Few experiences are as distressing for a parent or guardian as witnessing their child undergo a seizure. When a child has a high temperature, the diagnosis is often febrile seizures (also known as febrile convulsions). While they appear frightening, they are remarkably common and, in the vast majority of cases, do not result in long-term harm.
As a leading provider of first aid training at Practical First Aid, we believe that knowledge is the best antidote to panic. This guide provides an in-depth exploration of the condition, its triggers, management, and the crucial “red flags” every London parent should know.
What is a Febrile Seizure?
A febrile seizure is a fit or convulsion triggered by a rapid rise in body temperature, usually caused by an infection. They typically occur in children between the ages of 6 months and 5 years.
Statistically, about 1 in 20 children will have at least one febrile seizure. Because a child’s developing brain is more sensitive to temperature fluctuations than an adult’s, the “electrical storm” of a seizure occurs as the brain reacts to the fever.
Types of Febrile Seizures
Medical professionals categorise these events into two main groups:
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Simple Febrile Seizures: These are the most common (making up about 80% of cases). They involve the whole body shaking, last less than 15 minutes, and do not recur within a 24-hour period.
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Complex Febrile Seizures: these last longer than 15 minutes, may only affect one part of the body (focal), or happen more than once during the same illness.
What Does a Febrile Seizure Look Like?
Understanding the physical manifestations of a seizure helps caregivers remain calm and provide accurate information to emergency services.
Common Symptoms and Physical Signs
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Loss of Consciousness: The child will be unresponsive and unaware of their surroundings.
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Tonic-Clonic Movements: This involves the stiffening of limbs (tonic phase) followed by rhythmic jerking or twitching (clonic phase).
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Respiratory Changes: Their breathing may become irregular, and they might develop a blueish tinge around the lips (cyanosis) due to temporary changes in oxygen flow.
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Eye Rolling: The eyes may roll back or fixate in one direction.
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Foaming at the Mouth: Some children may drool or have slight foam at the mouth.
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Post-Ictal State: Following the seizure, the child will likely be very drowsy, confused, or irritable for up to an hour.
What Triggers Febrile Seizures?
It isn’t necessarily the height of the temperature that causes the fit, but rather the speed at which the temperature rises. A child might have a seizure at 38.5°C if the temperature jumped from 36.5°C in a matter of minutes.
1. Viral Infections
The most frequent triggers are common childhood illnesses such as:
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The flu (influenza)
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The common cold
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Chickenpox
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Tonsillitis or ear infections
2. Post-Vaccination Fevers
Occasionally, a child may develop a fever after routine immunisations (like the MMR vaccine). While a seizure may occur, it is important to note that the seizure is a reaction to the fever, not a toxic reaction to the vaccine itself. Research consistently shows the benefits of vaccination far outweigh the small risk of a febrile convulsion.
3. Genetic Predisposition
Genetics play a significant role. If a parent or sibling had febrile seizures as a child, the risk for the child increases significantly.
Immediate First Aid: What to Do During a Seizure
If your child begins to fit, the most important rule is not to restrain them. Follow these steps to ensure their safety:
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Note the Time: This is critical. Doctors need to know exactly how long the seizure lasted.
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Clear the Space: Move hard or sharp objects away from the child.
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The Recovery Position: If possible, gently roll them onto their side (the recovery position) to keep their airway clear.
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Protect the Head: Place something soft, like a folded jumper, under their head.
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Do NOT Put Anything in the Mouth: It is a myth that people can swallow their tongues. Putting objects in the mouth can cause choking or dental damage.
What are the Red Flags for Febrile Seizures?
While most seizures are “simple” and resolve on their own, certain “red flags” necessitate an immediate call to 999.
Emergency Indicators (Call 999 if):
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The seizure lasts longer than 5 minutes.
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This is the child’s first-ever seizure.
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The child has difficulty breathing or turns very blue.
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The child does not wake up or remains unusually drowsy after the fit ends.
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You suspect the fever is caused by something serious like meningitis (look for a non-fading rash, neck stiffness, or extreme light sensitivity).
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The child has a second seizure within the same illness period.
Diagnosis and Medical Evaluation
When you see a GP or attend A&E, the primary goal of the medical team is to identify the source of the infection causing the fever.
Diagnostic Tests
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Physical Exam: Checking ears, throat, and chest for signs of infection.
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Urine Samples: To rule out a Urinary Tract Infection (UTI).
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Blood Tests: To check for bacterial infections.
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Lumbar Puncture: Only performed if the doctor suspects meningitis, to test the fluid around the spine.
In most cases of simple febrile seizures, complex neurological tests like an EEG (Electroencephalogram) or MRI are not required because the brain function returns to normal once the fever subsides.
When Do Febrile Seizures Stop?
A common concern for parents is whether their child will grow up to have epilepsy.
The Outgrowing Phase
Most children stop having febrile seizures by the age of 5 or 6. As the brain matures, it becomes more resilient to the rapid shifts in body temperature.
Febrile Seizures vs. Epilepsy
It is vital to distinguish between the two. Febrile seizures are not epilepsy. Epilepsy is defined by recurrent seizures without a fever.
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The risk of developing epilepsy for a child who has had a simple febrile seizure is about 1-2%, which is only slightly higher than the general population.
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The risk is higher only if the child has pre-existing developmental issues or if the seizures were “complex.”
Managing Fevers at Home
While you cannot always prevent a febrile seizure (as the seizure often happens just as the fever starts, before you even realise the child is ill), you can make your child more comfortable.
Practical Tips:
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Hydration: Ensure they drink plenty of water or diluted juice.
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Clothing: Keep them in lightweight clothing. Do not “bundle them up” to sweat out a fever; this can dangerously raise their core temperature.
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Medication: Use infant paracetamol or ibuprofen as directed on the packaging. Note: These medications reduce discomfort but have not been proven to prevent a febrile seizure from occurring.
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Tepid Sponging: Avoid cold baths or ice packs, as these can cause shivering, which actually increases the body’s internal temperature. A lukewarm cloth can be used for comfort.
Why First Aid Training is Essential for Parents
At Practical First Aid, we see firsthand how confidence saves lives. In the heat of the moment, a parent who has practiced the recovery position on a manikin is much more likely to remain calm than one who has only read about it.
What You Learn in a Paediatric First Aid Course:
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CPR and Choking: Specific techniques for infants and children.
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Seizure Management: Hands-on practice for keeping a seizing child safe.
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Meningitis Awareness: Identifying the subtle early signs.
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Head Injuries and Bleeding: Managing the tumbles of toddlerhood.
Our courses in London and the surrounding areas are designed for busy parents, nannies, and childminders. We provide OFSTED-compliant training that gives you the peace of mind that you can handle an emergency.
The Psychological Impact on Parents
Witnessing a seizure is a traumatic event. It is common for parents to experience “fever phobia” afterwards—staying up all night to check a child’s temperature or feeling intense anxiety every time the child feels slightly warm.
It is okay to seek support. Talk to your health visitor or GP if you find yourself struggling with anxiety following a child’s seizure. Remember: you did the right thing by being there.
Summary Table: Simple vs. Complex Febrile Seizures
| Feature | Simple Febrile Seizure | Complex Febrile Seizure |
| Duration | Under 15 minutes | Over 15 minutes |
| Body Movement | Generalised (whole body) | Focal (one part of the body) |
| Recurrence | Once every 24 hours | Two or more in 24 hours |
| Recovery | Rapid return to normal | May take longer to recover |
| Frequency | Common (80%) | Less common (20%) |
FAQs About Febrile Seizures in Children
Can a child die from a febrile seizure?
It is extremely rare. While they look life-threatening, simple febrile seizures do not cause brain damage or death. The primary danger is injury from falling or choking on vomit, which is why the recovery position is so important.
Should I give my child a cold bath to stop a seizure?
No. Never put a seizing child in a bath. Not only does it pose a drowning risk, but the shock of cold water can make the situation worse. Focus on safety and timing the seizure.
Will my child have another one?
About one-third of children who have one febrile seizure will have another one during a future illness. This risk is higher if the first seizure happened before the age of one.
Is it okay for my child to sleep after a seizure?
Yes, it is normal for them to be exhausted. However, ensure they are in the recovery position and stay with them until they are fully awake and behaving normally.
The Bottom Line
Living in a busy area like London, you are never far from medical help, but the first few minutes of a seizure are entirely in your hands. Understanding febrile seizures in children—knowing that they are usually harmless, knowing how to react, and knowing when to call for help—is the hallmark of a prepared parent.
Don’t wait for an emergency to happen before you learn what to do. Join us at Practical First Aid for a Paediatric First Aid course. We serve London and the surrounding home counties, providing practical, hands-on skills that ensure your family’s safety.
Visit www.practicalfirstaid.co.uk today to book your course and gain the confidence to handle any childhood emergency.
