Febrile seizures (febrile convulsions)
The most common seizures of early childhood — frightening to witness, but usually harmless with an excellent outlook.
Febrile seizures are seizures triggered by fever in young children, without an infection of the brain or another clear cause. They are the most common type of seizure in childhood, affecting roughly 2–5% of children between 6 months and 5 years of age. Although they are very frightening for parents to see, the great majority are brief and harmless, carry an excellent long-term outlook, and do not damage the brain or mean the child has epilepsy. A smaller number are 'complex' or prolonged and need closer attention.
At a glance
- What it is
- Seizure with fever, age 6 months–5 years, no brain infection
- Frequency
- ~2–5% of children
- Most common type
- Simple (about 70%)
- Recurrence
- ~30% overall (higher if the first is before age 1)
- Later epilepsy
- ~1–2% after simple (vs ~0.5–1% in general population)
What febrile seizures are
A febrile seizure is a seizure that happens when a young child has a fever, in the absence of a brain infection (such as meningitis), a metabolic problem, or a history of seizures without fever. They occur in a specific age window — between about 6 months and 5 years — when the developing brain is more susceptible to fever.
A febrile seizure is not epilepsy. It is a one-off response of a young brain to fever, and most children simply grow out of the tendency.
Types
- Simple (about 70%) — a single, generalised seizure lasting under 15 minutes that does not recur within 24 hours
- Complex (about 25%) — focal features, lasting more than 15 minutes, or recurring within 24 hours
- Febrile status epilepticus (about 5%) — a prolonged febrile seizure lasting 30 minutes or more
What to do during a seizure
- Stay calm, keep the child safe from injury, and gently place them on their side
- Do not restrain them or put anything in their mouth
- Note the time the seizure starts — most stop on their own within a few minutes
- Call emergency services if the seizure lasts more than 5 minutes, the child has trouble breathing, seizures repeat, or it is the first one
- Seek urgent assessment if the child seems very unwell, drowsy, or has a stiff neck or rash, to rule out a serious infection
Evaluation
The main task is to find and treat the cause of the fever. A lumbar puncture is performed if meningitis is suspected, and may be considered in younger infants or after a complex seizure. For a typical simple febrile seizure in a well child, routine blood tests, EEG and brain imaging are not needed.
Treatment
Most febrile seizures need no specific treatment beyond keeping the child safe and treating the underlying illness. A seizure lasting more than about 5 minutes is treated with a rescue benzodiazepine, and febrile status epilepticus is managed like any prolonged seizure, in hospital.
Two points often surprise parents: fever-reducing medicines (paracetamol or ibuprofen) make a child more comfortable but do not prevent febrile seizures from recurring; and daily, preventive antiseizure medication is generally not recommended for simple febrile seizures, because the risks outweigh the benefits. In selected children with very frequent or prolonged seizures, an intermittent rescue benzodiazepine may be used — a decision for the treating clinician.
Simple febrile seizures do not cause brain damage and do not mean a child has epilepsy or will have learning problems. Reassurance and a clear plan are usually the most important 'treatment'.
Prognosis
The outlook is excellent. About 30% of children have another febrile seizure — closer to half if the first one happened before the age of 1, and around a fifth if it happened later — and almost all outgrow the tendency by school age.
The risk of going on to develop epilepsy is only slightly higher than in the general population (about 1–2% after a simple febrile seizure). The risk is higher after complex febrile seizures or febrile status epilepticus, with a family history of epilepsy, or where there is a pre-existing developmental difference. Normal development and intelligence are expected after simple febrile seizures.
How an educational review can help
After a frightening first seizure, families often want clarity: was it simple or complex, were the right tests done (or correctly not done), what is the chance of it happening again, and what should we do next time? An educational review can explain the episode and any reports in plain language, set out recurrence and epilepsy risk realistically, and help you prepare a simple seizure action plan to discuss with your doctor.
It is an educational second opinion — not a diagnosis, treatment or prescription — and it does not replace the care of your child's own clinicians.
Selected sources
- Eilbert W, Chan C. Febrile seizures: A review. JACEP Open. 2022.
- American Academy of Pediatrics. Clinical practice guideline — the neurodiagnostic evaluation of the child with a simple febrile seizure.
Last reviewed: 2026-05-22
Related treatments
Have a report you want explained?
Share your child's records and our specialists will prepare a written educational review.
Start a ReviewZatay Medical provides independent educational reviews only. Our reports are not a diagnosis, treatment, or prescription, and do not replace care from your treating physician.