UPMC Column: Pediatric Seizures - What Do They Mean

Caring for a child with seizures can be overwhelming, especially when you’re unsure of what to expect or how to help in a crisis. With proper support, you can feel more confident in managing your child’s condition and ensuring their safety.

What Do Seizures Mean in a Child?

Seizures in children are caused by disturbances in the brain’s electrical signals that temporarily interrupt normal brain function.

“Seizures in a child, in general, mean any episode of unresponsiveness where the child doesn’t respond to a parent’s touch and voice, and they stop doing what they were doing,” says Dr. Gull Zareen Sial, MD, a pediatric neurologist at UPMC Children’s Specialty Services in central Pa.

Seizures can be related to epilepsy, a neurological disorder characterized by recurrent, unprovoked seizures due to abnormal electrical activity in the brain. About 470,000 American children under the age of 14 have epilepsy. Seizures can also be provoked or caused by a known issue, such as head trauma, infection, low blood sugar, or electrolyte imbalances.

Types and Signs of Seizures in Children

Pediatric seizures can present in different ways, says Dr. Sial. Signs often depend on the type and cause of the episode.

Generalized seizures may arise from both sides of the brain. They can cause loss of consciousness and drowsiness, confusion, nausea, or heart rate fluctuation and headache after the seizure.

Symptoms may include:

Focal seizures, by contrast, happen when an abnormal electrical current arises from one side of the brain. They’re also called partial seizures.

Symptoms may include:

Causes of Seizures in Children

Primary factors that contribute to epilepsy include birth complications, such as lack of oxygen during birth or premature birth; brain injury, tumors, bleeding, and infection; electrolyte imbalances, such as abnormal levels of sodium, calcium, or magnesium; genetic factors and inherited metabolic disorders; high fever in young children; immune system dysfunction, which can lead to brain inflammation and seizures; and differences in brain structure.

Seizures can happen for a variety of reasons beyond epilepsy. In these cases, once the root cause is properly treated, children may never experience a seizure again. Some of the common causes of provoked seizures include fever, infections, stroke, low blood sugar, electrolyte imbalances, and more.

“Children are able to outgrow age-specific seizure disorders,” especially with proper treatment, says Dr. Sial. “Sometimes, the seizures might come back,” or require ongoing treatment, such as medication.

If Your Child Has a Seizure

“Witnessing a child have a seizure can be frightening, but it’s important to stay calm and take the right steps to ensure their safety,” says Dr. Sial. “Seizure first aid plays a crucial role in helping the child.”

It’s important to:

1. Stay calm and time it – Stay composed and start timing the seizure right away.

2. Ensure safety – Make sure the child is lying on their side to help keep their airway open and protect the child’s head without restraining them.

3. Never put objects in their mouth – Do not try to put anything in the child’s mouth during a seizure.

4. Monitor breathing – After the seizure, check if the child is breathing.

5. Stay with the child – Never leave a child alone during a seizure. Stay with them, even after the seizure ends, to offer comfort and monitor their recovery.

6. Record details – Write down the details of the seizure, such as the time it started, how long it lasted, the movements or behaviors observed, and any triggers.

7. Report – Report the episode to the child’s doctor or epilepsy specialist.

When to seek emergency help

Get emergency treatment if:

Diagnosis and Treatment

Neurologists often use blood tests, brainwave testing, and neuroimaging, such as MRI and CT, to differentiate between provoked and epileptic seizures. This helps guide the treatment.

Treatment includes addressing the cause of a seizure. If it is epileptic, the child may need daily antiseizure medication and rescue medication for seizures longer than five minutes.

Dr. Sial says it’s critical to monitor and treat seizures in small children immediately. “Sometimes, children can have seizures in the brain that you cannot see with your eyes,” she says.

“Once a child has a seizure, you want them to live as normal of a life as possible,” she says. “But I think the most important thing is there should be eyes on the child at all times at home and at school.”

Dr. Sial recommends looking to the Epilepsy Foundation, the American Academy of Neurology, and local organizations to find the support you need. If care is needed for your child, please talk to you pediatrician who can refer you to a pediatric neurologist. For more information about UPMC Children’s Specialty Services, please visit UPMC.com/CentralPaPediatrics.