Seizures in children

What is a seizure?

A seizure (sometimes called a fit) is best described as a sudden, uncontrolled surge of electrical activity in the brain. This surge can cause a person to move in unusual ways or hold unusual postures. In some cases, the person might see, feel or smell things that aren’t there.

About 1 in 20 children will have a seizure by the time they are 15. For most, it’s an isolated event and they will not have another seizure in the future.

What are the different types of seizures?

A seizure where someone falls to the ground and shakes for a minute or so, is just one type of seizure. There are different types of seizures:

• Focal seizures happen in one part of the brain.
• Generalised seizures happen all over the brain.

Seizures can also be described by the symptoms they cause.

Tonic seizures make the muscles go stiff and often happen when your child is asleep.

Atonic seizures make your child lose control of their muscles. Their head may slump, or they may fall to the ground.

Clonic seizures are where the muscles jerk around repeatedly.

Myoclonic seizures cause the muscles to jerk suddenly and briefly.

Tonic-clonic seizures (previously called grand mal seizures) are a type of generalised seizure. Someone having a tonic-clonic seizure might fall down, become unconscious, go stiff or jerk, lose bladder or bowel control, and be sleepy or confused afterwards.

Absence seizures (previously called petit mal seizures) are also generalised seizures. Someone having an absence seizure is not aware of what is happening or responsive to interactions with people. They might stare, blink their eyes or make chewing movements with their mouth.

During focal seizures, some people make automatic movements and behaviours such as:

• picking at clothing
• chewing
• swallowing
• staring
• picking up objects
• running on the spot

In all types of seizures, the person can't control what happens.

What causes seizures in infants and children?

A high fever (above 38°C) can sometimes cause seizures in young children. These are also called febrile convulsions.

Children can also have a seizure because of:

• an infection
• a brain injury
• a lack of oxygen to the brain

Certain triggers, such as flashing lights, can also lead to seizures in some children.

Most children won’t have more than one seizure. Some children who have repeated and unpredictable seizures might have epilepsy.

What should I do if my child has a seizure?

It can be scary to see your child have a seizure but you should try to stay calm.

If your child has a seizure, there are some things you can do to help keep your child safe:

• Try to protect their body and head from injury, by moving harmful objects away from them.
• Do not try to stop them from moving and do not put anything in their mouth.
• If the child is on the ground, place something soft under their head and loosen anything tight around their neck.
• If they’re in water, keep their face out of the water and call for an ambulance.
• Lay them on their side if there is fluid in their mouth.
• If you can, time how long the seizure lasts.
• Try to reassure your child and keep other people away, to give them some privacy.
• After their seizure ends, roll them on their side and make sure they are breathing normally.

When should I call an ambulance?

You should call triple zero (000) immediately and ask for an ambulance if:

• the seizure lasts more than 5 minutes, or they have more than one seizure quickly after the first
• your child had a seizure with food or liquid in their mouth
• your child is unconscious or not breathing normally during or after the seizure
• you think this is your child’s first seizure
• the seizure happens in water

You should also call an ambulance if:

• your child is unconscious for more than 5 minutes afterwards
• your child is hurt or injured
• your child has diabetes
• you are going to give them medicine to stop the seizure
• they do not seem to fully recover

If calling triple zero (000) does not work on your mobile phone, try calling 112.

When should I see my doctor?

Even if they make a full recovery, you should always see a doctor after your child's first seizure, or if your child has a seizure that lasts more than 5 minutes.

The risk of having another seizure is greatest within the next 3 months after a first seizure. Your doctor can give you advice on any activities to avoid and for how long.

Your child's doctor will also assist you to make an action plan for your child. This can help keep them safe. The plan may include:

• making sure that anyone caring for your child knows what to do in the event of a seizure
• taking care around water
• getting a medical identification bracelet
• ensuring adult supervision for potentially risky activities such as swimming, heights and cooking

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How are seizures diagnosed?

A doctor will assess your child. You should describe the seizure (how your child looked and behaved) to the doctor, or show them a video of the seizure, if possible.

If your child had a febrile convulsion, they may not need to undergo any tests, but they should still see a doctor.

If your child had a seizure, and especially if they had more than one, they might have tests including:

• an electroencephalogram (EEG), which is a reading of the electrical activity of the brain
• blood tests
• a brain scan (such as a CT scan or an MRI)

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How are seizures in children treated?

Following any seizure, perform first aid. Where a seizure continues for an extended period of time (more than 5 minutes), call triple zero (000) and ask for an ambulance. You might need a health professional to give your child medicine to stop the seizure.

Febrile convulsions aren’t usually harmful, but it’s a good idea to see a doctor to make sure your child doesn’t have a serious infection. However, children who have a febrile convulsion may be more likely to have a seizure again in the future.

If a child experiences multiple seizures, they might need regular medicines. Sometimes, you will need to try several different medicines before you find one that is effective for your child. Other treatments, such as surgery or vagus nerve stimulation therapy (where a pulse generator is inserted under the skin to give electrical signals to the brain), are sometimes needed.

Can seizures be prevented?

The good news is that many children grow out of seizures or epilepsy.

Febrile convulsions often can’t be prevented, because they can happen before a fever is obvious.

Your child should avoid anything that is known to trigger their seizures. Common triggers include:

• flashing or flickering lights
• lack of sleep
• missing a dose of anti-seizure medicine, if you child takes them regularly

Some triggers are hard to avoid, for example hormonal changes that occur during puberty.

What are the risks and complications of seizures?

Most children recover well after a seizure, although they might be sleepy and confused for a short while. It’s rare to die from a seizure, but there are risks if the seizure goes on for a long time (usually 30 minutes or more) or if the child chokes on water or vomit.

Resources and support

If your child has had a seizure, talk to your doctor (GP or paediatrician) about any concerns you have.

Contact the National Epilepsy Support Service on 1300 761 487 (Monday to Saturday 9.00am to 7.00pm AEST).