Seeing child seizures can freeze time: shaking, sudden stillness, a stare that won’t answer your voice. Parents often wonder what just happened, whether it will happen again, and what to do first—without guessing. Clear steps help. So does knowing that many child seizures are brief and treatable, and that “seizure” is not automatically “epilepsy.”
Child seizures: what they are and why they can look different
What a seizure is (in the brain)
A seizure is a short episode of abnormal, excessive, synchronous neuronal firing—groups of neurons discharging together in a fast burst. Because the brain coordinates movement, awareness, speech, sensation, and autonomic functions (breathing rhythm, heart rate, skin color), that electrical surge can temporarily disrupt normal circuits.
Some child seizures are convulsive (stiffening, jerking, sudden loss of tone). Others are non-convulsive and may look like staring, brief unresponsiveness, or repetitive, purposeless movements.
Two main onset patterns:
- Focal onset: starts in one area.
- Generalized onset: involves both sides from the start.
Seizure vs convulsive seizure vs epilepsy
- Convulsive seizure: visible motor signs.
- Seizure (epileptic seizure): abnormal electrical activity, convulsive or not.
- Epilepsy: recurrent, unprovoked seizures.
A child can have child seizures without having epilepsy.
Why child seizures look different by age
- Infants: eye deviation, brief stiffening, sudden limpness, lip-smacking/chewing, breathing pauses, perioral cyanosis (bluish color around the mouth). Infantile spasms can appear as clusters of quick flexion/extension movements around sleep.
- Toddlers: fever-triggered seizures are common, focal seizures may show automatisms or “zoning out.”
- School-age children: may describe an aura (odd smell/taste, déjà vu, rising stomach sensation).
- Teens: some syndromes become clearer (e.g., juvenile myoclonic epilepsy with morning jerks, often worsened by sleep loss).
How common child seizures are
Seizures are common in pediatrics, about 5% of people will have at least one seizure in their lifetime.
Typical age windows:
- Febrile seizures: 6 months to 5 years (peak 12–18 months).
- Infantile spasms: usually start in the first year.
- Absence seizures: often start around age 4.
After age 5, a seizure with fever is less typical, so assessment tends to be more thorough.
Causes and risk factors of child seizures
Provoked vs unprovoked
Clinicians often separate:
- Provoked (acute symptomatic): a short-term trigger (fever, hypoglycemia, electrolyte disturbance, toxins).
- Unprovoked: no temporary trigger found, suggesting an ongoing predisposition.
Fever and infection
Febrile seizures affect roughly 2–5% of children. Fever can lower the seizure threshold, especially when temperature rises quickly.
Most fever-linked child seizures occur with common infections (viral colds, gastroenteritis, otitis media, influenza). Fever after vaccination can also be the setting.
More serious infections can inflame the brain or its coverings:
- Meningitis
- Encephalitis
Seek urgent care if fever comes with persistent altered mental status, stiff neck, repeated vomiting, a purplish rash, or a child who does not progressively return toward baseline.
Metabolic causes (glucose, electrolytes, vitamin B6)
The brain needs steady fuel and stable chemistry.
Triggers include:
- Hypoglycemia
- Abnormal sodium
- Hypocalcemia
- Hypomagnesemia
Vomiting, diarrhea, dehydration, or very low intake can destabilize infants and toddlers quickly.
In some infants, treatable conditions can present with child seizures, such as pyridoxine (vitamin B6)–dependent epilepsy or other inborn errors of metabolism (very early onset, feeding difficulty, unusual sleepiness, developmental concerns).
Structural or injury-related causes
Possible links include head trauma, bleeding, stroke, tumor, or developmental malformations (e.g., focal cortical dysplasia). Mention any significant fall, new severe headache, or new weakness after the event.
Medications, substances, toxins
Some medicines and toxins lower seizure threshold, accidental ingestion is a real toddler risk. If it might have happened, say so right away.
Genetic causes and epilepsy syndromes
Many pediatric epilepsies have a genetic basis, sometimes with characteristic seizure patterns and EEG findings.
When no clear cause is found
A normal MRI or EEG does not always end the story, abnormal activity may not be captured during testing.
Types of child seizures parents may see
Generalized seizures
Often include sudden stiffening, rhythmic jerking, loss of awareness, drooling, eye deviation, and color change. Afterward, many children are sleepy or confused (the postictal phase).
Focal seizures
- Focal aware: unusual sensations, sudden fear, déjà vu, tingling, or a twitch in one area.
- Focal impaired awareness: staring, reduced responsiveness, automatisms (lip-smacking, hand rubbing), then confusion.
A focal seizure can spread into a bilateral tonic-clonic seizure.
Febrile seizures (simple vs complex)
- Simple: generalized, under 15 minutes, once in 24 hours, quick recovery.
- Complex: over 15 minutes, repeats in 24 hours, or focal features.
Recurrence occurs in about 20–40% of children, overall later epilepsy risk stays low, but rises with complex features or family history.
Infantile spasms
Brief, repeated “crunching” movements in clusters (often on waking or falling asleep). Because development can be affected, prompt evaluation matters.
Status epilepticus
Emergency definition:
- one seizure lasting 5 minutes or more, or
- repeated seizures without full recovery between them.
Recognizing child seizures: signs to watch for
What seizures can look like
- Jerking or rhythmic shaking
- Sudden stiffening or collapse
- Blank staring with true unresponsiveness
- Repetitive non-purposeful movements
- Sudden fear/confusion without clear trigger
Subtle signs in infants
Repeated eye deviation, chewing motions, brief stiffening or limpness, breathing pauses, color change around the mouth.
After the seizure
Sleepiness and confusion are common. A temporary one-sided weakness (Todd’s paralysis) can happen and needs urgent assessment.
What to observe (and video tips)
If you can, note:
- Start/end time (use a clock)
- Fever/illness, sleep loss, missed meds, possible ingestion
- What happened first, then next
- Breathing/color change, injuries
- Time to return toward usual behavior
A short, steady video can help—if it doesn’t delay first aid.
Events that can mimic child seizures
Some episodes look similar but have different mechanisms:
- Syncope (fainting)
- Breath-holding spells
- Night terrors
- Tics or stereotypies
- Daydreaming (responds to voice/touch)
- Sandifer syndrome (reflux-related posturing)
- Migraine variants
- Psychogenic nonepileptic events (often clarified with video-EEG)
Diagnosis and medical evaluation for child seizures
What clinicians ask
Expect detail: before/during/after description, duration, triggers, fever, sleep, medicines, family history, birth history, and development. A neurological exam checks for focal signs.
EEG
An EEG records brain electrical activity. It may be routine, sleep-deprived, or prolonged video-EEG. A normal EEG does not exclude epilepsy.
Imaging: MRI vs CT
MRI is preferred for non-urgent evaluation (no radiation, better detail). CT is used in urgent contexts (suspected bleeding, significant trauma) when speed matters.
Blood tests and lumbar puncture
Glucose and electrolytes are common. Broader metabolic tests or toxicology may be added when indicated. A lumbar puncture is considered when meningitis/encephalitis is suspected.
Febrile seizure workup
After a typical simple febrile seizure with quick recovery and a normal exam, EEG/imaging/lumbar puncture are not routinely done unless warning signs exist.
What to do during child seizures (first aid)
Step-by-step
1) Note the start time.
2) Clear hazards, cushion the head, loosen tight clothing.
3) Don’t restrain movements.
4) Turn to the side when possible (recovery position).
5) Watch breathing and color. Stay until fully awake.
Avoid
- Nothing in the mouth.
- No food/drink/medicine by mouth until fully awake and swallowing normally.
When it’s urgent or an emergency
Call emergency services immediately if
- The seizure lasts 5 minutes or more
- Seizures repeat without full recovery
- Breathing is abnormal or your child turns blue/gray
- Serious injury, major head trauma, or seizure in water
- Your child does not wake as expected
Contact a clinician soon
After a first seizure (including first febrile seizure), or if episodes repeat/change, or if development regresses.
Treatment options for child seizures
Treat the cause, then prevent recurrence
Management targets triggers (infection, glucose/electrolytes, toxins, injury). Recurrent or unprovoked child seizures may lead to antiseizure medication.
Fever care
Antipyretics improve comfort but do not reliably prevent febrile seizures. Fluids and rest matter.
Anti-seizure and rescue medicines
Daily antiseizure medicines are chosen by seizure type/syndrome. Some families receive rescue medication (often diazepam or midazolam via specific routes) for prolonged seizures, with a written plan for home and school.
Specialized options (selected cases)
For drug-resistant epilepsy: dietary therapy (e.g., ketogenic diet), surgery, or neuromodulation such as vagus nerve stimulation.
Living day to day with child seizures
Regular sleep, hydration, and consistent medication schedules can reduce risk. Water safety needs close supervision for bathing and swimming. A written seizure action plan shared with caregivers and school staff helps everyone act quickly.
Key takeaways
- Child seizures can be subtle or dramatic, age and seizure type change what you see.
- A convulsive seizure is not the same as epilepsy, epilepsy involves recurrent, unprovoked seizures.
- Febrile seizures (6 months–5 years) usually have an excellent long-term outlook, though recurrence can happen.
- Time the event, note context, and describe the first sign, a short video may help clinicians.
- First aid: protect from injury, place on the side when possible, and monitor breathing.
- Call emergency services for seizures lasting 5 minutes+, repeated seizures without recovery, breathing problems, injury, or water-related events.
- Your pediatrician and pediatric neurology team can guide evaluation and planning, and you can download the Heloa app for personalized tips and free child health questionnaires.
Questions Parents Ask
Can a child have a seizure while sleeping?
Yes—some seizures happen during sleep, and they can look different: sudden stiffening, rhythmic jerking, unusual sounds, drooling, or a child who seems confused or very tired on waking. Rassurez-vous: a single night event doesn’t automatically mean epilepsy. If you notice repeated episodes, bed-wetting that’s new, tongue biting, or injuries, you can mention it to your clinician and, if possible, share a short video to support evaluation.
Can seizures in children be triggered by flashing lights or screens?
In a small number of children, flickering lights, certain video games, or fast-changing patterns can trigger seizures (photosensitivity). Many children with seizures are not photosensitive, so pas d’inquiétude if screens haven’t caused any issues so far. If you suspect a link, you can try reducing brightness, increasing room lighting, sitting farther from the screen, and taking regular breaks—then discuss it with a pediatric neurologist, who can advise based on your child’s seizure type and EEG.
Can my child outgrow seizures?
Sometimes, yes. Some childhood epilepsy syndromes improve with age, and many children can eventually stop medication under medical supervision. Outcomes depend on the seizure type, cause, development, and response to treatment. It’s normal to want clear timelines—your care team can help set realistic expectations and a follow-up plan that feels reassuring and manageable.
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