What should you know about fever after a seizure?

Body temperature can rise briefly after intense muscle activity, but fever may also signal the illness that triggered the seizure. Meningitis can present with fever and a seizure, especially when headache, stiff neck, light sensitivity, vomiting or confusion occur. Hypoglycaemia and alcohol withdrawal can also be associated with seizures, although they do not explain every fever. A clinician needs the timing and examination to separate these possibilities.

Place the person on their side, clear nearby hazards, loosen tight clothing and time any further seizure. Do not restrain them, put anything in their mouth, or give food, drink or tablets until they are fully awake. Check temperature once it is safe, note medicines, recent illness, alcohol use, diabetes and the seizure’s duration. Keep the person cool without cold-water immersion and arrange medical advice even if they recover.

Call emergency services if the seizure lasts several minutes, repeats without recovery, causes injury, affects breathing, occurs in water, or is a first known seizure. Fever with a stiff neck, severe headache, rash, confusion, persistent drowsiness, breathing difficulty or repeated vomiting requires immediate help. Do not drive the person yourself if they remain confused or unsafe.

Ask whether infection or a metabolic problem could have triggered the event, which tests are needed, how to manage another seizure, and when fever can be treated at home.