When Minutes Feel Like Hours: Recognizing and Responding to Your Child’s First Seizure

Every year, 25,000 to 40,000 children in the United States will experience their first seizure. Would you recognize a seizure if you saw one? Would you know what to do if you witnessed a seizure?

The brain is the control center of the body. The brain uses electrical impulses to communicate within itself and to send messages throughout the body. A seizure occurs when something disrupts the flow of electrical impulses and the wrong messages are sent throughout the body.

Seizures can occur suddenly and appear just as you imagine they would. They might follow an illness or episode of high fever, or could seem to occur out of the blue. Some of the more subtle types of seizure could appear as repeated unusual behaviors or a pattern of the same behaviors happening around bedtime or when your child or infant is waking up. In these cases, it can be easy to question if you are witnessing a seizure. To confuse you further, seizures in infants can look different from seizures in older children and can mimic other medical conditions. The way a seizure appears depends upon the cause of the seizure, the part of the brain sending out the wrong messages, and the age of the individual.

Possible Signs of Seizure

(A combination of some of these signs might be present, or there might be just one.)

• Staring, kind of “zoning out”, some might resume activity as if nothing happened.
• Chewing or smacking the lips involuntarily.
• Moving the hands, arms, and legs in strange ways or in quick jerks.
• Arching the back.
• Making meaningless sounds.
• Not understanding what other people are saying.
• Have severe muscle spasms and jerking throughout the body.
• Suddenly falling down.
• Forcefully turning the head to one side.
• Clenching the teeth.

What to Do If You Witness a Seizure

• If the child is sitting or still standing, guide them to the floor so they don’t fall.
• Position them on their side (will help prevent choking).
• Remove furniture and any objects from around them so they do not injure themselves.
• Place a pillow or soft object under their head, or gently hold it to protect them from injury.
• Loosen tight clothing.

What Not to Do During a Seizure

• Do not stick anything into the mouth – they will not swallow their tongue.
• Do not try to stop or control any of their body movements.
• Do not try to shake or slap awake somebody who suddenly zones out (especially infants and toddlers!).
• Do not start CPR during a seizure – the heart does not usually stop during a seizure and a person is usually still breathing.
• Do not leave an individual alone until help arrives.

When to Call 911

• If it’s your child’s first seizure.
• If possible seizure behavior lasts more than 5 minutes.
• If seizure-like behaviors are repeated.
• If a seizure happened in water.
• If you do not know the history of the individual seizing.
• If you suspect an injury occurred during the seizure.
• If you see blueness around the infant or child’s nose, lips, and mouth.
• If there is a loss of consciousness.
• If the person seizing is pregnant.
• If you’re scared and don’t know what to do.

After the Seizure Ends

• Stay with the person until trained emergency personnel arrive, even if they seem normal and insist they are okay.
• Only a trained provider should determine if CPR is needed in case of a loss of consciousness.
• Try to keep a sleepy or confused child lying quietly on their side.
• Be prepared to handle the effects of:
• Biting the tongue.
• Drooling or frothing at the mouth.
• Losing bowel or bladder control.
• Trauma such as broken bones or cuts.

Other Ways to Help During a Seizure

• Respect their dignity – don’t be a “Lookie-Lou”.
• Calmly take other children to an area where they cannot see or hear what is happening, provide reassurance and distractions as needed.
• Secure pets out of the way.
• If necessary, unlock doors or gates and wait outside to guide paramedics to the scene.

Observations are vital during a seizure, write down notes about:

• Time the seizure began and ended.
• If the child did or said anything unusual before the seizure started.
• What the seizure looked like.
• If the infant or child was eating or drinking when the seizure began.
• Any suspected injury.
• How long a loss of consciousness lasted.
• If the seizure activity was repeated before consciousness returned.

Remain Calm, Keep Your Child Safe

Take comfort from the words of Dr. Katherine Nickels, M.D., Pediatric Neurologist at the Mayo Clinic in Rochester, Minnesota. “Although seeing your child have a seizure may be frightening, it is important to remember that brief seizures do not cause harm to the brain. The vast majority of seizures are brief, lasting less than 5 minutes. Furthermore, only half of the children who experience a first seizure will go on to have a second seizure or develop epilepsy.”

A first seizure can be an unmistakable medical emergency or it can be subtle and unusual behaviors that leave you questioning what you are seeing. If you are witnessing an emergency, don’t hesitate to call 911 and keep the operator on the line. Emergency operators are trained to help you stay calm, walk you through the above steps, and to help you make critical observations that will help doctors determine the cause of the seizure and if treatment is needed. If you are concerned but uncertain if your infant or child might be having seizures, call your pediatrician. A good pediatrician would rather discuss your fears then let seizures go undiagnosed. In either situation, the main thing to remember is to remain calm and keep your child safe until trained emergency personnel arrive or until the next step of diagnosis and treatment is begun.

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