Febrile Convulsions in Children: What to Do, and When to Worry

On this page

• What is a febrile convulsion?
• What does a febrile convulsion look like?
• What to do during a febrile convulsion
• What to do after a febrile convulsion
• How long does a febrile convulsion last?
• What causes febrile convulsions, and does temperature matter?
• Are febrile convulsions dangerous?
• Can a febrile convulsion happen without a fever?
• What age are febrile convulsions most common?
• Can you reduce the chance of a febrile convulsion?
• Febrile convulsion vs epilepsy vs shivering (rigors)
• When to call 000, and when to see a doctor
• FAQs

What is a febrile convulsion?

A febrile convulsion, or febrile seizure, is a seizure triggered by a fever in a young child whose brain is otherwise developing normally. It happens because a rapidly rising temperature briefly affects the developing brain — not because of anything you did or did not do. Febrile convulsions are common: around one in every 20 to 30 children will have at least one, usually between six months and six years of age.

Most are what doctors call “simple” febrile convulsions — they involve the whole body, last only a minute or two, happen once in a 24-hour period, and the child recovers fully. A “complex” febrile convulsion is one that lasts longer than 15 minutes, affects only one part of the body, or happens more than once in 24 hours. The distinction matters to a doctor, which is one reason any first seizure should be checked.

What does a febrile convulsion look like?

During a typical febrile convulsion a child usually becomes stiff, may lose consciousness, and their arms and legs twitch or jerk. They might roll their eyes back, clench their teeth, go pale or blue in the face, or wet themselves. It can last anywhere from a few seconds to a few minutes, and afterwards a child is often sleepy, confused or irritable for a while as they recover.

It looks and feels alarming, but the child is not in pain and will not remember it. Knowing what to expect makes it a little easier to stay calm and do the few things that actually help.

What to do during a febrile convulsion

Stay calm, note the time it starts, and keep your child safe. Lay them on their side (the recovery position), move anything hard or sharp out of the way, and cushion their head. Do not restrain them, do not put anything in their mouth, and do not try to give food, drink or medicine while they are seizing. Time how long it lasts, and call 000 if it goes beyond five minutes or it is their first seizure.

In more detail:

• Stay calm and note the time. Knowing how long the seizure lasts is one of the most useful things you can tell a doctor or paramedic.
• Lay your child on their side. The recovery position keeps their airway clear and lets any saliva drain out.
• Make the space safe. Move furniture, toys and hard objects away, and put something soft under their head.
• Do not put anything in their mouth. They cannot swallow their tongue, and objects or fingers can cause injury.
• Do not restrain the movements. Let the seizure run its course rather than holding your child still.
• Stay with them and watch the clock. Call 000 straight away if it lasts more than five minutes, if they have trouble breathing or turn blue, or if another seizure follows.

What to do after a febrile convulsion

Once the seizure stops, keep your child on their side and let them rest. It is normal for them to be drowsy, floppy or grumpy for up to an hour afterwards — this is called the recovery, or post-ictal, phase. When they are more alert, offer small sips of fluid. If this is their first febrile convulsion, see a doctor the same day so the cause of the fever can be checked, even if your child seems back to their usual self.

How long does a febrile convulsion last?

Most febrile convulsions are short, lasting less than two to three minutes and stopping on their own. A seizure that continues beyond five minutes needs emergency help — call 000. Even brief seizures can feel like they last much longer than they do, which is exactly why noting the time it starts is so useful.

What causes febrile convulsions, and does temperature matter?

Febrile convulsions are set off by a fever, most often from a common viral infection such as a cold, the flu, roseola or an ear infection. Occasionally one follows a routine childhood vaccination, because the vaccine can cause a mild fever. It is often the speed at which the temperature rises, rather than how high it climbs, that seems to trigger a seizure — which is why a convulsion can be the very first sign a parent notices that a child is unwell.

Importantly, there is no single temperature that causes a febrile convulsion, and you cannot reliably predict or prevent one by watching the thermometer. That leads to one of the most common questions parents ask, below.

Are febrile convulsions dangerous?

Understandably, this is what worries parents most. The reassuring answer is that simple febrile convulsions do not cause brain damage, do not harm intelligence or development, and are not the same as epilepsy. Having a febrile convulsion slightly increases the chance of having another one during early childhood, but the large majority of children simply grow out of them by around age six. A first seizure still needs a doctor to check the cause of the fever, and prolonged or unusual seizures need emergency care — but in themselves, most febrile convulsions are not harmful.

Can a febrile convulsion happen without a fever?

By definition, no — a febrile convulsion is a seizure driven by a fever, so a fever is part of what makes it “febrile”. Sometimes the fever is not obvious until after the seizure, so it can seem to come out of nowhere. If a child has a seizure with no fever at all, it is not a febrile convulsion and should be assessed by a doctor to work out the cause.

What age are febrile convulsions most common?

Febrile convulsions almost always happen between six months and six years of age, and are most common in toddlers around one to two years old. They are rare before six months and after six years. If an older child or a very young baby has a seizure with a fever, see a doctor, as the cause may need looking into more closely.

Can you reduce the chance of a febrile convulsion?

This is the part many parents find surprising. Giving paracetamol or ibuprofen to bring a fever down has not been shown to prevent febrile convulsions. Fever medicines can help a child feel more comfortable when they are miserable with a temperature, and that is a good enough reason to use them per your pharmacist or GP’s advice — but they are not a way to stop a seizure from happening. Because a convulsion is often the first sign of illness, there is frequently no window to act beforehand.

What you can do is stay prepared and calm:

• Keep track of the fever. A forehead thermometer makes it easy to check a temperature without disturbing a resting child. This is for keeping an eye on how your child is going, not for preventing a seizure. For what is normal at different ages, see our guides to a baby’s normal temperature and bringing down a toddler’s fever and keeping them comfortable.
• Keep your child comfortable. Offer fluids, dress them lightly, and if they have a fever a FeverMates cooling patch can give a cooling sensation some children find soothing. A cooling patch is for comfort only — it does not lower a temperature, and it does not prevent a febrile convulsion.
• Know the plan. Read this page before you need it, so that if a seizure ever happens you already know to note the time, lay your child on their side, and when to call 000.

Febrile convulsion vs epilepsy vs shivering (rigors)

Not every shake or shiver with a fever is a seizure. This table shows how a febrile convulsion differs from the shivering that can come with a high temperature, and from epilepsy.

	Febrile convulsion	Shivering (rigors)	Epilepsy
Fever	Always present — triggered by fever	Usually present with a rising temperature	Seizures happen with or without fever
Awareness	Usually loses consciousness or awareness	Stays awake and responsive	Awareness may be lost, depending on the type
Movements	Stiffening and rhythmic jerking of arms and legs	Trembling or shaking that stops if you hold them	Varies by seizure type; not fever-driven
Age	6 months to 6 years, mostly toddlers	Any age	Any age; a long-term condition

If you are not sure what you are seeing, treat it as a seizure: keep your child safe, note the time and, if it is a first episode or lasts more than five minutes, get emergency help.

When to call 000, and when to see a doctor

Call 000 for an ambulance straight away if your child:

• Is having a seizure for the first time
• Has a seizure that lasts longer than five minutes
• Has trouble breathing, or their lips or face turn blue
• Has one seizure straight after another, or does not wake up properly between seizures
• Seems very unwell, has a stiff neck, or does not recover as expected afterwards

See your GP the same day, or call healthdirect on 1800 022 222 (or 13 HEALTH on 13 43 25 84 in Queensland), if:

• This is your child’s first febrile convulsion, even if it was brief and they have recovered
• You are unsure what caused the fever, or your child is not improving
• You would simply feel better having your child checked

It is worth keeping a few basics on hand for childhood illnesses — a thermometer, hand sanitiser and a first aid kit. You can see the full FeverMates range in our online shop. For more on fevers and the illnesses that bring them on, see our guides to roseola in babies and toddlers and recognising common childhood illnesses.

Frequently asked questions

What should I do during a febrile convulsion?

Stay calm and note the time. Lay your child on their side, move hard objects away and cushion their head. Do not restrain them or put anything in their mouth. Call 000 if it is their first seizure, lasts more than five minutes, or they have trouble breathing.

Are febrile convulsions dangerous?

Most simple febrile convulsions are not harmful. They do not cause brain damage and are not epilepsy, and most children grow out of them by about age six. A first seizure should still be checked by a doctor, and any seizure lasting more than five minutes needs emergency care.

How long does a febrile convulsion last?

Most last less than two to three minutes and stop on their own. A seizure that continues beyond five minutes needs emergency help, so call 000. Noting the time it starts helps you and any doctor or paramedic judge how long it has gone on.

Can medicine to lower a fever prevent a febrile convulsion?

No. Paracetamol and ibuprofen have not been shown to prevent febrile convulsions. They can help a child feel more comfortable with a fever, but they do not stop a seizure from happening. Use fever medicines for comfort on your pharmacist or GP’s advice, not to prevent a convulsion.

What age do febrile convulsions happen?

They almost always happen between six months and six years of age, and are most common in toddlers around one to two years old. Seizures with fever outside this age range should be checked by a doctor to work out the cause.

Sources

Royal Children’s Hospital Melbourne — Febrile convulsions; healthdirect Australia — Febrile convulsions; Raising Children Network — Febrile convulsions. Reviewed against Australian guidance.

This article is general information only and is not a substitute for medical advice. A first febrile convulsion should always be assessed by a doctor. If you are worried about your child, contact your GP, call healthdirect on 1800 022 222, or in an emergency call 000.