Febrile convulsion (febrile seizure): what to do when a fever causes a fit

A febrile convulsion, or febrile seizure, is a fit that happens when a young child has a fever. HealthHub says it affects children between 6 months and 6 years. Your child may go stiff, jerk, roll their eyes up and stop responding. Most stop on their own within five minutes, NUH says, and short ones do not usually cause long-term harm. A first fit always needs a doctor.

What a febrile fit looks like

It tends to come with a fever that climbs fast. SingHealth's HealthXchange says above 38 degrees Celsius, and NUH says usually above 38.3. During the fit your child may:

• stiffen, then jerk their arms and legs
• roll their eyes up so only the whites show
• froth at the mouth or clench their teeth
• stop responding and lose consciousness

Afterwards, the NHS says, your child may be sleepy, irritable or confused for up to an hour. NUH says irritability and tiredness after a fit are common.

What to do during a febrile convulsion

The NHS says check the time it starts and ends. Then do what NUH advises:

• Stay calm and stay with your child.
• Lay them on their side so saliva or vomit can drain out.
• Put something flat and soft under their head and move sharp objects and furniture away.
• Loosen tight clothing.
• Keep your fingers, spoons and everything else out of their mouth, and never hold them down, shake them, slap them or pour water on them.
• Hold off drinks and medicine until the fit is over. HealthXchange says they can cause choking.

NUH asks you to note how long the fit lasted and what it looked like, because the doctor will want to know.

When to call 995 or go to Children's Emergency

NUH says take your child to Children's Emergency straight away if:

• it is their first febrile seizure
• they have a stiff neck
• they are confused or delirious
• they are still drowsy or not themselves more than 30 minutes after the fit
• they look unwell
• they have more than one fit in a day
• a fit lasts more than five minutes

For a fit past five minutes, NUH says give rectal diazepam if your doctor has prescribed it, or call an ambulance. KKH's number for medical emergencies is 995. The NHS adds that a child who is still fitting or unconscious should travel to hospital by ambulance.

For a baby under 3 months, a fever alone is an emergency. See fever in a newborn.

Will it happen again, and is it epilepsy?

NUH says about two in three children never have another one, while one in three may have repeat fits until about age six. Only about 3% go on to develop epilepsy, and the NHS stresses that febrile seizures are not the same thing as epilepsy.

Fever medicine such as paracetamol makes your child more comfortable, but NUH and HealthXchange both say it does not lower the chance of another fit. NUH says doctors do not recommend daily anti-seizure medicine to prevent repeats, because the fits are typically brief and harmless and the side effects are not worth it.

Not sure whether a fever needs a doctor? Our fever checker takes you through it by age and symptom.

Frequently asked questions

Is a febrile convulsion dangerous?

Usually not. NUH says seizures shorter than 15 minutes typically do not cause long-term problems such as brain damage. Fits longer than 30 minutes are rare but can starve the brain of oxygen, which is why a fit past five minutes needs emergency help.

Are febrile fits and fever fits the same thing as a febrile seizure?

Yes. Febrile seizure, febrile convulsion, febrile fit and fever fit all describe the same event. The NHS uses the terms side by side.

Can I prevent a febrile seizure by bringing the fever down?

No. The NHS says you cannot prevent febrile seizures, and NUH says fever medicine does not reduce the chance of one. It also advises against undressing your child or sponging them with cold water to cool them.

Will my child need tests after a first febrile seizure?

Possibly. The NHS says a child needs to be checked in hospital after a first febrile seizure and may have blood and urine tests. Some have a lumbar puncture to look for infection around the brain and spine.

Related terms

• Fever in a Newborn: A raised temperature in a baby under 3 months, which Singapore hospitals treat as a reason to come in straight away.
• HFMD (Hand, Foot and Mouth Disease): A common viral infection in young children that causes fever, mouth ulcers and a rash or blisters on hands and feet.
• Polyclinic: A public primary care clinic with subsidised fees, where Singapore families can take children for jabs and checks.

See every term in the glossary