High fever and seizure

Fever can trigger a seizure in some young children, but a seizure may also relate to meningitis, low blood sugar, medication or substance withdrawal, or another brain or metabolic problem. A fever does not explain away a first seizure. Clinicians will want to know the person’s age, previous seizures, temperature, recent illness, medicines, and recovery after the event.

During a seizure, muscles may stiffen, limbs may jerk, awareness may be lost, and breathing may look unusual. Confusion or sleepiness afterwards can occur, but ongoing reduced responsiveness needs urgent help.

Move hard or sharp objects away and cushion the head. Loosen tight clothing around the neck, place the person on their side when possible, and time the seizure. Do not restrain them, put anything in their mouth, give food or drink, or try to lower the fever during the movements. Stay nearby and observe breathing. If the seizure ends, keep them on their side and monitor them until help arrives.

Call emergency services if the seizure lasts longer than five minutes, repeats, causes injury, happens in water, or breathing does not return normally. Get urgent assessment for a first seizure, a stiff neck, severe headache, persistent vomiting, a widespread rash, marked drowsiness, weakness on one side, or failure to return to usual awareness. Do not drive the person yourself if they remain confused or unresponsive.

What might have triggered the event, and is testing needed for infection or low blood sugar? Should we have a rescue plan for another seizure? Which fever treatments are appropriate, and which symptoms mean we should return immediately?