Vomiting after a febrile seizure: what to know

A febrile seizure occurs with a fever, and the infection causing the fever may also cause vomiting. Vomiting can worsen fluid loss and make it harder to give medicines or drinks. A seizure followed by vomiting does not by itself show that the illness is meningitis, but a stiff neck, unusual sleepiness, light sensitivity, severe headache or a child who is difficult to wake is concerning. Gastroenteritis and other infections can also cause fever and vomiting.

Put the child on their side with the mouth clear, and stay with them. Do not restrain them, put anything in their mouth, or offer food and drink until they are fully awake and swallowing normally. Once alert, offer small sips of fluid. Record the seizure duration, temperature, movements and recovery, and follow the clinician’s fever and seizure plan. Do not give medicine to an unconscious or actively convulsing child.

Get emergency help if the seizure lasts longer than expected by the child’s emergency plan, repeats, breathing is difficult, the child stays unresponsive, or vomit obstructs breathing. Urgent assessment is also needed for a stiff neck, purple rash, severe headache, persistent vomiting, marked dehydration or unusual behaviour. Any first seizure or seizure in a child who is not recovering normally should be assessed promptly.

Ask what caused the fever, how to measure and replace fluids, and what your seizure action plan should say. Tell the clinician the child’s age, seizure duration, recovery pattern, vomiting episodes, fluid intake, urine output, fever symptoms and any rash or neck stiffness.