My Child Had a Seizure. Do They Have Epilepsy?

When it comes to potential scary parenting moments, seeing your child experience a seizure rates high on the list. But the chance of your child having a seizure is low. Less than 5% of kids experience a seizure during their childhood, with around 1% being diagnosed with epilepsy.

It’s important to keep in mind that seizures aren’t always the intense events written into TV shows and movies for dramatic effect.

“Seizures can be anything that triggers abnormal electrical activity in the brain and causes symptoms that are involuntary,” said pediatric neurologist Ariel Sherbany, MD, PhD, division chief of pediatric neurology at Joseph M. Sanzari Children’s Hospital in Hackensack, New Jersey. That involuntary action can range a brief lapse of consciousness in which the child stares straight ahead—known as “absence seizures”—to vomiting or, yes, those convulsive seizures you’ve seen on TV.

But if your child has a seizure, what should you do?

During a seizure: If they are convulsive seizures, it may be a medical emergency because there “are much higher risks for brain, cardiovascular and/or respiratory issues,” Dr. Sherbany said. “But it does not mean [the person has] epilepsy. It could be that there are other issues—for example, brain infections or electrolyte abnormalities or low sugar—so they require immediate medical attention.”

The first rule of helping a child through a convulsive seizure is to make sure they’re in a safe position away from sharp objects, he said. Here’s how to do this:

• Help lay them down on the floor or centered on a bed, and roll them onto their side.
• Do not restrain the child.
• Keep them propped on their side until the seizure ends. The position will let gravity do its job and keep their airway clear of saliva or vomit.
• Do not put any objects or fingers or anything else into their mouth to, as people used to believe, keep them from biting their tongue. That can push the tongue back and/or restrict the airway.
• If on a bed, make sure the child can’t roll off.
• If an infant has a seizure, it might be easiest to just pick them up and hold them in the air, face down, until the seizure subsides.
• As soon as possible, call 911 or take the child to the emergency room (ER).

If your child experiences any other kind of symptoms that might potentially be a seizure—such as staring and stopping their normal behaviors out of the blue— or making other abnormal involuntary behaviors or movements, make an appointment to see your pediatrician. If the symptoms recur frequently, go to the ER.

Collect information: No matter the kind of seizure—from an absence seizure (staring unresponsively) to a convulsive seizure—write down, videotape or make a voice recording of as much information as possible about the event to discuss with your pediatrician.

If your child had the seizure at school, make sure the teacher, nurse or other adult who was present gets a chance to speak directly with the ER doctor to describe the seizure. “That kind of first person information sometimes is more important, believe it or not, than all the testing that we do,” Dr. Sherbany said. He added that a parent probably isn’t going to truly hear the information or remember it clearly, right at first.

At the emergency room: The ER doctors will probably run tests to see what might have caused the seizure and whether there are any concerns about the seizures recurring and risk for brain damage.

The longer a seizure goes on for, the greater the chance it could have an impact on the brain. ER tests may include blood tests, an electroencephalogram (EEG) and/or a CAT scan of the head or MRI of the brain.

Is it epilepsy? A single seizure does not mean your child has epilepsy or a seizure disorder. Children can experience seizures for a variety of reasons: These could be “provoked,” such as from a fever, high or low blood sugar, head injury or stroke. Or, they could be “unprovoked,” because of a genetic condition, brain lesion or other medical condition. The most common factors leading to an epilepsy diagnosis are two or more seizures within a 24-hour period.

For more information about pediatric seizures and epilepsy, visit the Epilepsy Foundation website.