December 5, 2016

What parents need to know about childhood seizure


A neurologist shares how parents can help their children during seizures and what steps to take next.

Parents who witness their children having seizures can feel helpless and afraid. We asked Kevin Ess, M.D., Ph.D., the director of Pediatric Neurology at Monroe Carell Jr. Children’s Hospital at Vanderbilt, to answer parents’ questions about how to handle a child’s first seizure.

Should I attempt first aid during a seizure, call 911 or take my child to the ER?

  • Remain calm. Seizures are scary, but your child is safer if you stay calm. In most cases, seizures last fewer than 5 minutes and usually stop on their own.
  • Roll your child onto his side.
  • Remove any objects your child might hit. Try to cushion the head.
  • Do not restrain or hold the child down.
  • Loosen any clothing around the child’s head and neck.
  • Do not put anything in the child’s mouth.
  • When the seizure is over, talk to your child gently and stay with her until she is well enough to return to usual activities.
  • It’s normal to be sleepy after a seizure. You may let the child sleep.
  • Do not give your child anything to eat or drink until he or she is awake and alert.

“We recommend calling 911 the first time a child has a seizure so that they can be acutely assessed and stabilized,” said Ess. After the event, it’s important to determine if the event was actually a seizure. An exam can find abnormalities that increase the risk for developing epilepsy or the possibility of future seizures.

Does a seizure mean my child has epilepsy?

A seizure does not necessarily mean your child has epilepsy. Many first seizures in children have a provoking cause, including fever, head injury, low blood sugar or dehydration. Seizures related to fever are common in young children and are usually outgrown by 5 or 6 years of age. Most of these children never have another seizure and do not need treatment.

If doctors cannot find a provoking cause or your child has a second unprovoked seizure separated by at least 24 hours, doctors recommend a follow-up exam to test for epilepsy or other conditions.

“We have a team of nationally recognized experts at Children’s hospital to diagnose seizures in children,” said Ess. “Families have rapid access to our night clinic. Children can also be assessed in our new onset seizure clinic, our daytime neurology clinic or the epilepsy monitoring unit. Forty percent of our patients see a doctor within five days.”

How will my child’s seizure be assessed during a clinic visit?

Your child will have an electroencephalogram, or EEG, to record brain activity. An EEG records the electrical activity of the brain and may help determine the potential for more seizures. An EEG is usually scheduled on the same day as the clinic visit, ideally before the visit.

We’ll ask you about medical history and perform a neurologic exam. It’s important for parents to provide details about the child’s seizure. It’s best if the person who witnessed the seizure writes down everything about the event as soon as possible.

Based on results from the EEG, medical history and exam, your child may be scheduled for a brain MRI to evaluate brain structure.

A child’s first seizure can be a scary event. The Pediatric New Onset Seizure Clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt can help. The hospital also has a four-bed pediatric epilepsy monitoring unit to accurately diagnose seizures in children and teens.

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