Febrile Seizures: What to Do When Your Child Has Convulsions With Fever

Your child suddenly goes stiff, their eyes roll back, their arms and legs are jerking — all during a high fever. This is one of the most frightening experiences a parent can have. But in most cases, what you are seeing is a febrile seizure — and while it looks alarming, it is usually not dangerous.

What Is a Febrile Seizure?

A febrile seizure is a seizure triggered by a sudden rise in body temperature — usually above 38.5°C. It most commonly occurs in children between 6 months and 5 years of age. It typically happens during the first few hours of a fever, often before parents even realise the child has a fever.

Febrile seizures affect about 2–5% of all children. Having one febrile seizure does not mean a child has epilepsy — the risk of developing epilepsy after simple febrile seizures is only marginally higher than in the general population.

Simple vs Complex Febrile Seizure

• Simple febrile seizure: Lasts less than 15 minutes, involves the whole body (generalised), and the child recovers completely. This is by far the more common type.
• Complex febrile seizure: Lasts more than 15 minutes, involves only one part of the body, or occurs more than once in 24 hours. Needs more thorough investigation.

What to Do During a Febrile Seizure

• Stay calm. The seizure will usually stop on its own within 1–3 minutes.
• Place the child on a flat surface on their side (recovery position) to prevent choking.
• Do not put anything in the child's mouth — there is no risk of "swallowing the tongue".
• Do not try to restrain the jerking movements.
• Note the time — how long the seizure lasts matters greatly to the doctor.
• After the seizure stops, the child may be very sleepy and confused — this is normal and called the post-ictal phase.

When to Go to Hospital Immediately

• The seizure lasts more than 5 minutes
• Seizure occurs more than once in the same illness
• The child does not return to their normal self within 30–60 minutes
• Child under 6 months or over 6 years
• The child has neck stiffness, severe headache, or a rash (could suggest meningitis)

Does a Febrile Seizure Mean My Child Has Epilepsy?

No. Most children who have febrile seizures never develop epilepsy. The risk of recurrence of another febrile seizure is about 30–35% (mainly if the child is young, has a family history, or the fever was not high). Long-term anti-epileptic treatment is not recommended for simple febrile seizures.

"Febrile seizures are one of the most common neurological events in childhood. They look frightening but the vast majority resolve quickly and leave no lasting harm. The key is staying calm, keeping the child safe, and seeking evaluation afterwards."

Sri Anand Child and Neuro Center, Chanda Nagar offers paediatric neurology consultations for febrile seizures, epilepsy, and all neurological concerns in children. Call +91 90633 66983.