Febrile Seizure in Children: What to Do and When to Worry
In short: A febrile seizure is a fit caused by a rise in temperature in a child aged roughly 6 months to 5 years. It looks frightening, but most last under five minutes, stop on their own and cause no lasting harm. Lay your child on their side, time it, put nothing in their mouth, and call 999 if it lasts more than five minutes. Every first febrile seizure should be checked by a doctor the same day.
Key takeaways
Febrile seizures affect about 2 to 5 in every 100 children, usually between 6 months and 5 years of age, and are most common at around 18 months.
A simple febrile seizure involves the whole body, lasts less than 15 minutes and does not happen again within 24 hours.
About one in three children who have one febrile seizure will have another, usually within the following year or two.
Paracetamol and ibuprofen make a child with fever more comfortable, but they do not prevent febrile seizures.
Simple febrile seizures do not cause brain damage and do not affect a child's intelligence, learning or behaviour.
What is a febrile seizure?
A febrile seizure is a fit triggered by fever in a young child whose brain is otherwise healthy, with no infection of the brain itself and no earlier seizures without fever.
Many Malaysian families call it sawan demam or sawan panas. A young brain is more sensitive to a quick rise in temperature, and in some children that rise sets off a brief burst of electrical activity. Most children outgrow this by the age of 5 or 6.
The fever almost always comes from a common infection such as a cold, influenza, roseola, an ear infection or gastroenteritis. Dengue can also trigger one, so a child with fever and a seizure should always be assessed properly.
What does a febrile seizure look like?
Your child may suddenly go stiff, then the arms and legs jerk rhythmically. The eyes may roll back. Some children go limp instead. Breathing can look irregular, the lips may look slightly blue, and your child will not respond to you. They may wet themselves or vomit. Most seizures last one to two minutes, although it will feel far longer.
Shivering at the start of a fever can look similar, but a shivering child is awake and responds to you.
What is the difference between a simple and a complex febrile seizure?
A simple febrile seizure is generalised, lasts under 15 minutes and happens once in 24 hours. A complex one is focal, longer than 15 minutes, or repeats within 24 hours.
Most febrile seizures are simple. A complex febrile seizure has at least one of these features:
It affects only one side or one part of the body.
It lasts longer than 15 minutes.
It happens more than once in the same illness, within 24 hours.
A complex febrile seizure is not necessarily dangerous, but it calls for a more careful assessment, sometimes with tests or a referral to a paediatric neurologist.
What should I do during a febrile seizure?
Stay calm, place your child on their side on a safe surface, time the seizure and do not put anything in their mouth. Call 999 if it lasts longer than five minutes.
Note the time it started.
Lay your child on their side on the floor or a bed, away from hard or sharp edges, so saliva or vomit can drain from the mouth.
Loosen tight clothing around the neck and remove thick layers.
Stay beside them. Do not try to hold them still.
If someone else is with you, ask them to take a short video. It helps your doctor understand what happened.
When the jerking stops, keep your child on their side until they are breathing normally and starting to wake.
When should I call an ambulance?
Call 999 if the seizure lasts more than five minutes, if your child is struggling to breathe or stays blue, if another seizure follows soon after, if they are injured, or if they do not start to wake within about an hour. If you are not sure what is happening, calling for help is always reasonable.
What happens after the seizure stops?
It is normal for your child to be sleepy, irritable or confused for up to an hour. Many simply fall asleep. Keep them on their side and check that their breathing stays steady and their colour returns. Once fully awake and able to swallow, they can have a drink and a dose of fever medicine for comfort.
Why does my child need to see a doctor after a febrile seizure?
A first febrile seizure always needs a same-day medical review, mainly to find the cause of the fever and make sure it is not a serious infection such as meningitis.
The seizure itself usually needs no treatment. Most children who have had a simple febrile seizure and are back to normal can go home once the cause of the fever is clear. Routine blood tests, brain scans and EEG (brainwave tests) are not needed after a simple febrile seizure, because they do not change what we do. Tests focus on the fever instead, for example a urine test.
A doctor will be more cautious, and may keep your child in for observation, if your child:
is under 18 months old, as signs of meningitis are harder to spot at this age;
had a complex febrile seizure;
is still drowsy an hour after the seizure;
has not had their routine vaccinations.
Will my child have another febrile seizure?
About one in three children have another febrile seizure, most often within a year or two of the first. The risk falls steadily as they get older.
The chance of another one is higher if:
the first seizure happened before 18 months of age;
a parent or sibling had febrile seizures;
the seizure happened at a fairly low temperature, below about 39°C;
the seizure came within an hour or so of the fever starting.
Can I stop another febrile seizure by bringing the fever down?
Sadly, no. Studies show that giving paracetamol or ibuprofen early, or around the clock, does not prevent febrile seizures. Seizures often happen as the temperature is rising, sometimes before parents notice the fever at all. Fever medicines are still worth using because they help an unwell child feel better.
Does a febrile seizure mean my child has epilepsy?
No. Febrile seizures are not epilepsy. After simple febrile seizures, the risk of later epilepsy is similar to, or only slightly higher than, that of other children. It is somewhat higher after complex febrile seizures, or when there is a family history of epilepsy or a developmental condition.
Are febrile seizures dangerous?
Simple febrile seizures are not dangerous to the brain. They do not cause brain damage, lower intelligence or learning problems, even when they happen more than once.
The real risks during a seizure are practical: a fall, a knock against furniture or breathing in vomit. Lying your child on their side on a safe surface matters more than anything else you do.
When to see a doctor, and when not to worry
Any first febrile seizure needs a same-day check. After that, children who wake up fully and return to their usual selves can usually be managed with a planned review.
Usually fine
Your child already has a diagnosis of simple febrile seizures, had a short one and was back to normal within an hour.
Your child is sleepy for up to an hour after a seizure, then wakes, recognises you and drinks.
Your child shivers at the start of a fever but is awake and responds to you.
Book an appointment soon
Your child has had two or more febrile seizures and you want a plan for next time.
There is a family history of epilepsy.
You notice changes in your child's development, speech or behaviour.
Your child has staring spells, jerks or seizures without fever.
See a doctor the same day
This was your child's first febrile seizure, even if it was short and they now seem fine.
The seizure lasted more than five minutes (call 999), or affected one side of the body only.
Your child had more than one seizure in the same illness.
Your child is still drowsy, confused or floppy an hour later.
Your child has a stiff neck, a rash that does not fade under a glass, or a bulging soft spot.
Your child has fever with dengue warning signs, such as tummy pain, persistent vomiting, bleeding gums or lethargy.
What can I do at home?
Focus on comfort, fluids and watching your child, rather than chasing a number on the thermometer. Learn the first-aid steps so you can act calmly.
For babies, offer breastfeeds or milk feeds more often during a fever and count wet nappies.
For toddlers, offer small, frequent drinks such as water, milk or clear soup.
Dress your child in one light layer and keep the room comfortably cool.
Give fever medicine only for comfort, at the dose for your child's weight, using the measuring device provided.
Keep a note of each seizure: date, length, what it looked like and the temperature.
Tell your child's taska, kindergarten and other carers what to do if a seizure happens.
What not to do
Do not put a spoon, fingers or cloth in your child's mouth. Children cannot swallow their tongue, and objects can break teeth or block the airway.
Do not hold your child down or try to stop the movements.
Do not put your child in a cold bath or sponge them with cold water.
Do not give food, drink or medicine by mouth until they are fully awake.
Do not give fever medicine round the clock to prevent seizures.
From Dr Nisa's clinic: Parents often tell me that watching their child have a febrile seizure was the most frightening moment of their lives. Many were sure their child was dying. When we sit down together afterwards, I explain what happened in the brain, why it stopped on its own and why it does not cause harm. I also walk through the first-aid steps, so that if it happens again they feel prepared rather than helpless. That plan usually brings more relief than any test.
Worried about febrile seizures?
If your child has had a febrile seizure, or you would like a clear plan for next time, I am happy to help. I am Dr Nisa Khalil, a consultant paediatrician with more than 18 years of experience, seeing children at ParkCity Medical Centre in Kuala Lumpur. If your child is having a seizure now, call 999.
Book an appointment or arrange an online eConsult for follow-up advice.
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Frequently asked questions
How long does a febrile seizure last?
Most febrile seizures last one to two minutes, and nearly all stop within five minutes without treatment. Afterwards, your child may be drowsy or confused for up to an hour. A seizure lasting longer than five minutes needs emergency help, so call 999. Seizures lasting over 15 minutes are called complex febrile seizures and need a fuller assessment.
At what temperature do febrile seizures happen?
There is no single temperature that causes one. Febrile seizures usually happen with a fever of 38°C or higher, often while the temperature is rising quickly and sometimes before parents notice their child is hot. A seizure at a lower temperature slightly raises the chance of another. How fast the temperature climbs seems to matter more than how high it goes.
Can febrile seizures cause brain damage?
No. Simple febrile seizures do not cause brain damage, and they do not affect intelligence, learning or behaviour, even if a child has several. Long-term studies show these children do as well at school as their peers. The main risk during a seizure is injury from a fall or choking on vomit, which is why lying your child on their side matters.
At what age do febrile seizures stop?
Most children stop having febrile seizures by age 5 or 6. They are most common between 12 and 18 months, and the risk falls each year after that. A child who has seizures with fever after age 6, or seizures without fever at any age, should see a paediatrician, because this pattern needs a different assessment.
Should I give paracetamol to prevent a febrile seizure?
Fever medicine does not prevent febrile seizures, so there is no need to give it just because your child has had one before. Studies show that giving paracetamol or ibuprofen early or regularly does not lower the chance of a seizure. You can still use it to make an uncomfortable child feel better, at the dose for their weight.
Medically reviewed by Dr Nisa Khalil on 22 October 2026. This article is general information and does not replace a consultation with your own doctor.
References
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