When a child's temperature rises quickly, the brain may respond in two very different ways. Chills cause rapid, fine shivering as muscles contract to generate heat — the child stays aware and responsive throughout. A febrile seizure is an electrical misfire in the brain triggered by fever, causing involuntary rhythmic jerking or rigid stiffening where the child loses awareness and cannot respond.
Example of generalized body shaking during a febrile seizure.
What do normal fever chills look and feel like?
Chills are the body's natural way of raising its temperature — muscles rapidly tighten and relax in small shivery movements to produce heat when the brain's internal thermostat has been reset higher by illness
During chills, a child may tremble, have chattering teeth, feel cold to the touch even though their temperature is rising, and want to be bundled up
The child remains fully conscious and aware during chills — they can look around, respond to their name, cry normally, and be comforted
Chills typically last a few minutes and stop once the body reaches the new temperature set point, often followed by the child feeling warm or hot
A child who is shivering but can still hold a cup, reach for a parent, or respond to voice is experiencing normal fever chills rather than a seizure
What does a febrile seizure actually look like?
Febrile seizures affect children between about 6 months and 5 years of age, with a peak around 18 months — they occur in roughly 2 to 5 out of every 100 children
The most common type — a simple febrile seizure — involves the whole body stiffening, followed by rhythmic jerking of the arms and legs, lasting less than 15 minutes and occurring only once in a 24-hour period
The child loses consciousness or awareness during the episode — eyes may roll back or stare blankly, the child will not respond to their name or to being touched, and cannot be snapped out of it
Some children may turn blue or pale around the lips, drool, or briefly stop breathing during the seizure — this is frightening but typically resolves on its own as the seizure ends
After the seizure stops, the child enters a recovery phase — called the postictal period — where they may be very sleepy, confused, or fussy for minutes to an hour — this drowsiness after the event is normal and expected
What should parents do if a child has a seizure?
Gently place the child on their side on a flat, safe surface — this helps keep the airway clear and prevents choking if they vomit
Note the time the shaking starts — knowing how long the seizure lasts is one of the most important pieces of information for the doctor
Do not put anything in the child's mouth — children do not swallow their tongue during a seizure, and placing objects in the mouth can cause injury
Do not restrain the child or try to stop the jerking movements — hold them only enough to prevent them from falling off a surface or hitting something sharp
Do not place the child in a bath or pour water on them during a seizure — wait until the episode has fully ended before addressing the fever
If the seizure lasts longer than 5 minutes — call 911 immediately — prolonged seizures may need medication to stop
Describe what the shaking or stiffening looked like
Which description matches what you saw?
Select the observation that best describes the shaking or movement you noticed. Brief shivering while your child stays aware is common with fever; stiffening or rhythmic jerking is a different pattern worth describing clearly.
What shaking episodes during fever need prompt attention?
A first-time seizure with fever should always be evaluated by a doctor — even if the child seems fine afterward — to confirm it was a febrile seizure and identify the source of the fever
Call 911 immediately if the seizure lasts longer than 5 minutes, if the child has difficulty breathing after the seizure ends, or if a second seizure occurs within the same 24-hour period
Seek immediate evaluation if the child does not return to their normal self within an hour after the seizure — prolonged confusion, ongoing sleepiness, or inability to be woken needs urgent attention
A seizure that involves only one side of the body, or jerking in just one arm or leg, is considered more complex and needs prompt evaluation
Any seizure in a child under 6 months of age is not a typical febrile seizure and requires urgent medical assessment — this age group is more vulnerable to serious infections
A non-blanching rash — one that does not fade when pressed firmly — alongside any seizure is a medical emergency — call 911
Log observations to share with your doctor
Log temperature readings
Enter up to 6 temperature readings with times. The dot plot shows the pattern visually — it does not interpret the readings.
How do pediatricians generally evaluate and manage febrile seizures?
For a child who had a simple febrile seizure — whole-body shaking lasting under 15 minutes, occurring once, with a return to normal behavior — routine blood tests, brain scans, and brain wave tests (EEG) are generally not needed according to current guidelines
The doctor's main focus is finding the cause of the fever — this may include checking the ears, throat, and urine, and in some cases ordering blood work depending on the child's age and symptoms
For children under 12 to 18 months, doctors may consider additional testing to rule out meningitis, since younger children may not show the classic stiff-neck signs of this infection
Daily seizure-prevention medications are generally not recommended for children with febrile seizures — the seizures are considered harmless and the medications carry side effects that outweigh the benefits
Fever-reducing medications help a child feel more comfortable during illness but have not been shown to prevent febrile seizures from occurring — a seizure can still happen even when fever medicine has been given
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Check Your Understanding
Tap the answer that best fits each scenario.
A 2-year-old has a fever of 102.8°F and is shivering noticeably. The child is wrapped in a blanket, teeth chattering, and feels cold to the touch despite the high temperature. When the parent calls the child's name, the child looks up and reaches for a toy.
How would you describe this shaking episode?
An 18-month-old with a fever of 103.6°F suddenly goes stiff, eyes roll back, and arms and legs begin jerking rhythmically. The child cannot be roused and does not respond to voice. The shaking has been going on for about 2 minutes.
What does this episode describe?
A 3-year-old had a febrile seizure that lasted about 90 seconds and then stopped. The child is now very sleepy and hard to rouse but is breathing normally. It has been 20 minutes since the seizure ended.
PediaPulse is an independent, visual educational initiative founded by Ebenezer Adebiyi, MD, MPH, FAAP. It is not affiliated with, endorsed by, or representative of the views or clinical practices of any hospital network or medical institution. Dr. Adebiyi's work on PediaPulse is strictly educational, does not constitute the establishment of a doctor-patient relationship, and does not provide medical advice or diagnostic triage. Always consult your child's physician for medical concerns. PediaPulse is a product of ProParenting Pulse LLC.
Not every fever is the same—and not every fever needs the same response.
American Academy of Pediatrics, Subcommittee on Febrile Seizures. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389-394.
Smith DK, Sadler KP, Benedum M. Febrile seizures: risks, evaluation, and prognosis. American Family Physician. 2019;99(7):445-450.
Ebenezer Adebiyi, MD, MPH, FAAP
Board-Certified Pediatrician · FAAP · Founder of PediaPulse
Dr. Adebiyi built PediaPulse to help parents understand what they are observing so they can have better, more informed conversations with their own doctors.
