Febrile convulsions in children symptoms causes and treatment methods

Febrile Seizures in Children can be worrying for any parent, especially when the seizure happens suddenly and affects the child’s awareness or movement. Understanding the causes, types, and the best ways to treat and prevent febrile seizures can help protect your child and reduce risks. In this Dalily Medical article, we’ll explain in a simple and clear way everything you need to know about febrile seizures in children—from early warning signs to first aid and treatment—along with practical tips for parents to ensure their child’s safety and healthy development.

Febrile Seizures in Children

A febrile seizure is a seizure that occurs in children due to a high fever. It usually appears in children between 6 months and 6 years old. The seizure can last from a few seconds up to 15 minutes, but most last less than 3 minutes. After the seizure, the child often feels sleepy and tired.

Do febrile seizures affect the brain?
Generally, short and properly treated febrile seizures do not harm the brain. However, if seizures are frequent or untreated, they may affect brain cells responsible for thinking, memory, and movement.

Are febrile seizures dangerous?
Most febrile seizures are not dangerous and do not cause death or permanent brain damage. They usually stop by the time the child reaches school age. Still, it’s important to consult a doctor after any seizure to rule out serious conditions like meningitis or epilepsy.

Febrile seizures and the risk of epilepsy
In rare cases, children with recurrent febrile seizures may be at higher risk of developing epilepsy, especially if:

The first seizure occurred before 9 months of age and there is a family history of epilepsy.
The seizure lasted more than 15 minutes.
The child had delayed mental or motor development before the seizure.

Without these risk factors, the likelihood of a child developing epilepsy after febrile seizures is very low, about 1%.

Do febrile seizures recur?
Yes, febrile seizures can recur in some children, especially if the first seizure happened before 18 months. Children with a family history of febrile seizures are also more likely to have repeated episodes.

What to Do if Your Child Has a Febrile Seizure
If your child experiences a seizure due to fever:

Place your child on their side to prevent choking.
Keep any dangerous objects away from the child.
Do not put anything in their mouth.
After the seizure ends, gently lower their temperature.
Call emergency services immediately if necessary.

First Aid for Febrile Seizures

Keep the child in a safe position on their side.
Cool the body with a wet cloth or by loosening clothing.
Do not give any medications until the child fully regains consciousness.
See a doctor immediately to assess the situation and prevent recurrence.

Types of Febrile Seizures in Children
Febrile seizures are seizures related to fever, usually occurring between 6 months and 5 years. There are two main types:

1️⃣ Simple Febrile Seizure

Duration: Less than 15 minutes
Type: Generalized seizure affecting the whole body
Recurrence: Once in 24 hours
Symptoms: Temporary loss of consciousness, shaking, or involuntary movements throughout the body
Risk: Usually not dangerous, does not affect brain development

2️⃣ Complex Febrile Seizure

Duration: More than 15 minutes
Type: May be focal, affecting only part of the body
Recurrence: Can happen multiple times during the same fever episode
Symptoms: Longer loss of consciousness, localized movements, sometimes temporary breathing difficulty
Risk: Needs careful medical follow-up; may indicate a higher risk of future epilepsy

Causes of Sudden Seizures in Children
Sudden seizures can have different causes, some mild and temporary, others requiring careful medical attention:

1️⃣ Fever or Febrile Seizures – Most common in children 6 months to 5 years; sudden high fever can trigger a temporary seizure.
2️⃣ Low Blood Sugar (Hypoglycemia) – Sharp drop in blood sugar can lead to loss of consciousness or seizures; may happen in children with diabetes or after long fasting.
3️⃣ Brain or Meningeal Infections (Meningitis/Encephalitis) – Infections of the nervous system can cause sudden seizures with serious symptoms like severe headache, vomiting, and fever.
4️⃣ Brain Electrical Problems (Epilepsy or Abnormal Brain Activity) – Seizures or abnormal electrical activity may cause recurrent seizures.
5️⃣ Electrolyte Imbalance – Low calcium, magnesium, or sodium can trigger seizures.
6️⃣ Head or Brain Injuries – Any strong blow or fall can cause sudden electrical activity in the brain.
7️⃣ Genetic or Congenital Causes – Some children have a hereditary predisposition to epilepsy or structural brain issues.
8️⃣ Lack of Oxygen (Hypoxia) – Oxygen deficiency during birth or in specific cases can lead to seizures.
9️⃣ Toxins or Certain Medications – Some drugs or chemicals may cause seizures.

Stages of Febrile Seizures in Children
Febrile seizures typically go through several stages, and recognizing each stage helps parents respond quickly and reduce risks:

1️⃣ Prodromal Phase (Warning Stage)

Definition: Right before the seizure, the child shows unusual signs
Symptoms:
- Sudden fever or rising temperature
- Irritability or unusual crying
- Loss of focus or irregular sleep
Duration: A few hours before the seizure

2️⃣ Ictal Phase (Seizure Stage)

Definition: During the seizure
Symptoms:
- Temporary loss of consciousness
- Shaking or involuntary movements (generalized or focal)
- Sometimes temporary breathing difficulty or blue lips
Duration: Usually less than 15 minutes for simple seizures, longer for complex ones

3️⃣ Postictal Phase (Recovery Stage)

Definition: After the seizure, the child gradually returns to normal activity
Symptoms:
- Sleepiness or fatigue
- Temporary confusion or unsteady movements
- Minor changes in behavior or mood

Symptoms After a Febrile Seizure (Postictal Phase)

Drowsiness or extreme fatigue
Confusion or temporary loss of full consciousness
Headache or mild changes in mood and behavior
Duration: Usually lasts a few minutes to about an hour, depending on seizure severity

What to Do if Your Child Has a Febrile Seizure

1️⃣ Stay Calm and Observe

Take a deep breath and watch the seizure carefully.
Note the time when the seizure starts.
If it lasts more than 5 minutes, call emergency services and go to the nearest ER.
If it lasts less than 5 minutes but the child does not recover, seek medical help immediately.

2️⃣ Ensure a Safe Environment

Place the child on a firm, safe surface such as the floor to prevent injury.
Do not try to carry the child while panicking during the seizure.

3️⃣ Maintain Normal Breathing

Place the child on their side or stomach to avoid choking.
Remove any nearby objects from around the mouth.
Never put anything inside the mouth, as this could block the airway.

4️⃣ Avoid Cold Water Baths

Do not put the child in cold water during the seizure; it may be dangerous.

5️⃣ Seek Medical Advice After the First Episode

Always see a doctor after the first febrile seizure to determine the cause of the fever.
If additional symptoms appear (severe headache, vomiting, stiff neck), these may signal a serious infection such as meningitis, requiring urgent medical care.

Comparison: Simple vs. Complex Febrile Seizures

Feature	Simple Febrile Seizures	Complex Febrile Seizures
Duration	Less than 15 minutes	More than 15 minutes
Type of movement	Generalized shaking of the whole body	May be limited to one part of the body (focal)
Recurrence	Once in 24 hours	Can happen more than once in the same day
Post-seizure recovery	Child quickly returns to normal	Child may appear weak or drowsy longer
Loss of consciousness	Usually brief or partial	More prolonged or obvious
Age of onset	Typically 6 months – 5 years	Same age group but often with added risk factors
Epilepsy risk later	Very low	Higher risk, especially if associated with neurological signs
Additional notes	Always linked to fever, otherwise healthy before/after	Needs closer medical follow-up to rule out other causes

How to Prevent Febrile Seizures in Children

1️⃣ Control Fever Quickly

Monitor your child’s temperature closely during illness.
Use safe fever reducers (paracetamol/acetaminophen or ibuprofen) as advised by a doctor.
Avoid sudden or extreme rises in temperature.

2️⃣ Keep the Child Hydrated

Ensure plenty of fluids (water, juice, oral rehydration if needed).
Fluids help lower fever and prevent dehydration, which can increase seizure risk.

3️⃣ Light Clothing

Dress the child in light clothing during fever.
Avoid heavy blankets or excessive layers.

4️⃣ Watch for Early Warning Signs

Look for irritability, shivering, or twitching before/during fever.
Contact a doctor if these signs appear.

5️⃣ Treat Infections Promptly

Manage infections (like ear, throat, or urinary infections) that may trigger fever under medical supervision.

6️⃣ Comfortable Sleep Environment

Keep the child’s room cool and well-ventilated.
Avoid overheating or crowded environments.

7️⃣ Early Medical Consultation

If the child has a history of febrile seizures or neurological issues, the doctor may recommend preventive medication or a specific monitoring plan.

Diagnosis of Febrile Seizures in Children

Since symptoms can overlap with other conditions like epilepsy or infection-related seizures, diagnosis requires careful evaluation:

1️⃣ Medical History & Physical Examination

When did the fever and seizure occur?
Seizure characteristics: whole body or just part of it?
Other symptoms: vomiting, headache, rash?
Family history: seizures or epilepsy increase risk.
Post-seizure behavior: weakness, delayed recovery?

2️⃣ Laboratory Tests

Blood tests: to rule out low sugar, electrolyte imbalances, or infections.
Blood/urine cultures: if bacterial infection is suspected.

3️⃣ Imaging Tests

MRI or CT scan: not required for all children, but done if seizures are complex, recurrent, or accompanied by unusual neurological symptoms.

4️⃣ Electroencephalogram (EEG)

Not usually needed for simple febrile seizures.
Recommended in:
- Complex or recurrent seizures
- Suspected epilepsy alongside febrile seizures

Tips for Parents

Record the time, duration, type of movements, and temperature before and during the seizure.
If possible, take a video of the seizure to help the doctor make a more accurate diagnosis.
Early diagnosis reduces the risk of complications and helps in planning proper treatment.

???? First Aid for Febrile Seizures in Children

1️⃣ Stay Calm

Keep yourself calm; this helps reduce fear and stress for your child.
Most febrile seizures are short and stop on their own within a few minutes.

2️⃣ Protect the Child from Injuries

Place your child on a flat, safe surface, away from sharp edges.
Do not try to restrain their arms or legs during the seizure.

3️⃣ Positioning During the Seizure

Lay your child on their side (recovery position) to prevent choking.
Tilt the head slightly forward to allow saliva or vomit to drain.

4️⃣ Track the Time

Record how long the seizure lasts.
Most seizures are under 5 minutes. If it lasts longer, seek urgent medical help.

5️⃣ Do Not Put Anything in the Mouth

Do not insert your fingers, spoons, or any objects—this can cause choking or injury.

6️⃣ Lower the Fever After the Seizure

Apply a lukewarm compress to the forehead or neck.
Remove heavy clothing or blankets.
Offer fluids if your child is alert and able to drink.

7️⃣ Call the Doctor

Contact your doctor immediately after the seizure and report the details.
If the seizure lasts more than 5 minutes, or your child remains unconscious or has trouble breathing, call emergency services immediately.

????️ Prevention of Febrile Seizures in Children

While febrile seizures cannot always be fully prevented, parents can reduce the severity and keep the child comfortable during fever.

Best ways to lower fever:

1️⃣ Light Clothing

Dress your child in a single light layer.
Use a thin blanket at night.

2️⃣ Encourage Fluids

Water, milk, or fresh juices help keep the body hydrated and reduce fever.

3️⃣ Lukewarm Bath

Give a lukewarm bath to lower the fever.
Avoid cold water—it can cause shivering and increase body temperature.

4️⃣ Control Room Temperature

Keep the room moderate, not too hot or too cold.

5️⃣ Use Fever-Reducing Medication

Use paracetamol (acetaminophen) or ibuprofen, as prescribed by the doctor and according to the child’s weight and age.

❄️ Shivering (Rigors) with Fever

Shivering during fever may be a warning sign of febrile seizure, especially in children under 5 years.

Cause: the nervous system’s immature response to sudden temperature rise.
Most febrile seizures are not dangerous, but wrong handling can cause complications.

Preventive steps:
1️⃣ Lower fever quickly with lukewarm compresses or safe medications.
2️⃣ Monitor warning symptoms like staring, brief loss of consciousness, or muscle stiffness.
3️⃣ Avoid wrapping the child in heavy blankets during fever.
4️⃣ If the child has a history of febrile seizures, consult the doctor for a prevention plan.

???? Treatment of Febrile Seizures in Children

Treatment depends on whether the seizure is simple or complex, and how the child recovers.
The main goals are safety, fever control, and follow-up.

1️⃣ Immediate Measures During the Seizure

Place the child on their side for safe breathing.
Remove any hard or sharp objects nearby.
Do not put anything in the mouth.
Record seizure duration.
If the seizure lasts more than 5 minutes, call a doctor or ambulance immediately.

2️⃣ Fever Reduction

Use fever-reducing medicines (paracetamol or ibuprofen) in correct doses.
Dress the child lightly and avoid overheating.
Offer fluids if the child is alert.

3️⃣ Post-Seizure Monitoring

Watch the child after the seizure: note sleepiness, imbalance, or unusual symptoms.
Keep a record of every episode: time, duration, movements, and fever level.

4️⃣ Preventive Medications

Most simple febrile seizures do not need anti-seizure drugs.
Preventive medication may be prescribed for complex or recurrent seizures, under a pediatric neurologist’s guidance.

5️⃣ Important Advice for Parents