Treatment:

During the seizure, leave your child on the floor.

• You may want to slide a blanket under the child if the floor is hard.
• Move him only if he is in a dangerous location.
• Remove objects that may injure him.
• Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
• If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach. This is also important if it looks like the tongue is getting in the way of breathing.

Do NOT try to force anything into his mouth to prevent him from biting the tongue, as this increases the risk of injury. Do NOT try to restrain your child or try to stop the seizure movements.

Focus your attention on bringing the fever down:

• Insert an acetaminophen suppository (if you have some) into the child's rectum.
• Do NOT try to give anything by mouth.
• Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol may make the fever worse.
• After the seizure is over and your child is awake, give the normal dose of ibuprofen or acetaminophen.

After the seizure, the most important step is to identify the cause of the fever.

Expectations (prognosis):

The first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage. However, simple febrile seizures are harmless. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.

A small number of children who have had a febrile seizure do go on to develop epilepsy, but not because of the febrile seizures. Children who would develop epilepsy anyway will sometimes have their first seizures during fevers. These are usually prolonged, complex seizures.

Nervous system (neurologic) problems and a family history of epilepsy make it more likely that the child will develop epilepsy. The number of febrile seizures is not related to future epilepsy.

About a third of children who have had a febrile seizure will have another one with a fever. Of those who do have a second seizure, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime.

Most children outgrow febrile seizures by age 5.

Complications:

• Biting oneself
• Breathing fluid into the lungs
• Complications if a serious infection, such as meningitis, caused the fever
• Injury from falling down or bumping into objects
• Injury from long or complicated seizures
• Seizures not caused by fever
• Side effects of medications used to treat and prevent seizures (if prescribed)

Calling your health care provider:

Children should see a doctor as soon as possible after their first febrile seizure.

If the seizure is lasting several minutes, call 911 to have an ambulance bring your child to the hospital.

If the seizure ends quickly, drive the child to an emergency room when it is over.

Take your child to the doctor if repeated seizures occur during the same illness, or if this looks like a new type of seizure for your child.

Call or see the health care provider if other symptoms occur before or after the seizure, such as:

• Abnormal movements
• Agitation
• Confusion
• Drowsiness
• Nausea
• Problems with coordination
• Rash
• Sedation
• Tremors

It is normal for children to sleep or be briefly drowsy or confused right after a seizure.