Simple febrile seizure in pediatrics: what parents should know

The child may stiffen, jerk, become unresponsive, or roll their eyes while the seizure occurs. Simple means it affects the whole body, lasts less than a prolonged episode, and does not recur during the same illness. It can happen when a fever rises quickly, even when the temperature is not extremely high. A child may be sleepy or confused for a short time afterward.

A febrile seizure is different from a seizure caused by low blood sugar, poisoning, or an infection affecting the brain. Fever with a stiff neck, unusual rash, severe headache, or marked difficulty waking needs urgent assessment because meningitis must be considered.

Place the child on a safe surface on their side, remove nearby hard objects, and loosen tight clothing around the neck. Note when the movements begin and end. Do not restrain the child, put anything in the mouth, or give food, drink, or medicine until they are fully awake. Stay with them and check that they are breathing normally after the movements stop. Arrange medical review after a first seizure so the cause of the fever can be assessed.

Call emergency services if the seizure continues, repeats without recovery, affects only one side, the child has trouble breathing, or they do not wake as expected. Seek urgent help for a child under six months, a very unwell child, a stiff neck, a purple or spreading rash, repeated vomiting, or signs of dehydration. A seizure after a head injury or possible ingestion also needs immediate assessment.

Ask what may have caused the fever, how to respond if another seizure occurs, and whether the child needs follow-up. Tell the clinician the seizure duration, body movements, recovery pattern, medicines given, and any recent illness or exposure.