What to know about high temperature and seizures

A seizure with a high temperature needs calm first aid, careful timing, and urgent help if it is prolonged, repeated, or followed by breathing problems. Fever-related seizures, also called febrile seizures, most often affect young children. They can involve stiffening, rhythmic jerking, staring, or a brief loss of awareness. The seizure may happen as the temperature rises, rather than only when the fever reaches a particular reading.

A high temperature is usually a sign that the body is responding to an infection. Respiratory infections, such as a common cold, croup, bronchiolitis, or COVID-19, can cause fever; other illnesses can do so as well. A febrile seizure is different from ordinary shivering: the child may not respond, and their body may become stiff or jerk. Afterward, they can be sleepy or confused for a short time. A first seizure should be assessed by a clinician, even if the child seems well again.

Place the child on a safe surface, move nearby hard or sharp objects away, and protect their head with something soft. Turn them onto their side if you can do so safely, especially once the jerking stops, and keep the airway clear. Note when the seizure starts and ends. Do not hold the child down, put anything in their mouth, give food or drink, or try to stop the movements. Do not use a cold bath or ice. Once the episode has ended, check their breathing and stay with them while arranging medical advice.

Call emergency services if the seizure lasts longer than five minutes, another seizure begins before the child fully recovers, the child has trouble breathing, remains unresponsive, or is seriously injured. Seek urgent assessment for a first seizure, a seizure affecting only one part of the body, or a child who remains unusually weak or confused afterward. Emergency help is also needed with a stiff neck, a widespread rash that does not fade when pressed, severe difficulty waking, or signs of dehydration.

Ask what may have caused the fever, whether the episode fits a febrile seizure, and what warning signs should prompt emergency care. Ask how to measure and monitor the temperature, whether the child needs an examination or tests, and whether you should have a written seizure first-aid plan. Tell the clinician how long the episode lasted, what the movements looked like, how the child behaved before and afterward, and any medicines already given.