seizure in children

Overview

A seizure is a sudden, temporary change in the brain's normal electrical activity. This can cause unusual movements, feelings, or behaviors, and sometimes a loss of awareness. When a child has a seizure, it can look scary, but most seizures stop on their own within a few minutes. Seizures are a symptom, not a disease — they can happen for many reasons, from high fever to epilepsy.

Yes. Around 4 to 5 children out of every 100 will have a seizure at some point. Febrile seizures affect about 2 to 5 out of 100 children between the ages of 6 months and 5 years.

Seizures can occur in infants, children, and teenagers. Febrile seizures are most common in children under 5. Other types of seizures can start at any age. Some children may have seizures only once, while others may have repeat seizures (epilepsy).

Symptoms

Common symptoms

• Stiffening of the body
• Shaking or jerking of arms and legs
• Loss of consciousness
• Staring blankly and not responding
• Confusion or drowsiness after the event

Symptoms in children

• Staring spells where the child loses awareness briefly (absence seizure)
• Jerking movements of one side of the body
• Seizure during or after high fever (febrile seizure)
• Unusual head rolling or eye movements
• Falling suddenly without a clear reason

Causes

Main causes

• High fever (febrile seizure)
• Epilepsy – a condition that causes repeated, unprovoked seizures
• Head injury
• Infections of the brain, such as meningitis
• Low blood sugar or other metabolic problems

Risk factors

• Being younger than 5 years for febrile seizures
• Family history of seizures or epilepsy
• A previous seizure
• Developmental or brain conditions
• History of head trauma

When to see a doctor

See a doctor urgently if:

• If your child has a seizure lasting more than 2 minutes
• If your child has trouble breathing or does not wake up after a seizure
• If this is the first seizure your child has ever had
• If your child has a seizure while in water
• If your child is under 1 year old and has a seizure

Book a routine appointment if:

• If your child has had a second seizure
• If you have concerns about unusual staring spells or movements
• If your child does not return to normal behavior after a few hours

Diagnosis

A doctor will take a detailed medical history, ask you to describe the seizure, and examine your child. They may order tests to look for underlying causes.

Tests that may be done

• Blood tests to check for infections or chemical imbalances
• Electroencephalogram (EEG) – a painless test that records brain waves
• MRI or CT scan of the brain
• Neurological exam to check reflexes and coordination

What to expect at your appointment

The doctor will ask you about what happened before, during, and after the seizure. You may be asked to keep a seizure diary. If the tests are normal and the seizure was caused by fever, the child may not need treatment. If epilepsy is suspected, the doctor may refer you to a child neurologist.

Treatment

Treatment depends on the cause of the seizure and how often it happens. For a single febrile seizure, no treatment may be needed. For epilepsy, medicines can help prevent further seizures. The goal is to control seizures with the fewest side effects.

Self-care at home

• During a seizure, lay your child on their side on a soft surface
• Do not put anything in their mouth or hold them down
• Stay with them and time the seizure
• Remove nearby objects that could cause injury
• Cushion their head and loosen tight clothing

Medical treatments

If your child has epilepsy or repeated seizures, a doctor may prescribe anti-seizure medicine. These medicines work by calming the electrical activity in the brain. The doctor will choose the type based on your child's age and the seizure type. Most children with epilepsy control their seizures well with medicine. Always give medicines exactly as prescribed. Do not stop or change without talking to your child's doctor.

When is surgery considered?

If a child's seizures are caused by a specific area of the brain and do not respond to medicines, surgery to remove that area may be an option. This is considered only after a full evaluation by a specialist team.

Living with this condition

For most children with a single seizure, life goes back to normal. For children with epilepsy, a safe and supportive routine helps. Make sure all caregivers, teachers, and family members know what to do during a seizure.

Lifestyle tips

• Make sure your child gets enough sleep – lack of sleep can trigger seizures
• Avoid flashing lights if your child has photosensitive epilepsy
• Supervise swimming and bathing – never let a child swim alone
• Wear a helmet while cycling or riding scooters
• Keep regular meal times to avoid low blood sugar

Diet and exercise

Most children with seizures can exercise and play sports safely. It is important to have a partner or supervisor who knows about the condition. A balanced diet with regular meals helps overall health. For certain types of epilepsy, a special high-fat diet (ketogenic diet) may be used under medical supervision.

Mental health and emotional wellbeing

Seizures can be frightening for both the child and the family. Some children may feel anxious or embarrassed about having seizures. It is important to talk openly and offer reassurance. Children with epilepsy may also have higher rates of attention or learning problems, so watch for school difficulties and ask for support if needed.

Prevention

Not all seizures can be prevented. A febrile seizure cannot always be predicted. For children with epilepsy, taking prescribed medicines and avoiding known triggers may reduce the chance of a seizure. In general, preventing head injuries with car seats, helmets, and safe play can reduce the risk.

Vaccines

Some infections that can cause seizures, such as meningitis, can be prevented with vaccines. Make sure your child's immunizations are up to date.

Screening programmes

There is no routine screening test for seizures in otherwise healthy children. If your child has a condition that increases the risk of seizures, a specialist may arrange regular check-ups.

Complications

If left untreated

• Injury from falling or hitting the head during a seizure
• Prolonged seizures (status epilepticus) can cause brain damage
• Struggling at school due to missed learning time
• Breathing difficulties during a severe seizure

Long-term outlook

Most children who have a seizure – especially a febrile seizure – grow and develop normally. Many children who develop epilepsy become seizure-free with treatment, and some outgrow the condition. With proper care and support, the outlook for children with seizures is generally good. Your child's team will guide you every step of the way.

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