What are the key clinical features that differentiate simple febrile seizures from complex febrile seizures in children?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 17 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Simple febrile seizures are characterised by being generalized tonic-clonic seizures lasting less than 15 minutes, occurring once in a 24-hour period, and with no focal neurological signs or deficits.

Complex febrile seizures differ by having one or more of the following features: focal onset or focal neurological signs during the seizure, duration longer than 15 minutes, or multiple seizures within 24 hours.

Children presenting with any features of complex febrile seizures require immediate hospital assessment by a paediatrician due to the increased risk of underlying pathology or neurological complications.

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