Child Has a Fever and a Seizure?
Here's Exactly What To Do
What Is a Febrile Seizure?
A febrile seizure is a convulsion triggered by a rapid rise in body temperature, usually above 100.4°F (38°C), in an otherwise healthy child. They are most common between the ages of 6 months and 5 years, with the peak occurring around 12–18 months, and affect roughly 2–5% of children in this age group at some point.
Importantly, a febrile seizure is not the same as epilepsy. It does not mean your child has a seizure disorder, and in the vast majority of cases it causes no lasting harm to the brain. It's the sudden spike in temperature — not the fever's severity — that usually triggers the event, which is why a seizure can sometimes be the very first sign that a child is unwell, even before you knew they had a fever at all.
🔬 Quick Facts
- Febrile seizures are the most common type of seizure in childhood.
- They usually last less than 2–3 minutes and rarely more than 5.
- Roughly 1 in 3 children who have one febrile seizure will have another during a future illness.
- Children almost always outgrow the tendency by age 5–6.
- A family history of febrile seizures increases the likelihood in siblings or children.
What Does a Febrile Seizure Look Like?
Recognising a seizure quickly helps you respond calmly instead of freezing in panic. Signs can vary, but the most common features include:
Loss of Consciousness
Your child suddenly becomes unresponsive and may not react to your voice or touch.
Stiffening & Jerking
The body, arms, and legs may stiffen and then jerk or twitch rhythmically on both sides.
Rolled-Back Eyes
Eyes may roll upward or stare fixedly during the episode.
Breathing Changes
Breathing may become irregular, and lips can look slightly bluish for a few seconds.
Loss of Bladder Control
Some children may urinate involuntarily during the seizure — this is normal and not a cause for alarm.
Post-Seizure Drowsiness
After it ends, your child is often sleepy, confused, or irritable for several minutes to an hour.
Step-by-Step: What To Do During the Seizure
If your child starts seizing, the most important thing you can do is stay calm and keep them safe. Follow these steps in order:
Stay calm and note the time
Look at a clock or start a timer the moment the seizure begins. Duration is the single most important detail you'll need to report.
Lay your child on their side
Gently place them on a flat, soft surface in the "recovery position" (on their side) to keep the airway clear and prevent choking if they vomit.
Clear the area
Move away any hard, sharp, or hot objects nearby so your child doesn't get injured during the jerking movements.
Loosen tight clothing
Loosen anything around the neck that could restrict breathing, such as a collar or scarf.
Do not restrain the movements
Let the seizure run its course. Do not hold your child down or try to stop the jerking — this cannot stop a seizure and may cause injury.
Never put anything in the mouth
Do not attempt to hold the tongue, give water, or insert any object — children cannot swallow their tongue, and this can cause choking or injury.
Stay with your child until it ends
Remain close, keep watching the clock, and reassure your child once the seizure stops and they begin to wake up.
Let them rest and check the fever
Once alert, comfort your child, check their temperature, and give fever-reducing medication as advised by your pediatrician if appropriate.
What NOT To Do
In the panic of the moment, well-meaning instincts can sometimes do more harm than good. Avoid the following:
Call Emergency Services / Go to the Hospital Immediately If:
- The seizure lasts longer than 5 minutes
- Your child has difficulty breathing, or their lips/face stay bluish after the seizure ends
- This is your child's first-ever seizure
- Your child is under 12 months old
- A second seizure occurs shortly after the first, or it doesn't fully stop
- Your child does not return to normal alertness within about an hour
- There is vomiting, a stiff neck, unusual drowsiness, or a rash alongside the fever (possible signs of a more serious infection)
- The seizure affects only one side of the body, or your child seems weak on one side afterward
When in doubt, always seek emergency medical care. Even if the seizure was brief, your child should be seen by a doctor the same day to identify and treat the underlying fever.
Simple vs. Complex Febrile Seizures
Doctors classify febrile seizures into two categories, which helps guide how much further evaluation is needed:
| Feature | Simple Febrile Seizure | Complex Febrile Seizure |
|---|---|---|
| Duration | Less than 15 minutes Common | 15 minutes or longer Uncommon |
| Body Involvement | Generalized (whole body, both sides) | Focal (one side or one limb only) |
| Recurrence | Does not recur within 24 hours | May recur within the same 24-hour period |
| Frequency | About 70–75% of febrile seizures | About 25–30% of febrile seizures |
| Follow-Up Needed | Routine pediatric review | Further evaluation, sometimes including EEG or imaging |
Even a "simple" febrile seizure should always be evaluated by a doctor afterward — this classification only describes the seizure itself, not whether your child needs medical attention.
How Is a Febrile Seizure Diagnosed?
At Sri Rama Children's Hospital, our pediatric team focuses first on finding and treating the source of the fever, since the seizure itself is a symptom rather than the underlying problem. This typically involves:
Detailed History
We ask about the seizure's duration, appearance, what the fever was caused by, and any family history of febrile seizures or epilepsy.
Physical Examination
A thorough exam to identify the source of the fever — commonly a viral infection, ear infection, or throat infection — and to rule out signs of meningitis or other serious illness.
Further Tests (If Needed)
Most children with a simple febrile seizure and an obvious feverish illness need no additional testing. However, blood tests, urine tests, or in rare cases a lumbar puncture (spinal tap) or EEG may be recommended — particularly for infants under 12 months, first-time seizures, complex seizures, or if the child appears unusually unwell.
Managing Fever & Preventing Future Seizures
✅ Practical Tips for Parents
- Use paracetamol or ibuprofen (as dosed by your pediatrician) to keep your child comfortable — note that fever reducers do not reliably prevent febrile seizures, but they help your child feel better
- Dress your child in light clothing and keep the room comfortably cool during a fever
- Offer fluids frequently to prevent dehydration during illness
- Keep a simple seizure diary noting date, duration, and appearance if your child has had one before
- Share your child's seizure history with school staff or daycare providers
- Avoid tepid sponging or cold baths to "break" a fever quickly — gradual fever reduction is safer
- Schedule a follow-up with your pediatrician after every seizure, even if your child recovers quickly
- Remember: routine childhood vaccinations are safe and do not need to be delayed because of a past febrile seizure — discuss any concerns with your doctor
Frequently Asked Questions
Our pediatric team at Sri Rama Children's Hospital answers the questions we hear most often from worried parents.
Has Your Child Had a Seizure With Fever?
Even if your child has recovered and seems fine, every febrile seizure deserves a medical evaluation. Our pediatric emergency and neurology team at Sri Rama Children's Hospital is here around the clock to help you understand what happened and how to keep your child safe.
Book an Appointment Today →