American Academy of Pediatrics approach to febrile seizures

Febrile seizures occur in some young children during an illness with fever. The immediate priorities are preventing injury, keeping the airway clear, noting how long the movements last, and checking the child after the episode.

A child may become unresponsive, stiffen, and develop rhythmic jerking during a febrile seizure. The eyes may roll, breathing may look irregular, and sleepiness can follow. Fever-associated seizures are not the same as epilepsy, but the clinical details matter because other serious causes of a seizure must be considered.

The assessment focuses on the seizure pattern and the illness causing the fever. Influenza is one possible source of fever, alongside many other infections. Fever medicine may improve comfort, but it does not reliably prevent another seizure, so caregivers still need a clear safety plan.

Place the child on a safe surface away from hard objects and turn them onto their side when possible. Protect the head, loosen tight clothing around the neck, and time the seizure. Stay nearby and observe which parts of the body move.

Do not restrain the child, put anything in the mouth, or give food, drink, or oral medicine until fully alert. Once movements stop, check breathing and responsiveness. Let the child rest on their side while arranging the level of care advised for the episode.

Call emergency services if seizure activity continues beyond five minutes, another seizure begins before recovery, breathing remains difficult, the child turns blue or grey, or movements affect only one side. Emergency help is also needed after a serious injury or when the child does not begin to regain awareness.

A first seizure requires prompt medical evaluation even when it stops quickly. Seek urgent assessment for a stiff neck, a non-fading rash, persistent vomiting, extreme drowsiness, dehydration, severe headache, or concern about a very unwell child. These features relate to the underlying illness or recovery and should not be attributed to fever alone.

Ask whether the event fits a febrile seizure, what illness is causing the fever, and which signs should prompt reassessment. Clarify the correct fever-medicine dose for comfort, whether rescue medicine is appropriate, how it would be given, and who should receive a copy of the child's seizure plan.