What does a seizure look like in a child?
Seizures do not always involve dramatic shaking. A child may stiffen and jerk, but they may also simply stop and stare for several seconds without responding, have repeated jerks of one limb, suddenly drop, or make repetitive movements such as lip-smacking or plucking at clothes.
Afterwards a child may be sleepy, confused, or briefly weak on one side. That recovery period is itself informative, and worth noting.
What should I do during a seizure?
Stay with the child and keep them safe. Move hard or sharp objects away, place them on their side, put something soft under the head, and loosen tight clothing at the neck. Do not restrain the movements and do not put anything, including fingers, spoons or water, into the mouth.
Note the time the seizure starts. If it lasts longer than five minutes, if a second seizure follows without full recovery in between, if the child is injured, or if breathing does not return to normal afterwards, get emergency help immediately.
How is epilepsy diagnosed and treated?
Diagnosis rests mainly on the description of the episodes, supported where useful by EEG and sometimes brain imaging. A normal EEG does not exclude epilepsy, and an abnormal EEG alone does not make the diagnosis.
Treatment is chosen for the seizure type and the child's age. Many childhood epilepsies respond well to a single medication, and some childhood seizure types are self-limiting and are monitored rather than treated. Medication is never stopped abruptly.
Living with epilepsy at school and home
Most children with controlled epilepsy take part in school, sport and daily life normally. Sensible precautions focus on swimming with supervision, avoiding heights unsupervised, and making sure the school knows what to do. Sleep deprivation and missed doses are the two most common avoidable triggers.
What causes epilepsy in children?
In a large proportion of children no single cause is ever identified, and this is a normal result rather than an incomplete assessment. Where a cause is found it may be genetic, a difference in how an area of the brain formed before birth, a scar from an earlier brain injury, infection or lack of oxygen, or a metabolic condition.
A genetic cause does not necessarily mean the condition was inherited from a parent. Many genetic epilepsies arise from a new change that appeared in the child and is present in neither parent. Where the cause matters for treatment choice or for advice about future pregnancies, genetic testing is discussed rather than ordered routinely.
What is an EEG, and what does it actually show?
An EEG records the brain's electrical activity through small sensors placed on the scalp. It is painless, involves no radiation and no needles, and typically takes thirty to sixty minutes. For children, a sleep-deprived EEG is often requested, meaning the child stays up late and wakes early so they are likely to fall asleep during the recording, because some abnormalities appear only in sleep.
An EEG helps classify the seizure type and can support a diagnosis, but it cannot rule epilepsy in or out on its own. Many children with epilepsy have a normal EEG between seizures, and a small number of children who never have seizures show minor abnormalities. This is why the description of the episodes carries more diagnostic weight than the tracing.
What to expect from medication
The aim is the smallest dose of a single medicine that stops the seizures without troublesome side effects. Doses usually start low and increase gradually, so seizure control may take several weeks to establish and the first prescription is rarely the final one.
Most children do well on one medicine. Side effects are worth asking about directly rather than waiting to notice them: drowsiness, irritability, appetite or weight change, and effects on concentration at school are the ones parents report most. Many settle after the first few weeks. Report a rash promptly, as a small number of medicines can cause a significant skin reaction.
Never stop or change a dose without advice, including when the child has been seizure-free for a long period. Abrupt withdrawal can trigger a prolonged seizure. When treatment is eventually withdrawn, it is tapered slowly under supervision.
Keeping a seizure diary
A simple record of each episode is one of the most useful things a family brings to follow-up. Note the date, the time of day, how long it lasted, what the child was doing beforehand, what the movements looked like, and how long recovery took. Add whether doses were missed and how the child had slept.
Over months this reveals patterns that are invisible in a single consultation, such as clustering around illness, poor sleep, or a particular time of day. It also gives an objective basis for deciding whether a medicine is working, rather than relying on recall of a frightening event.
Frequently asked questions
Will my child outgrow epilepsy?
Some childhood epilepsy syndromes do resolve with age, and many children eventually stop medication after a sustained seizure-free period. Whether that applies to your child depends on the seizure type, EEG findings and cause, which is what the assessment establishes.
Can my child go to a normal school?
Yes. Most children with epilepsy attend mainstream school. The school should be told what a seizure looks like for your child and what to do, and be given a copy of the action plan.
How long is too long for a seizure?
A seizure lasting more than five minutes is a medical emergency and needs immediate help. Time it from the start rather than estimating afterwards, because seizures almost always feel longer than they are.
Is epilepsy inherited? What about our other children?
Most children with epilepsy have no affected relative, and most parents of a child with epilepsy do not have it themselves. Some epilepsies do run in families, and for those the risk to a sibling is modestly higher than in the general population but still low. If several family members are affected, or the epilepsy began in infancy alongside developmental concerns, this is worth raising so genetic testing and counselling can be considered.
Can my child play sport, swim or cycle?
Most sport is encouraged, and the benefits of normal activity outweigh the risks for the majority of children. Swimming requires an adult who knows about the epilepsy watching directly, not general pool supervision. Cycling needs a helmet and, while seizures are uncontrolled, quieter routes away from traffic. Climbing at height and swimming alone are the activities that warrant genuine restriction.
What should the school be told?
Give the school a short written plan covering what your child's seizures look like, what staff should do, how long to wait before calling for help, who to contact, and any rescue medication with instructions. Also mention likely effects on concentration or tiredness, so a dip in schoolwork is understood rather than treated as inattention.
My child had one seizure. Does treatment start straight away?
Often not. After a single unprovoked seizure, many children are observed rather than treated, because a meaningful proportion never have another. Treatment is usually advised after a second seizure, or after a first if the EEG, imaging or examination indicates a high likelihood of recurrence. The reasoning is explained so the decision is made with you.
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Book an appointment
Consultations are by appointment at Huda, Sushant Lok 2, Sector 55, Gurugram. Tell us what is worrying you and the clinic will call you back.