Seizures in children: Signs to look for and what to do

Approximately 4-5% of all children will experience a seizure at some point during their childhood. About 1% of children are diagnosed with epilepsy, and 1 in 26 people develop this neurological condition during their lifetime.

Given these statistics, it's vital for everyone to know what steps to take if they see a person having a seizure.

Seizures are common, and while a seizure may never happen to you or to a member of your family, it's good for everybody to know what to do in case of a seizure.

What causes seizures in children?

A seizure is an abnormal electrical discharge in the brain. There are many different types of seizures and many different reasons this can occur in a child. Not all seizures are caused by epilepsy. Other causes of seizures in children can include high fever (called febrile seizures), infection or traumatic head injury.

For other kids, when they get very upset and hold their breath, they have an event that looks like a seizure where they pass out or have some stiffening or shaking. This is not considered an epileptic seizure but rather a response to the child holding their breath.

Epileptic seizures occur when sudden electrical discharges in the brain happen without another cause provoking it. Anyone at any age can develop epilepsy, but young children and older adults are at greatest risk. People with epilepsy may identify triggers that increase chance of seizure. Common seizure triggers can include illness, not taking epilepsy medication, stress, flashing lights, certain times of day, dehydration or lack of sleep.

What does a seizure look like in a child?

A seizure can look like lots of different things in a child. The most commonly recognized signs of a seizure are when the body stiffens and shakes. These types of convulsive seizures (generalized tonic-clonic or "grand mal" seizures) can cause a person to fall and injure themselves, bite their tongue or lose control of the bladder or bowel.

Other seizures are not as obvious. Some children may have a seizure but only stare into space, blank out or not respond to a parent – these are sometimes called "absence" or petit mal (staring) seizures. Often when this happens, parents might think their child is not paying attention. This type of seizure can go undiagnosed for months or even years.

Depending on the type of seizure, a child can experience many different symptoms. Common signs of a seizure include:

• Blank staring
• Confused speech
• Loss of consciousness
• Uncontrollable shaking or jerking movements
• Wandering

What to do if a child has a seizure

Seizures can be frightening for a parent or loved one. But when a child has a seizure, it's important to remain calm and to focus on keeping the child safe.

The most important thing, and the hardest, is not to panic. Seizures can be scary to watch, but many times they will stop on their own, and seizures that stop in less than five minutes are not usually dangerous to the child.

Follow the recommendations below to help your child through the seizure safely.

First aid for convulsive seizures

If your child has a convulsion (a seizure where they lose consciousness with stiffening and shaking), follow these steps for seizure first aid:

• Stay calm and stay with your child
• Turn your child on their side
• Make your child as comfortable as possible, cushion the head and remove glasses
• Loosen any tight clothing
• Do not ever put anything in your child's mouth
• Do not try to "stop" the convulsions or restrain your child
• Pay attention to the length of the seizure – when the seizure started and stopped
• Call 911 for any seizure lasting more than 5 minutes, or if the child is injured during the seizure

First aid for absence seizures

When a child experiences an absence or staring seizure, the most important thing to do is to stay with the child to ensure they stay safe. Make sure they are fully conscious and aware before being left on their own.

If your child has an absence seizure, follow these steps for seizure first aid:

• Stay calm and stay with your child
• Time the seizure
• Don't grab or hold your child
• Explain to others what is happening
• Protect child from any hazards

When to seek emergency help for seizures in children

Many seizures in children will resolve on their own, and in those cases, children often do not require emergency care. However, if your child is experiencing their first seizure, you must take them to the emergency room or to your doctor to determine why it happened.

Call for emergency medical assistance if the seizure:

• Lasts more than 5 minutes
• Is the child's first seizure
• Causes an injury due to a fall
• Causes breathing difficulty
• Is convulsive and changes to a staring seizure and the parent isn't sure if the child is still having a seizure

If your child does not return to full awareness, seek medical assistance or call 911.

Safety precautions for children who have seizures

The biggest risk to children who have seizures is where they occur. If a child is walking down the stairs or is in the bathroom and has a seizure, the child risks falling and hurting themselves.

Most importantly, especially here in Texas in the summertime, if a child is in the water and has a seizure, they can fall under the water and drown. We tell parents to be very careful about watching kids anywhere around water, including lakes, pools, the bathtub or shower.

Take these seizure precautions to ensure your child remains safe.

• Avoid tub baths; showers are safer than baths
• Make sure the bathroom door is not locked
• No swimming without constant adult supervision
• Wear a life jacket at all times when boating or on a jet ski
• No climbing higher than 10 feet including ladders, trees and bunk beds
• Wear a helmet at all times when bike riding and horseback riding
• For children with frequent seizures, avoid bike riding on streets
• No cooking over an open stove (use microwave instead) or using an iron
• Teenagers with uncontrolled seizures shouldn't drive, including ATVs, mini-motor cycles, 4-wheelers
• Do not allow the handling of firearms

As a parent, it will be helpful to develop a plan and to share your plan with others to help keep your child safe during a seizure. Talk to your child's school or anyone who may be in contact with your child about seizure first aid and safety.

Learn more

Designated as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers, Children's Medical Center Dallas provides the highest level of treatment for the most complex cases of pediatric epilepsy, with additional advanced epilepsy treatment options available at our Level 3 Epilepsy Center in Plano. Learn more about our program and services.

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