Can Febrile Seizures be Prevented?


My 18-month-old son recently had a simple febrile seizure. I had no idea what was happening. It was terrifying! His doctor says that he’s all right now, but I’m still worried about lasting brain damage. I also feel guilty for not noticing his fever. How can I prevent this terror from happening again?

Dr. Greene's Answer

Some children have seizures or convulsions when they have fevers. Although febrile seizures are fairly common, many parents have never seen one until it happens to their child. Febrile seizures occur in 3% to 5% of otherwise healthy children between the ages of 6 months and 5 years. Toddlers are the most commonly affected.

The seizure begins with the sudden sustained contraction of muscles on both sides of a child’s body — usually the muscles of the face, the trunk, the arms and the legs. Often a haunting, involuntary cry or moan emerges from the child, from the force of the muscle contraction. The contraction continues for seemingly endless seconds, or tens of seconds. The child will fall, if standing, and may pass urine. He may vomit. He may bite his tongue. The child will not be breathing, and may begin to turn blue. Finally, the sustained contraction is broken by repeated brief moments of relaxation — the child’s body begins to jerk rhythmically. The child is unresponsive to the parent’s screams.

This is usually one of lifetime’s most frightening moments for the parents. Most parents are afraid that their child will die or will have brain damage. Thankfully, simple febrile seizures are harmless.

Febrile seizures are brought on by the sudden stimulation of many brain cells at once. Experts argue over whether febrile seizures are triggered by the height of the fever or by the rate of rise. I suspect that both play a role. Most febrile seizures occur well within the first 24 hours of an illness, not necessarily when the fever is highest. Often the seizure is the first sign of a fever, making febrile seizures hard to prevent.

A simple febrile seizure stops by itself within a few seconds to 10 minutes, sometimes followed by a brief period of drowsiness or confusion. Anticonvulsant medicines are generally not needed.

A complex febrile seizure is one that lasts longer than 15 minutes, occurs in an isolated part of the body, or recurs during the same illness.

During the seizure leave your child on the floor, although you may want to slide a blanket under him if the floor is hard. Move him only if he is in a dangerous location. Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up. If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach. Don’t try to restrain your son, or stop the seizure movements. Don’t try to force anything into his mouth to prevent him from biting his tongue, as this increases the risk of injury and choking. Be sure that your child is breathing during the seizure. If he appears blue around his lips, you should call 911 immediately.

Focus your attention on bringing the fever down. Inserting rectal acetaminophen (Tylenol) is a great first step — if you happen to have some. Don’t try to give him anything by mouth.

Apply cool washcloths to the forehead and neck. Sponge the rest of his body with lukewarm (not cold) water. (Cold water or alcohol may make him shiver and make the fever worse). After the seizure is over and your son is awake, give him the normal dose of ibuprofen (Motrin or Advil) or acetaminophen (Tylenol). Children should see a doctor as soon as possible after their first febrile seizure. If the seizure ends quickly, drive him to an emergency room when it is over. If the seizure is lasting several minutes, call 911 to have an ambulance bring him to the hospital.

After the seizure, the most important step is to identify the cause of the fever. Most febrile seizures are brought on by fevers arising from viral upper respiratory infections, ear infections, or roseola. Meningitis causes less than 0.1% of febrile seizures but should always be considered, especially in children less than one year old or who still look ill when the fever drops.

About one third of the children who have had a febrile seizure will have another one with a subsequent fever (about 2/3 won’t). Of those who do, about half will have a third seizure. Few have more than three. Sometimes febrile seizures run in families. If there is a family history, if the first seizure happened before 12 months of age, or if the seizure happened with a fever of <102, a child is more likely to fall in the group that has more than one febrile seizure.

To try to prevent future febrile seizures, many health care providers recommend using acetaminophen (Tylenol) and/or ibuprofen (Motrin or Advil) at the first sign of a fever. However, researchers have found that these medications may not necessarily prevent febrile seizures. Despite the question of their utility in preventing febrile seizures, these medications can make children more comfortable when they are feverish and are worth trying for that reason(Eur J Pediatr (2008) 167:17–27).

Other things to try include sponging your child with lukewarm water. Also give him cool liquids to drink — both to lower the temperature and to keep him well hydrated. Since febrile seizures can occur as the first sign of illness, prevention is often not possible. Neither an initial nor a recurrent febrile seizure suggests second-rate care of your child.

Sometimes children who have had a febrile seizure are subsequently treated by their parents as weak or vulnerable children. This does not help anyone. Simple febrile seizures should not hold a child back from his normal activities.

There is no evidence that febrile seizures cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.

A small number of children who have had a febrile seizure do go on to develop epilepsy, but not because of the febrile seizures. Children who would develop epilepsy anyway will sometimes have their first seizures during fevers. These are usually prolonged, complex seizures. Previous neurologic problems and a family history of epilepsy also make future epilepsy more common (about 2% of these high risk children will develop epilepsy, compared to about 1% in the general population). The number of febrile seizures has no correlation with future epilepsy.

I have no doubt that your son’s febrile seizure was a moment of terror for you. For many families, these seizures shake more than the children’s bodies. The seizure can shake up the routine of being a parent. For parents of toddlers, the battles of the wills can get exasperating. The work can be exhausting. The seizure can shake off the layers of weariness and frustration to reveal the intense love you have for each other.

Last medical review on: April 03, 2009
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

My son he’s one year and five month and currently he had a high fever 38. 5 and then he goes through febrile seizure twice for ten min we went to doc they said its a food poision and gave him a shote ever since his fever his still high and his been coughfing ever since we ruped him with luckwarm water his been crying and didn’t want to eat or take his milk. Please if you have any adice let us know

My son’s first Febrile Seizure was 2 years old he had his second one 9 months later. His pediatrician referred him to a neurologist only because there is a family history of epilepsy. On his EEG’s (2 regular sleep deprived and 1 48hr video EEG) he had slowing of the spike and wave patterns but no seizure activity. He ended up having another febrile seizure a year and a half after the second one. But in between he started having absence seizures. Last month he had another EEG and had two seizures while hooked up so was diagnosed with epilepsy. Deep down I knew he would develop epilepsy but that doesn’t mean all children with Febrile Seizures will. On the comments about their children and grandchildren passing away. I’m so sorry about your loss and I’m wondering if maybe they did in fact have epilepsy and no one knew yet because this sounds like SUDEP.

MY beautiful grand son who was only 23 months old when he died in his crib in the middle of the night. My daughter found him face down and he was ice cold. He had a history of febrile seizures and had all the tests done but the doctors said the same thing about this not being life threatening. We are devastated. If we only knew the danger he was in everytime he was put to bed. Aren’t there alarms for their cribs? Isn’t there some kind of medication ?

Dr. Greene, my son who’s 1 year and 4 mos also had a seizure due to fever for several times already like 5 times. Me and my wife are very scared everytime this thing happened to him. Is there any alternative way for parents like us to avoid this seizure?

Hi, a 10 year old child could experience a febrile seizure? My son had something very similar to this, the doctors at hospital weren’t clear about what happened. For me, he was dead, I did cpr, and he started to breath, was the worst experience of my life and I would like to know what was it to avoid it again in the future

My son was 7m when he got first seizure and now he is 3 years old and got second seizure for 2 – 3min because of high fever we took him to hospital and gave treatment but not satisfied with the details got by doctor does this come again in future how to prevent this

Our 2 beautiful, healthy 2.5-year old girl passed away in her sleep last week following what all indications suggest was another febrile seizure. She had experienced three febrile seizures over the year prior to her passing, but had not had one for about 8 months prior to what we believe was her final, fatal event. After the first seizure that we witnessed, we had her tested by a pediatric neurologist (EEG and heart testing) who explained she was just prone to febrile seizures, would likely have them again when she ran high temperatures. Her last night, she had a tiny little runny nose, on one side, and we felt silly giving her Children’s Ibuprofen (Motrin) (just in case). Whens she was checked in the night, she was not hot, and tucked back in. In the morning, she was gone. Face down in a light blanket (she was only 3 months shy of her third birthday and had slept with blankets for some time), with mucus at her mouth, very similar to how she was found in her first (suspected) seizure a year prior.

Please be careful with your children when they have a history of febrile seizures. We felt our little one was under control and “growing out” out of the condition at the time she suddenly passed. It was more likely that she just didn’t catch any viruses during the non-cold/flu season. If your little one has a history of febrile seizures, consider taking it more seriously than you may be lead to do by doctors/pediatrician’=s who tend to communicate the “most common outcome” (i.e, they are fairly common, and are “generally” not fatal, they grow out them, etc.). Generally not fatal does not mean they are never fatal. We are absolutely devastated and upset we weren’t told, “Yes, they can be fatal. It is rare, but they can be fatal.” That would have been enough to change our entire outlook and level of attention – which was already high alert. I would have had her sleep in my room until she was 6 if I’d know, or used a seizure-detection motion sensor on herbed, or even considered full-time preventive medication during the higher risk winter months when viruses are circulating.

My wife repeatedly told our pediatric neurologist that she was terrified about a seizure occurring in the night when no one would hear/notice and she would stop breathing. We were told she would just have the seizure, we would find her in the morning with symptoms/lethargic (but alive), or wouldn’t even notice that she had one.

Absolutely crushed, feeling that we could have done more had we know there was a risk of death, and we were already doing A LOT. We were paranoid about it. But you just don’t know, one can hit at any time, with no warning in the middle of the night. Please pay a lot of attention and look into options for avoiding this kind of tragic outcome if your child has experienced repeated febrile seizures. I’m not comfortable with the general advice out there that febrile seizures are “relatively common” and “generally not life threatening.” This issue needs more attention, especially for kids that have several of them.

Why dint the dictors give a care what’s happening? They dint tell you anything but they do all the tests not helping you prevent them !!! How long did these kooks know that this was inevitable
How do we prevent them ??? More info and strategy is needthey cuz they dont care !

My grandson just had one this Friday that past he had two before that one when he was like 6 months than the next when he was 1. The first time I seen him have one I didn’t have a clue what was going on I felt his body and knew he had to have a fever because he was burning up. I didn’t know what to do so I just called 911. They keep saying this is normal. But I don’t agree with that. his doctor told me that every time his body temp reaches over 103 he will have a seizure. I have done a lot of research hoping to get answers and how to prevent it from happening again and nothing comes up. When he has these seizures the really scare me and I get upset because there is nothing I can do to stop it. So my only solution is to keep my eyes on him 24/7 if I notice a change in his behavior like him not acting like his normal self I worry. Question what should I have the doctor test him for so I can rule out any possible medical issues.

This is my problem right now. My son had two Febrile Seizures within a two week period. Now we are literally on pins and needles watching him and his body temperature like crazy. All test and blood work show normal. All the docs can say is it must be a viral infection causing his fevers. My child reach 100.4 and had a febrile seizure. I really wish i could find more information as well. Good luck to you and your grandson. I know its scary.

I just don’t understand. My perfect 2.5 year old son died of a febrile seizure on 12/21/15. It’s the finding in his medical report! How can doctors keep saying they don’t cause death? I miss my son and I had a false sense of security that it’s a benign condition.

Holly – I’m so sorry, my wife and I just experienced exactly the same tragedy. It’s not right, the “benign condition” advice we received. We just lost our daughter 11/6/2016. How I wish we had seen this site earlier.

I am so sorry that happen to you can your family I pray for comfortable for you and your family that you get through this hard time. I just wish that there were more answer available for the situation because it will sure help just to have some answers.

Thank you for this informative article currently my wife and I are very frustrated with this condition my soon to be 12 month old has been having these seizures about once a month for the last six months. Most of his seizures have lasted 1 hour the shortest was 15 minutes. With the exception of a fever his EEG, MRI and CT scan all came back normal. When he has his seizures the emergency Diazapam doesn’t work most of the time within the first 15 minutes. Is there anything else we can test him for because this doesn’t seem normal.

Hi, I just read what was going on with you precious baby. I wanted to ask if you ever got any diagnosis? I have a 11 month old with exactly the same thing. Febrile seizures, lasting typically an hour, shortest lasting 21 minutes. She takes Keppra twice a day, but it is not working like I would hope. Everything like you as for as EEG, MRI, etc is normal. Diazapam does not work, Ativan is the only thing that stops them. They are currently doing some genetic testing, but thought I would see if you had any good news by chance.

Great article. The most through I’ve read from alm the resources I looked up. I also appreciate the kind words for parents in there.

My son had two fiberal seizures the other night and this article was very informative and reassuring.

Keep up the good work.

I would love to join a practice with such a compassionate, caring, and knowledgeable doctor.

There’s an abundance of information in this site that’s really helpful.

I don’t see a kids book yet. I’m hoping you’ll release one soon.

Again an abundance of thanks for a great well written article.

My daughter had febrile seizures when she was 1 yr plus – she was getting them often at least once for the month but due to the flu or some sort of infection when she was 2 yrs plus it stopped. On December 04 2015 she got another seizure. Will she out grow this? Should she go to the doctor every time she gets a seizure even though it lasts under a minute and she’s back to normal.

I’m so sorry you’re going through this. Your doctor should help you come up with a strategy for dealing with them so you know what to do in the future.

My 3 year old had febrile seized last Friday 27:11:2015. I didn’t know it was a seizer cause she never had anything medical problems before but my house keeper had the virus and so I think she got it cause a few weeks back she had the flu, I got scared and started crying and luckily her father prevented her from going into it, her one lasted few seconds. I’m worried she can get another.

My son had 2 febrile seizures when he was 3 years old in one morning within an interval of about 2 hours. It lasted less than 2 mins and is due to high fever. Currently he is 7 years and 6 months old and due to high fever again, he has seizure again which he shouldn’t at his age. It lasted less than 2 mins. He complains headache and neck pain. He got his blood test done and LP test which to extract his fluid from his spinal cord. The result shows normal and rule out possible meningitis. What could be the reason for him not able to outgrown seizure? And what are the other factors that I need to watch out on him? Thanks!

My 27 month old son had 4th febrile seizer on 26/2/2015. I am very afraid due to doctors are not giving me right suggestion. Please help me and suggest me.

Hi our daughter to our knowledge had her first at 14m and 3 within a few days. She then had one 6m later then 3m later then a further Ur later and now tonight that we have witnessed or witnessed the after effects :( it’s so hard you don’t necessarily know they are coming our ds seams to scream just before them :( it’s hard when we took her in the first time the pead told us it may not of been her first as she was so young n she stayed in a febrile state for so long n no matter how much Panadol &knit often they gave her they kept re occurring it turned out she had Broncitis the first few seizures the next was a middle ear infection an again we know it’s broncitis this time around as she is already on antibiotics for it. All you can do is slowly cool them down cool face washers stripping of clothes and so on slowly cool them down goodluck I know the first time it happened for us I was in tears wanting to know what was wrong with my baby girl thinking something so serious and the next time I wasn’t so bad but still so very worried :(

Dr. Greene, my daughter (5 years old) has brain damage due to a surgery when she was 5 days old. In 2013 she suffered a big seizure. Neurologist told me she had a prolonged seizure. After that we took her to the ER and doctors treat her as if she had meningitis, but thanks God she didn’t. She is on seizure medication. Could you please give me your advice? Could she have another febrile seizure? I live with fear. I love her dearly and I don’t want to lose her. God bless you.

My 3 year-old girl has had it twice. I felt very uncomfortable when ever I saw her like that. please DR help me.

My 22 months son went through 3rd seizure today in last 12 days, I believe it is epilepsy now. What are the consequences involved and what best can we do now.