Fever and seizure: what should you know?

Fever can accompany a seizure during an infection, but a seizure has other possible triggers. Low blood sugar, alcohol withdrawal, and meningitis are examples that require specific assessment. The person may stiffen, jerk, stare, lose awareness, or be confused afterward. The appearance alone cannot establish the cause, and a first seizure should be medically reviewed even if movement stops quickly.

Move hard or sharp objects away, cushion the head, loosen tight clothing around the neck, and place the person on their side when safe. Time the seizure. Do not restrain them, put anything in their mouth, give food or drink during it, or try to lower the fever by force. Stay nearby and note breathing, movements, colour, recent illness, medicines, and recovery.

Call emergency services if the seizure lasts several minutes, repeats without recovery, causes injury, happens in water, or the person has breathing difficulty. Treat it as an emergency when there is a stiff neck, severe headache, marked drowsiness, confusion, a new rash, or suspected poisoning. Emergency assessment is also needed for a first seizure, pregnancy, diabetes, or a child who remains unwell after the event.

What tests could identify the trigger? How should we respond if another seizure occurs? Does the person need a treatment plan, safety advice, or review of current medicines?