Febrile Seizures in Children: What Parents Need to Know

Your child has a fever. Nothing unusual — you’ve seen it before. Then suddenly, they go stiff, their eyes roll back, and their limbs begin to shake. It can be the most frightening of moments for any parent.

What just happened is known as a febrile seizure. Whilst febrile seizures look alarming, they are usually harmless. This guide walks you through what is happening and what to do, so you can feel more prepared if it happens again.

What are febrile seizures?

A febrile seizure, as its name suggests, is a seizure triggered by a rise in body temperature. It usually affects children between ages 6 months and 6 years old. Febrile seizures are likely a result of the developing nervous system in a young child and their susceptibility to the rapid rise in temperature.

What does a febrile seizure look like?

During a febrile seizure, your child may:

• Lose consciousness
• Become stiff or limp
• Have jerking or shaking movements of the arms and legs
• Have upward rolling of the eyes
• Froth at the mouth
• Breathe differently for a short period of time
• Feel drowsy, confused or agitated after the seizure, known as the postictal phase

Although simple febrile seizures can potentially last up to 15 minutes, most resolve within 5 minutes.

What should you do if it happens?

If your child has a seizure, please remain calm and focus on keeping them safe.

What to do during a seizure

• Remove your child from any surrounding danger
• Place them onto a flat surface
• Turn them onto their side. This helps to open up their airway
• Never put anything in their mouth
• Do not try to hold them down
• Take note of how long the seizure has lasted

If the seizure is approaching 5 minutes and does not appear to be stopping, call an ambulance. Paramedics can administer anti-seizure medication if the seizure becomes prolonged.

What to do after the seizure

Once the seizure stops, your child may feel irritable and tired. This drowsy or confused state after a seizure is normal and is known as the postictal phase. Stay with your child, speak calmly, and let them rest.

It is best to have your child checked by a doctor. This allows the doctor to identify the source of the infection and ensure that your child is clinically well.

Can my child have more than one febrile seizure?

Most children will only have one febrile seizure during an acute febrile illness, which refers to a short-term illness accompanied by a fever. This is known as a simple febrile seizure. Some children may have more than one seizure episode during the same illness, usually within 24 hours. This is known as a complex febrile seizure.

Regardless, it is best to have your child checked after any seizure episode so that a doctor can assess your child and advise on the appropriate care.

When should you seek urgent medical care?

Seek immediate medical attention and call 955 if:

• The seizure lasts longer than 5 minutes
• Your child has trouble breathing following the seizure
• Seizures happen repeatedly or close together
• Your child does not wake up or seems unusually drowsy
• It occurs in a child younger than 6 months

For seizures that have stopped and your child appears to be recovering, you can bring them to the nearest Paediatric Urgent Care Centre for assessment.

Will my child now have seizures every time they have a fever?

Some children may have another febrile seizure in the future, especially if they are still within the typical age range of 6 months to 5 years.

The chances may be slightly higher if:

• Your child had their first seizure at a younger age
• There is a family history of febrile seizures
• They develop another fever during a future illness

While this can be worrying, most repeat seizures are still brief and similar to the first episode.

Will febrile seizures affect my child in the long term?

Fortunately, studies have shown that typical febrile seizures do not have long-term effects on your child’s health or development. Most children outgrow them by age 5 and continue to develop as expected.

However, if your child has seizures that are prolonged, happen frequently in the absence of a fever, you should speak to your child’s paediatrician for further evaluation.

Can febrile seizures be prevented?

In short, febrile seizures cannot be prevented. This is because they are often triggered by a sudden rapid rise in body temperature, which can be difficult to detect in time — sometimes even before you realise that your child is unwell.

What you can do is monitor your child closely when they have a fever, keep them well hydrated, and use fever-relieving medication if advised by your doctor.

Understandably, watching your child have a seizure can be a frightening experience for any parent. We hope this guide helps you feel more prepared and reassured should it happen. Keep it somewhere handy, share it with your child’s other caregivers, and do not hesitate to reach out to your doctor if you have any concerns.

This article was reviewed by Dr Victoria Tan, paediatrician at Parkway East Paediatric Urgent Care Centre.