(sometimes called fever convulsions or febrile seizures) can
occur in children who have a rapid increase in body temperature. You may not
even know that your child has a fever. The rapid increase in body temperature in a
short period of time may happen at the same time as the fever seizure. After a fever has reached a
high temperature, the risk of a seizure is probably over. Most children who
have a fever seizure have temperatures above 102Â°F (39Â°C).
seizure is likely to be fever-related if:
There is one seizure in a 24-hour period.
The seizure lasted less than 15 minutes.
The seizure affected the entire body, not just one side of the
The child is between 6 months and 5 years
The child does not have nervous system (neurological)
The child has had fever seizures before.
Fever seizures affect 2% to 5% of children.
Children can have another seizure. The chance of another fever seizure varies
with age, but about 30% to 50% will have another within a year of the first
one. These seizures are not a form of epilepsy.
A child who is having a seizure
often loses consciousness and shakes, moving his or her arms and
legs on both sides of the body. The child’s eyes may roll back. The child may
stop breathing for a few seconds and might also vomit, urinate, or pass stools.
It is important to protect the child from injury during a seizure.
Fever seizures usually last 1 to 3 minutes. After the seizure, the child
may be sleepy. You can let the child sleep, but check him or her frequently for
changes in color or breathing, or for twitching arms or legs. The child also may
seem confused after the seizure, but normal behavior and activity level should
return within minutes of the seizure.
Fever seizures can
be frightening, but they are not usually harmful to the child and do not cause
long-term problems, such as brain damage, intellectual disabilities, or learning
Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious
illness or bleeding problem. There are two types.
Petechiae (say “puh-TEE-kee-eye”):
Are tiny, flat red or purple spots in the skin or
the lining of the mouth.
Do not turn white when you press on
Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
May spread over a large area of the body within a few hours.
Are different than tiny, flat red spots or birthmarks that are
present all the time.
Purpura (say “PURR-pyuh-ruh” or â€œPURR-puh-ruhâ€):
Is sudden, severe bruising that occurs for no clear
May be in one area or all over.
than the bruising that happens after you bump into something.
If you’re not sure if a child’s fever is high, moderate, or
mild, think about these issues:
With a high fever:
The child feels very hot.
It is likely
one of the highest fevers the child has ever had.
With a moderate fever:
The child feels warm or hot.
sure the child has a fever.
With a mild fever:
The child may feel a little warm.
think the child might have a fever, but you’re not sure.
Certain health conditions and medicines weaken the immune system’s ability to fight off infection and
illness. Some examples in children are:
Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
which are used to treat a variety of conditions.
after organ transplant.
Chemotherapy and radiation therapy for
Not having a spleen.
Symptoms of difficulty breathing can range from mild to severe. For example:
You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when youâ€™re at rest (severe difficulty breathing).
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:
The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Severe trouble breathing means:
The child cannot eat or talk because he or she is
breathing so hard.
The child’s nostrils are flaring and the belly
is moving in and out with every breath.
The child seems to be
The child seems very sleepy or confused.
Moderate trouble breathing means:
The child is breathing a lot faster than
The child has to take breaks from eating or talking to
The nostrils flare or the belly moves in and out at times
when the child breathes.
Mild trouble breathing means:
The child is breathing a little faster than usual.
The child seems a little out of breath but can still eat or talk.
Symptoms of heatstroke may
Feeling or acting very confused, restless, or
Sweating heavily, or not
sweating at all (sweating may have stopped).
Skin that is red,
hot, and dry, even in the armpits.
Nausea and vomiting.
Heatstroke occurs when the body can’t control its own
temperature and body temperature continues to rise.
Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever.
Symptoms of dehydration can range from mild to
severe. For example:
The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For
You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
Severe dehydration means:
The baby may be very sleepy and hard to wake
The baby may have a very dry mouth and very dry eyes (no
The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means:
The baby may have no wet diapers in 6 hours.
baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means:
The baby may pass a little less urine than usual.
Severe dehydration means:
The child’s mouth and eyes may be extremely dry.
The child may pass little or no urine for 12 or more
The child may not seem alert or able to think clearly.
The child may be too weak or dizzy to stand.
child may pass out.
Moderate dehydration means:
The child may be a lot more thirsty than
The child’s mouth and eyes may be drier than
The child may pass little or no urine for 8 or more hours.
The child may feel dizzy when he or she stands or sits up.
Mild dehydration means:
The child may be more thirsty than
The child may pass less urine than usual.
Symptoms of serious illness in a baby
may include the following:
The baby is limp and floppy like a rag doll.
The baby doesn’t respond at all to being held, touched, or talked
The baby is hard to wake up.
Symptoms of serious illness may
A severe headache.
Mental changes, such as feeling confused or much less
Extreme fatigue (to the point where it’s hard for you to
Symptoms of a joint infection may
Sudden redness over or around the
Warmth in or around a joint.
Not being able to
move the joint because of pain or swelling.
Pus draining from the
Pain in children 3 years and older
Severe pain (8 to 10): The pain
is so bad that the child can’t stand it for more than a few hours, can’t sleep,
and can’t do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and
sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
High: 104Â°F (40Â°C) and
Moderate: 100.4Â°F (38Â°C) to 103.9Â°F (39.9Â°C)
Mild: 100.3Â°F (37.9Â°C) and
A forehead (temporal) scanner is usually 0.5Â°F (0.3Â°C) to 1Â°F (0.6Â°C) lower than an oral temperature.
Armpit (axillary) temperature
High: 103Â°F (39.5Â°C) and higher
Moderate: 99.4Â°F (37.4Â°C) to 102.9Â°F (39.4Â°C)
Mild: 99.3Â°F (37.3Â°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.
Symptoms of shock in a child may include:
Passing out (losing consciousness).
Being very sleepy or hard
to wake up.
Not responding when being touched or talked to.
Breathing much faster than usual.
The child may not know where he or she is.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don’t have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms
and arrange for care.
If you cannot reach your doctor or you don’t
have one, seek care today.
If it is evening, watch the symptoms and
seek care in the morning.
Ease the child to the floor, or lay a very small
child facedown on your lap. Do not restrain the child.
child onto his or her side, which will help clear the mouth of any vomit or
saliva. This will help keep the tongue from blocking the air passage so the
child can breathe. Keeping the head and chin forward (in the same position as
when you sniff a flower) also will help keep the air passage
Do not put anything in the
child’s mouth to prevent tongue-biting. This could cause
Try to stay calm, which will help calm the child. Comfort
the child with quiet, soothing talk.
Time the length of the seizure
and pay close attention to the child’s behavior during the seizure so you can
describe it to your child’s doctor.
Check your child for injuries after the seizure:
If the child is having trouble breathing, turn
his or her head to the side and, using your finger, gently clear the mouth of
any vomit or saliva to aid breathing.
If the child does
not need to see a doctor right away, put him or her in a cool room
to sleep. Sleepiness is common following a seizure. Check on the child often.
Normal behavior and activity level should return within minutes of the
If your child has had a fever seizure in the past and you have
talked with your child’s doctor about how to care for your child after a
seizure, be sure to follow the doctor’s instructions.
American Academy of Pediatrics (2008). Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures. Elk Grove Village, IL: American Academy of Pediatrics.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine Kathleen Romito, MD – Family Medicine Adam Husney, MD – Family Medicine Specialist Medical ReviewerH. Michael O’Connor, MD – Emergency Medicine David Messenger, MD