What to do if a child has an unexpected seizure

Seeing your child have a seizure is scary. No matter how big or small, subtle or intense it might be, it can still be enough to put a parent into emergency mode and assume something is horribly wrong.

While a seizure certainly can be indicative of a serious condition — and injuries can occur during the seizure itself — there are times when it’s not necessarily a cause for major concern. For example, it can be quite common for children of a certain age to have febrile seizures, which are those associated with a fever. Much of my time seeing patients after their first seizure is spent reassuring the child and their parents that they will be OK. At times, no further testing is needed and seizure medications are not necessary. Having a single seizure doesn’t necessarily point toward a diagnosis like epilepsy, and there are actually many seizures that have no discernible cause at all.

What is a seizure?

A seizure results from abnormal electrical activity in the brain; sometimes that activity is too much and other times it is not active enough. This abnormal activity is not under the control of the child, and there is nothing a parent or anyone else can do to make it stop or to change it.

There are seizures that result in violent shaking, but others are much milder to the point where they can hardly be noticed at all. Someone having a seizure could — among other things — stare off into space for a while, have twitching/shaking in one or more parts of their body, experience unusual feelings or sensations (including taste and hearing), or abruptly stop what they’re doing and freeze.

If a seizure happens

Regardless of whatever type they are, most seizures stop on their own within one to three minutes. The most important thing to do during this time is to keep your child safe. The best way to do that is to keep calm and remember these steps:

• Do not try to stop the movements or restrain them in any way.
• Clear any hard, sharp or hot objects from the area. If your child is walking around, gently lead them away from potential dangers like doors or stairs.
• If your child is on the ground, turn them on their side to allow any saliva or vomit to come out of their mouth.
• Do not attempt to put anything in your child’s mouth or between their teeth.
• Stay with your child until the seizure is over and they can respond when you talk to them. It is normal for your child to be very sleepy after a seizure, and it’s OK to go ahead and let them sleep.

What’s next?

If your child’s seizure lasts longer than five minutes, or if they have multiple seizures in a row without waking up, call 911. If it is their first seizure, you should take them to the emergency room to be evaluated to make sure there isn’t a bigger problem (such as a bad infection or low blood sugar, for example). Otherwise, make an appointment for them see their primary care doctor. They may then be referred to a specialist who will try to determine a cause and plan of action if treatment is necessary.

Children can have seizures for many different reasons, and they can mean many different things. So if you’re faced with this situation, be sure to keep as calm as possible, and try to keep track of how long the seizure lasted and what the event looked like.

Katie Ricciardi, PA-C Physician Assistant Neurosciences Center

The Children’s Wisconsin Neurosciences Center is the largest and most comprehensive pediatric neurosciences center in the state and ranks among the nation’s best by U.S. News & World Report. The center combines excellent clinical care for your child with innovative research, while advancing the development of pediatric neurological and neurosurgical treatment options.