Seizure management

Seeing your child having a seizure may be frightening, but the majority of seizures do not cause any harm. The advice below will help you to provide seizure management and first aid.

What to do depends on the type of seizure.

Absence seizures

Absence seizures can often be overlooked by parents or teachers, as children might be mistaken for day dreaming.

A child having an absence seizure will lose consciousness for a few seconds and will not be aware of their surroundings. They will stop what they were doing before the seizure started and will return to what they were doing once the seizure has ended.

Absence seizures are usually short, lasting only a couple of seconds before self resolving.

If a child has an absence seizure, please:

• be calm and reassuring
• guide them away from any danger, especially if they are having repeated absences
• stay with them until they are fully recovered
• explain anything they may have missed

If you can, make note of the number of absence seizures a child has during a day so that this information can be given to their doctor.

Focal seizure

A focal seizure happens when the epileptic activity happens in just one part of the brain. The symptoms are usually, but not always, only on one side of the body.

Focal seizure symptoms include:

• jerky movements
• odd sensations
• feeling afraid or anxious
• appear dazed
• feeling confused
• unable to communicate properly
• wandering around
• repeated strange or purposeless movements

If a child has a focal seizure, please:

• time the seizure from the start
• make sure the area is safe for the child and yourself
• talk to them and offer reassurance
• repeat any information they may have missed during the seizure

Drop seizures

Some children may drop or fall to the ground during a drop seizure. Your child may be stiff or floppy. Recovery is usually quick, although it is possible for someone to hurt themselves when they fall to the ground. Please make sure to check your child for any injuries following a drop seizure.

A protective helmet may be necessary for children who have very frequent drop seizures.

Tonic-clonic seizures

Tonic-clonic seizures are convulsive seizures most commonly associated with epilepsy. At the start of the seizure, your child may cry out, then stiffen and fall to the ground. Their arms and legs will jerk quickly and rhythmically. Your child may be incontinent or bite their tongue during this type of seizure.

When a tonic-clonic seizure stops, your child will usually take a deep breath and their colour will return to normal. If they want to sleep after a seizure, let them. They will recover in their own time.

Rescue medication

Some children with a history of longer seizures may be prescribed rescue medication. This can either be buccal midazolam, rectal diazepam, or rectal paraldehyde.

The doctor will give instructions on the use of rescue medication. An epilepsy nurse will explain how it should be given to your child.

When to call for an ambulance?

The following advice applies to children who have tonic-clonic seizures who are not prescribed rescue medication.

Parents and carers of a child who has been prescribed rescue medication should follow the advice in your child’s protocol.

The recovery position

This position makes sure that:

• your unconscious child maintains an open airway
• their tongue cannot fall to the back of their throat
• their head and neck are extended so their air passage is widened
• any saliva or vomit in their mouth will drain freely
• their arms and legs are stable and keep their body propped up in a safe and comfortable position