🧒 Men's Health
Febrile Seizure First Aid
Your child is convulsing with fever — what to do and what not to panic about
A febrile seizure is a convulsion triggered by fever in a young child (6 months to 5 years). It is the most common type of seizure in childhood, affecting 2–5% of children. Seeing your child convulse is terrifying — but most febrile seizures stop on their own within 1–2 minutes and cause no brain damage. The key is knowing what to do, what not to do, and when to seek emergency care.
Signs and Symptoms
✓ Simple febrile seizure: generalised shaking and stiffening of the whole body; loss of consciousness; lasts less than 5 minutes; only one episode in 24 hours; child fully recovers within 1 hour
✓ Complex febrile seizure (requires emergency assessment): lasts more than 5 minutes; recurs within 24 hours; affects only one side of the body; child is not fully recovering after 30–60 minutes
✓ After the seizure: child is sleepy, confused, and clingy — this is the postictal state and is normal
✓ The seizure is triggered by fever (38°C or above), most commonly from viral illness, malaria, or ear infection
When to Seek Help
Seizure lasting more than 5 minutesStatus epilepticus — emergency. Call for help and start transfer to hospital immediately while giving rescue diazepam if available.
Seizure in a child under 6 months or over 5 yearsNot a typical febrile seizure age — requires assessment.
Multiple seizures in 24 hoursComplex febrile seizure — hospital assessment needed.
Child not recovering normally after 1 hourExclude meningitis, severe malaria, or other serious cause.
Child with neck stiffness, severe headache, or persistent altered consciousnessPossible meningitis or cerebral malaria — emergency.
First febrile seizure in any childAlways see a doctor after the first episode to confirm diagnosis and identify the cause of the fever.
Tests & Diagnosis
🧪 Malaria rapid test or blood film
In Nigeria, malaria is a common cause of fever triggering febrile seizures — must always be tested.
🧪 Blood glucose
Hypoglycaemia causes seizures — check at bedside.
🧪 Full blood count
Infection indicators.
🧪 Lumbar puncture
If meningitis cannot be excluded — especially in children under 18 months where meningism signs are unreliable.
🧪 EEG
Not needed after a simple febrile seizure — only for complex or recurrent seizures.
Frequently Asked Questions
Will my child develop epilepsy after a febrile seizure?
The risk of developing epilepsy after a simple febrile seizure is 1–2% — only slightly above the general population risk. Complex febrile seizures (prolonged, focal, or recurring) have a higher risk (5–10%). A single simple febrile seizure in an otherwise healthy child is NOT a diagnosis of epilepsy and does not require anti-epileptic treatment.
Can I prevent febrile seizures by giving paracetamol at the first sign of fever?
No — studies consistently show that prophylactic paracetamol (given to prevent fever from rising) does not reduce the risk of a febrile seizure occurring. Febrile seizures are triggered by the rapid rise in temperature, which occurs before parents notice fever. Treat fever for comfort, not for seizure prevention.
Is a febrile seizure the same as a malaria seizure?
Cerebral malaria causes seizures through different mechanisms — direct brain involvement and high fever. Febrile seizures from malaria in Nigerian children are common. In Nigeria, all children with a first febrile seizure must be tested for malaria — cerebral malaria is a medical emergency with very different management from simple febrile seizures.
How do I know if it is a febrile seizure or meningitis?
Meningitis: fever + stiff neck + extreme headache + rash (meningococcal) + progressively deteriorating consciousness. Simple febrile seizure: fever + seizure + child recovers to normal within an hour + no stiff neck. If in doubt — go to hospital for a lumbar puncture to exclude meningitis.
Should rescue medication (diazepam) be prescribed for my child?
Rescue medication is prescribed for children with complex or prolonged febrile seizures, or those with multiple recurrences — where a prolonged seizure is likely in the future. A single brief simple febrile seizure does not require rescue medication. Discuss with your doctor after assessment.