The what and why of seizures in kids

Seizures can be scary. From how they happen to the safest response, there’s a lot to know. Dr. Nassim Zecavati, neurologist and epilepsy expert answers some key questions.

Why do seizures occur?

A seizure happens when a burst of abnormal electrical signals interrupts normal brain functioning.

Are seizures always associated with epilepsy?

No. The most common seizures in kids younger than 6 years old are febrile seizures, which are associated with a fever above 101°F. Approximately 2-4% of children have febrile seizures. Kids who have a viral infection, attend day care or have a family history of febrile seizures are at greatest risk. Sometimes, a child may not have a fever at the time of the seizure but will develop one a few hours later. While febrile seizures are scary for parents, it’s comforting to know that kids typically outgrow them with no long-term health problems.

Having a seizure triggered by a fever doesn’t mean a child has epilepsy. A person is considered to have epilepsy when they’ve had at least two seizures more than 24 hours apart without a fever or other underlying illness.

What do seizures look like?

Seizures in kids can look like a lot of different things. Some are very short, and others last for several minutes.

Convulsive seizures cause the body to stiffen and shake, and are what people typically think about when they hear the word seizure. Seizures can also appear as staring into space, unresponsiveness and eye fluttering. These are sometimes called absence or petit mal seizures. Depending on the type of seizure, children may also have confused or garbled speech, decreased or loss of consciousness, jerking movements of the arms and legs, and facial twitching.

How do I know if my child has had a seizure?

Seizures can cause kids to fall and injure themselves, bite their tongue, or lose control of their bladder or bowels. They may seem sluggish and tired following a seizure too. Kids who’ve had absence seizures may struggle to learn and remember information in school. It’s not always obvious that someone has had a seizure, so many go undetected.

How is epilepsy diagnosed?

We’re still learning a lot about the specific causes of epilepsy. In order to diagnose a child with epilepsy, we gather information through detailed history, physical and neurological exams, and usually an electroencephalogram – or EEG – which is a test that tracks and records brain wave patterns to look for abnormalities. Sometimes head imaging, such as an MRI, is helpful to look for any structural issues in the brain that could be associated with the seizures. Genetic testing, done by a simple swab in the cheek, can reveal hereditary links to epilepsy. Most of these tests aren’t painful but provide essential clues to help with diagnosis and care.

How are seizures treated?

This depends on the underlying cause of the seizures. Febrile seizures often require only fever reducing medication, such as Tylenol. For other types of seizures, treatment options may include medications or dietary therapies such as a ketogenic (high-fat, low-carb) diet. You’ll want to work with your child’s doctor to make sure you’re trying treatments that are appropriate for the specific type of seizure.

In some cases, medicines don’t work long-term and surgery becomes the best approach. CHoR is a Level 4 Epilepsy Center, which means our neurosciences team provides the most sophisticated monitoring and surgical treatment for kids with epilepsy. We start with non-invasive options and progress from there for the most comprehensive recovery with the least disruption for kids and families.

What should I do if my child has a seizure?

The most important thing is to try to prevent them from getting hurt.

If they’re convulsing or shaking:

• Gently help them to the ground and remove things around them
• Turn them onto their side to keep them from choking on their saliva
• Don’t try to restrict their movement
• Don’t put anything in their mouth as it could block their airway

With any type of seizure, you’ll want to stay with your child until it’s over. It’s also helpful to keep track of how long the seizure lasts if you can so you can share this information with the doctor.

When should I seek medical care for my child's seizure?

Many seizures resolve on their own and don’t require emergency care. Even so, it’s a good idea to tell your child’s doctor so they can make a note and keep an eye out for future events.

Call 911 and get immediate medical attention for a seizure that:

• Lasts more than five minutes
• Causes an injury due to a fall
• Results in trouble breathing
• Involves convulsive shaking that doesn’t stop on its own

Discover more about our neurosciences team and their comprehensive care for kids with seizure disorders, epilepsy and other neurological conditions.