seizures?

Febrile seizures are seizures that occur in about 2–6% of otherwise healthy young children, typically between the ages of 6 months and 5 years, and are triggered by a fever. These seizures are generally harmless and are not indicative of epilepsy or other serious health conditions.

What causes febrile seizures?

• Infections: Febrile seizures are usually caused by a rapid rise in body temperature, often due to infections such as a cold, flu, or ear infection. The exact reason why some children experience febrile seizures while others do not is still unknown.
• Post-vaccination fever: The risk of febrile seizures may increase after certain childhood vaccinations, such as diphtheria, tetanus, and pertussis (DTP) and measles-mumps-rubella (MMR). Some children may develop a low-grade fever after vaccination. It is the fever—not the vaccine—that triggers the seizure.

Risk factors

Several factors may increase the risk of febrile seizures:

• Age: Most occur between 6 months and 5 years, with the highest risk between 12 and 18 months
• Family history: A genetic tendency may increase susceptibility

Signs and symptoms

• Sudden shaking or jerking of the arms and legs
• Loss of consciousness
• Rolling back of the eyes
• Clenching of teeth or jaw
• Difficulty breathing
• Pale or bluish skin

Types of febrile seizures

Simple febrile seizures:

• Last less than 15 minutes
• Do not recur within 24 hours
• Involve the entire body

Complex febrile seizures:

• Last more than 15 minutes
• May recur within 24 hours
• May affect only one part of the body

What to do during a febrile convulsion

• Stay calm: Most febrile seizures are brief and stop on their own
• Protect your child: Place them on a soft surface and turn them onto their side to prevent choking
• Do not restrain: Do not hold your child down or try to stop the movements
• Clear the area: Remove nearby hard or sharp objects
• Note the time: Keep track of how long the seizure lasts

What to do after the convulsion

• Check your child’s temperature
• Give fever-reducing medication (paracetamol or ibuprofen) as advised
• Ensure adequate fluid intake
• Allow your child to rest in a safe and comfortable environment

Recurrent febrile seizures

The risk of recurrence is higher if:

• The first seizure occurred with a low-grade fever
• The seizure was the first sign of illness
• There is a family history of febrile seizures

When to seek emergency help

Seek immediate medical care if:

• The seizure lasts more than 5 minutes
• Your child has difficulty breathing or turns blue
• Your child does not wake up or remains very drowsy after the seizure
• It is your child’s first seizure
• The seizure occurs in water
• Another seizure occurs within 24 hours

Prevention tips

• Keep your child’s immunizations up to date
• Monitor and treat fever early
• Keep your child well hydrated
• Dress your child appropriately to avoid overheating

Most febrile seizures occur during the early phase of a fever, when the temperature is rising rapidly.

• Medications: Giving paracetamol or ibuprofen at the onset of fever may improve comfort but does not prevent seizures
• Prescription medications: In rare cases, anticonvulsants such as rectal diazepam, clobazam, or nasal midazolam may be prescribed for children prone to prolonged or recurrent seizures. These are typically used if a seizure lasts longer than 5 minutes or recurs within 24 hours

Key takeaways

• Febrile seizures, though alarming, are usually harmless
• They are triggered by a sudden rise in body temperature
• Most children outgrow them by the age of 5
• Knowing how to respond can help keep your child safe

For more information Consult your pediatrician.

Apollo Cradle & Children’s Hospital, Jubilee Hills, Hyderabad

Department of Pediatrics and Neonatology

Dr. K. Krishna Swaroop Reddy I Dr. K. Raja Subba Reddy