Diagnosis

Febrile seizures occur in children with normal development. Your doctor will carefully review your child's medical history and developmental history to exclude other risk factors for epilepsy. In normally developing children, identifying the cause of your child's fever is the first step after a febrile seizure.

Simple febrile seizures

Children who are current with their vaccinations who have a first simple febrile seizure don't need testing. Your doctor can diagnose the febrile seizure based on history.

In children with delayed immunization or a compromised immune system, your doctor may recommend tests to look for severe infections:

  • A blood test
  • A urine test
  • A spinal tap (lumbar puncture), to find out if your child has a central nervous system infection, such as meningitis

Complex febrile seizures

To diagnose the cause of a complex febrile seizure, your doctor may also recommend an electroencephalogram (EEG), a test that measures brain activity.

Your doctor may also recommend an MRI to check your child's brain if your child has:

  • An unusually large head
  • An abnormal neurological evaluation
  • Signs and symptoms of increased pressure in the skull
  • A febrile seizure that lasted an unusually long time

Treatment

Most febrile seizures stop on their own within a couple of minutes. If your child has a febrile seizure, stay calm and follow these steps:

  • Place your child on his or her side on a surface where he or she won't fall.
  • Start timing the seizure.
  • Stay close to watch and comfort your child.
  • Remove hard or sharp objects near your child.
  • Loosen tight or restrictive clothing.
  • Don't restrain your child or interfere with your child's movements.
  • Don't put anything in your child's mouth.

If your child has a febrile seizure that lasts more than five minutes — or if your child has repeated seizures — call for emergency medical attention.

More-serious episodes

A doctor may order medication to stop a seizure that lasts longer than five minutes.

Your child's doctor may hospitalize the child for observation if:

  • The seizure is prolonged
  • The seizure is accompanied by a serious infection
  • The source of the infection can't be found

But a hospital stay isn't usually necessary for simple febrile seizures.

Preparing for your appointment

You're likely to start by seeing your child's family doctor or pediatrician. You may then be referred to a doctor who specializes in disorders of the brain and nervous system (neurologist).

Here's some information to help you get ready for your appointment.

What you can do

  • Write down everything you remember about your child's seizure, including signs or symptoms that occurred before the seizure, such as a fever.
  • List medications, vitamins and supplements your child takes.
  • Write down questions to ask your doctor.

For febrile seizures, some basic questions to ask your doctor include:

  • What's the most likely cause of my child's seizure?
  • What tests does my child need? Do these tests require special preparation?
  • Is this likely to happen again?
  • Does my child need treatment?
  • Will giving my child fever-reducing medications during an illness help prevent febrile seizures?
  • What should I do the next time my child has a fever?
  • What can I do to help my child during a febrile seizure?
  • My child has another health condition. How can we manage them together?
  • Are there brochures or other printed material I can take? What websites do you recommend?

Don't hesitate to ask other questions, as well.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • Did your child have a fever or illness before having this seizure?
  • Can you describe your child's seizure? What were the signs and symptoms? How long did the seizure last?
  • Has this happened before?
  • Does anyone in your family have a history of febrile seizures or seizure disorders?
  • Has your child been exposed to illnesses?
  • Does your child have a history of head trauma or a neurological disease?

What you can do in the meantime

If your child has another febrile seizure:

  • Don't restrain your child, but do place him or her on a safe surface, such as the floor.
  • Place your child on his or her side, keeping the face to the side and the lower arm extended under the head, to prevent your child from inhaling vomit if vomiting occurs.
  • If your child had anything in his or her mouth when the seizure began, remove it to prevent choking. Don't put anything in your child's mouth during a seizure.
  • Seek emergency care for a seizure that lasts longer than five minutes.
July 16, 2018
References
  1. Febrile seizures fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm. Accessed Dec. 4, 2017.
  2. Millichap JG, et al. Clinical features and evaluation of febrile seizures. https://www.uptodate.com/contents/search. Accessed Dec. 4, 2017.
  3. Millichap JG, et al. Treatment and prognosis of febrile seizures. https://www.uptodate.com/contents/search. Accessed Dec. 4, 2017.
  4. Febrile seizures. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/head-neck-nervous-system/Pages/Febrile-Seizures.aspx. Dec. 5, 2017.
  5. Clinical practice guideline—Febrile seizures: Guideline for the neurodiagnostic evaluation of a child with a simple febrile seizure. American Academy of Pediatrics. 2011;127:389.
  6. Wong-Kisiel LC (expert opinion). Mayo Clinic, Rochester, Minn. March 6, 2018.