Fever with fits: possible causes and what to do

A febrile seizure may happen when a child’s temperature rises during an infection. The child may stiffen, jerk, lose awareness, or become sleepy afterwards. The appearance can be frightening, but the movements alone do not identify the cause.

Common childhood infections can trigger fever, including respiratory infections such as a common cold, croup, bronchiolitis, or acute bronchitis. Chickenpox and COVID-19 can also cause fever. Less common but serious causes include infection around the brain, a severe bloodstream infection, or a seizure that is not caused by fever.

A fit is more concerning when it affects one side of the body, happens more than once during the same illness, lasts longer than a few minutes, or the child does not return towards their usual alertness. A clinician may ask about the fever, the illness symptoms, the episode’s movements and duration, and any previous fits.

Place the child on a safe surface, move nearby hard or sharp objects away, and turn them onto their side if possible. Note when the fit starts and stops. Loosen tight clothing around the neck and stay with the child.

Do not restrain the movements, put anything in the child’s mouth, or give food, drink, or medicine until they are fully awake. After the episode, check their breathing and arrange medical advice even if they seem better, particularly after a first fit.

Call emergency services if the fit is still happening after five minutes, breathing is difficult, the child remains unresponsive, another fit follows soon afterwards, or the child is seriously injured. Seek urgent assessment for a stiff neck, unusual rash, severe headache, repeated vomiting, marked drowsiness, or a child who looks seriously unwell.

A first fit with fever should be medically assessed. Do not wait for the temperature to fall before seeking help when warning signs are present. Keep the child on their side while waiting and follow the emergency operator’s instructions.

Ask what may have caused the fever, whether the episode fits a febrile seizure, and which signs should prompt emergency help if it happens again. Tell the clinician how long the fit lasted, which body parts moved, whether the child changed colour or breathing, and how quickly they became responsive.