Febrile Seizures in Kids: What to Do and When to Worry

Quick answer: Febrile seizures in kids are seizures set off by a fever in otherwise healthy young children, usually between 6 months and 5 years old. They affect about 3 or 4 out of every 100 children, according to the American Academy of Pediatrics (AAP), and most last only a minute or two. During a seizure, lay your child on a safe surface on their side, clear away hard objects, time it, and never put anything in their mouth. Call 911 if a seizure lasts longer than 5 minutes, if your child has trouble breathing, or if they don’t start recovering quickly afterward. Simple febrile seizures don’t cause brain damage, and fever medicine does not prevent them. Every child who has a seizure should be checked by a doctor to find the cause of the fever.

What is a febrile seizure?

A febrile seizure is a convulsion triggered by a fever. It is not the same as epilepsy, which means repeated seizures that happen without a trigger like fever. The National Institute of Neurological Disorders and Stroke (NINDS) says children between about 6 months and 5 years are most likely to have them, with the highest risk between ages 1 and 3. The AAP says they happen most often around 12 to 18 months. (The UK’s NHS uses a slightly wider range, up to 6 years.)

Febrile seizures usually happen early in an illness, often within the first 24 hours and sometimes before parents even notice a fever. They’re most common with temperatures of 102°F (38.9°C) or higher, but MedlinePlus notes that any fever of 100.4°F (38°C) or above can trigger one, and a seizure doesn’t necessarily happen when the fever is at its peak. They tend to run in families.

What causes febrile seizures?

Almost any illness that causes a fever can trigger one. Common culprits include colds, flu, ear infections, roseola, RSV, COVID-19 and chickenpox. The seizure is a reaction to the fever, not usually a sign that the infection itself has reached the brain. That’s why doctors focus on finding out what’s causing the fever.

What about vaccines? Some vaccines can cause a fever, and a febrile seizure after a shot is possible but uncommon. Both the AAP and NINDS say the seizure is due to the fever, not the vaccine itself. Recommended vaccines also help prevent some febrile seizures by protecting against fever-causing illnesses such as measles, flu and pneumococcal infections. If you have questions, talk with your pediatrician before skipping or delaying a vaccine.

What a febrile seizure looks like

Seeing your child have a seizure is terrifying, even when it turns out to be harmless. Signs can include:

Stiffening of the arms and legs, or rhythmic jerking or twitching
Eyes rolling back
Not responding to you, or passing out
Changes in breathing, or skin that looks pale or bluish for a short time
Moaning, vomiting, wetting themselves or biting their tongue

Afterward, most children are sleepy or a little confused for a short time and then gradually return to normal.

Simple vs. complex febrile seizures

Simple febrile seizures are by far the most common. They involve the whole body, happen only once in 24 hours and are short. Most last less than 1 to 2 minutes.
Complex febrile seizures last longer than 15 minutes, affect only one side or part of the body, or happen more than once in 24 hours. These are more likely to need extra tests.

The 15-minute line is how doctors classify a seizure afterward. It is not how long you should wait at home. If a seizure is still going at 5 minutes, call 911.

What to do during a febrile seizure

Stay calm and note the time the seizure starts.
Move your child to a safe spot, such as the floor, away from furniture and sharp or hard objects. Put something soft under their head.
Turn them on their side so saliva or vomit can drain out of the mouth.
Loosen tight clothing, especially around the neck.
Stay with your child the whole time and watch their breathing.
Once it stops, keep them on their side and let them rest, then get medical advice (see below).

What not to do

Don’t put anything in your child’s mouth, including your fingers. Children can’t swallow their tongue, and objects can cause choking or injury.
Don’t hold your child down or try to stop the movements.
Don’t put your child in a bath or sponge them with cold water to bring the fever down. The NHS also advises against undressing them for this purpose.
Don’t give medicine by mouth during the seizure. Wait until your child is fully awake and able to swallow.

Do febrile seizures cause brain damage?

No. According to the AAP and MedlinePlus, simple febrile seizures do not cause brain damage, intellectual disability, learning problems or death. Most children outgrow them by about age 5.

NINDS adds an important nuance: very long seizures (more than 30 minutes, called febrile status epilepticus) are different and can raise the risk of later epilepsy. That’s why a seizure lasting longer than 5 minutes is treated as an emergency.

Will my child get epilepsy or have another one?

Epilepsy: Only a very small number of children who have febrile seizures go on to develop epilepsy. The NHS describes the chance as slightly higher than average but still rare. NINDS says the risk is higher in children with long or complex seizures, developmental delay, cerebral palsy or other neurological conditions.

Another febrile seizure: Repeat seizures are common. The AAP says children who have their first febrile seizure before age 1 have about a 50% chance of another, while healthy children over 1 have about a 30% chance. NINDS lists these factors as raising the odds of a repeat:

A first seizure before 18 months of age
A family history of febrile seizures
A seizure that happened before other signs of illness
A first seizure with a relatively low temperature

MedlinePlus notes that few children have more than 3 febrile seizures in their lifetime, and having several doesn’t by itself raise epilepsy risk.

Fever care after a seizure (and why it won’t prevent one)

This surprises many parents: fever-reducing medicine does not prevent febrile seizures. The AAP, NINDS and MedlinePlus all say studies show that treating a fever doesn’t lower the chance of a seizure. Acetaminophen or ibuprofen can still help your child feel more comfortable.

Follow the package directions or your pediatrician’s advice for your child’s age and weight, and check with your doctor before giving any fever medicine to a baby under 6 months.
Never give aspirin to children or teens.
Offer plenty of fluids and let your child rest.
Dress them in light clothing, but don’t use cold baths, ice or rubbing alcohol.

Doctors generally don’t prescribe daily seizure medicine after a simple febrile seizure. If your child has had long or repeated seizures, your doctor may prescribe a rescue medicine to give during a seizure, with instructions on exactly when and how to use it. For tips on reading a thermometer and fever thresholds by age, see when to call the pediatrician about a fever.

How doctors check a child after a febrile seizure

For a typical simple febrile seizure, the exam is usually normal apart from the illness causing the fever, and a full workup (brain wave test, head scan and spinal tap) is often not needed. The doctor’s main job is to find the cause of the fever. More testing may be done if your child is very young, had a complex seizure, has a neurological or developmental condition, or has signs of a serious infection. A spinal tap may be recommended to rule out meningitis, especially in babies under 1 year.

When to call the doctor

Every seizure deserves a call. Sources differ a little on where to go after a first, brief seizure: the AAP advises calling your child’s doctor, while NINDS, MedlinePlus and the NHS advise getting your child checked urgently or taken to an emergency department. If you’re unsure, treat a first seizure as urgent. Call your pediatrician right away if:

Your child has had a short seizure and is now awake and acting more like themselves
Your child has had febrile seizures before and has one that looks the same as usual (follow any plan your doctor has given you)
The fever lasts more than a few days, or your child seems to be getting sicker
You notice signs of an ear infection, dehydration, a new rash or other symptoms
Your child has new shaking, tremors, clumsiness or unusual behavior after the illness

When to go to the ER or call 911

Call 911 or your local emergency number if your child:

Has a seizure lasting longer than 5 minutes
Has trouble breathing, or their lips or face stay blue or gray
Doesn’t start to recover quickly after the seizure, or is still unusually sleepy an hour later
Has a seizure that affects only one side of the body
Has two or more seizures within 24 hours
Has a stiff neck, severe headache, a rash that doesn’t fade when pressed, repeated vomiting or is very hard to wake (possible signs of meningitis)
Is having a first seizure and you can’t reach a doctor right away

If your child is still seizing or unconscious, call 911 rather than driving them yourself. Not sure what to do? Our child symptom checker can help, but always call 911 for a long seizure or breathing trouble.

Frequently Asked Questions

Are febrile seizures in kids dangerous?

Most febrile seizures in kids are brief and harmless. Simple febrile seizures do not cause brain damage, learning problems or death, and most children outgrow them by about age 5. A seizure lasting more than 5 minutes is an emergency and needs a call to 911.

What should I do if my child has a febrile seizure?

Lay your child on the floor on their side, away from hard or sharp objects, and note the time. Don’t hold them down or put anything in their mouth. Call 911 if the seizure lasts more than 5 minutes or your child has trouble breathing, and get your child checked by a doctor afterward.

Can Tylenol or Motrin prevent a febrile seizure?

No. Studies show that fever reducers such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) do not prevent febrile seizures. They can make a child with a fever more comfortable. Follow the package directions or your pediatrician’s advice for dosing.

Will my child have another febrile seizure?

Maybe. According to the AAP, about 50% of children who have a first febrile seizure before age 1 have another, compared with about 30% of healthy children older than 1. A family history of febrile seizures also raises the chance.

Does a febrile seizure mean my child has epilepsy?

No. A febrile seizure is triggered by fever, while epilepsy means repeated seizures without a fever trigger. Only a very small number of children with febrile seizures develop epilepsy later, and the risk is higher mainly after long or complex seizures.

Can a vaccine cause a febrile seizure?

Rarely. Some vaccines can cause a fever, and the fever can trigger a seizure in a child who is prone to them. Experts say the seizure is caused by the fever, not the vaccine. Vaccines also prevent many illnesses that cause high fevers.

At what age do febrile seizures stop?

Most children outgrow febrile seizures by age 5, or by school age. They most often happen between 12 and 18 months old, and the risk is highest between ages 1 and 3.

Related guides

Sources

This article is for general information and is not a substitute for advice from your child’s doctor. If your child has a seizure lasting more than 5 minutes or is struggling to breathe, call 911 or go to the nearest emergency department.

Febrile Seizures in Kids: What to Do, When to Call 911 and What It Means

What is a febrile seizure?

What causes febrile seizures?