Febrile Seizures: What to Look for and How to Take Action

The word “seizure” can spark fear in the heart of a new parent, especially since many people associate seizures with a diagnosis of epilepsy or a seizure disorder. It’s not uncommon, however, for a child between 6 months to 5 years to experience a seizure triggered by a fever, which is defined as a body temperature of 100.4° or higher. This is called a febrile seizure.

Febrile seizures occur in approximately two to four percent of children, most commonly between 12 to 18 months old. They are more common in children with a family history of febrile seizures. Though a febrile seizure does not mean your child has epilepsy, it’s important to recognize a seizure when it’s happening, so you can take appropriate action and keep your child safe.

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How to identify a seizure

A febrile seizure often occurs in the first few hours of a fever, when the temperature is rising.

“Fever from any viral or bacterial infection can result in febrile seizures,” says Sara Molisani, MD, attending physician in the Division of Neurology at Children’s Hospital of Philadelphia (CHOP). “One of the more common viruses associated with febrile seizures is HHV-6, the virus that causes roseola.”

Characteristics of seizures, including febrile seizures, may include:

• Stiffening of arms and/or legs
• Shaking of arms and/or legs
• Lack of responsiveness
• Eye rolling or eye deviation
• Change in breathing pattern
• Change in color around the lips or mouth (blue, white or gray)

Febrile seizures often involve stiffening and/or shaking on both sides of the body, but sometimes only one side of the body is involved. Sometimes a child may lose consciousness, but not noticeably shake or move. While all seizures can be scary to see, most seizures, including febrile seizures, usually end in less than one to two minutes. After a seizure, your child may be sleepy or confused, but this will improve over the next several minutes to hours. Here’s what you can do if your child experiences a febrile seizure.

Take action

If your child experiences a febrile seizure, try to stay calm. You can keep your child safe by taking the following actions:

• Gently place your child on the floor, lying on their side. This will keep your child from choking on any saliva or food that may be in their mouth.
• Remove any nearby objects, like toys or furniture, to prevent accidental injury. Do not try to restrain your child.
• If there is an object in your child’s mouth, gently remove it if possible. Otherwise, nothing should be placed in your child’s mouth during a seizure. Contrary to popular misconception, your child cannot choke on their tongue, and putting an object in their mouth can make it difficult for them to breathe.
• Loosen any clothing around their head or neck.
• Watch for signs of breathing difficulty.
• Time your child’s seizure, if at all possible.

Call 911 immediately if:

• Your child’s seizure lasts more than five minutes.
• Your child turns blue.
• Your child has repeated seizures.
• Your child doesn’t quickly improve once the seizure is over.

Seek treatment

If this is your child’s first febrile seizure, it’s important to seek treatment right away. Some infections can be very dangerous, and it’s important that a doctor determine and treat the cause of the fever.

The doctor will examine your child and ask you to describe the seizure. Depending on your child’s symptoms, they may also order tests. If a serious infection is found, if the seizure was prolonged, or if your child is younger than 6 months, they may be admitted for further observation and testing.

Usually, however, no further testing or treatment is needed, and your doctor will talk to you about the best way to manage your child’s fever.

Stay calm

Even though febrile seizures can be scary, there’s no need to fear the worst outcome. Most febrile seizures are short and don’t cause any long-term problems. Even when a febrile seizure lasts a long time, most children recover completely. Says Dr. Molisani, “Febrile seizures do not cause brain damage, lowered IQ or lowered school achievement later in life.”

Most children outgrow febrile seizures altogether by 5 to 6 years old. Once a child has experienced one febrile seizure, however, they are more likely to have another. Though fever-reducing medications may make your child more comfortable during illness, they can’t prevent a febrile seizure. If future febrile seizures are likely, it’s important to have a plan in place with your doctor. Knowing what to expect ahead of time can help you feel more confident and keep your child safe.