Pediatric Seizure Management: Tips for Parents and Caregivers

Children who suffer from birth injuries may be at a higher risk of experiencing seizures.
Brain damage that results in cerebral palsy may cause children to suffer from seizure disorders such as epilepsy. Learn more about pediatric seizure management.

Birth Injuries and Seizures

Seizures are caused by abnormal electrical activity in the brain and chemical changes in the nerve cells.

In some cases, seizure disorders such as epilepsy can be the result of a birth injury. Epilepsy, which is often linked to cerebral palsy, can cause frequent or infrequent seizures that range in severity.

Seizure disorders and birth injuries such as cerebral palsy cannot be cured, but they can be managed. Establishing a clear and effective pediatric seizure management plan is very important to prevent your child from experiencing frequent seizing episodes.

How Do I Know If My Child Is Having a Seizure?

An important part of pediatric seizure management is being aware of uncommon signs and symptoms of seizures, especially in infants.

The most common and well-known sign of a seizure is convulsions. Some children — especially infants — do not convulse. In turn, it may be difficult to know if and when your child is having a seizure. The University of California San Francisco Benioff Children’s Hospital provides a helpful list of symptoms to determine if your infant is having a seizure.

These symptoms include:

• Long pauses in breathing (apnea)
• Random or roving eye movements, eyelid blinking/fluttering, eyes rolling up, eye opening, staring
• Sucking, smacking, chewing, and protruding tongue
• Thrashing or struggling movements
• Unusual bicycling or pedalling movements of the legs

Other symptoms may occur depending on the type of seizure your child is experiencing.

For example, symptoms of clonic seizures include rhythmic jerking movements of the face, tongue, arms, and legs. Tonic (grand mal) seizures show signs of stiffening or tightening of the muscles, or turning the head to one side. Symptoms of myoclonic seizures include quick, single jerking motions involving one arm or leg or the whole body.

Breath-holding spells can often be mistaken for seizures. These spells happen when there is a clear trigger that the child is upset and is followed by crying, pallor, and a brief syncopal activity from decreased cerebral blood flow. Generally, the spells are rapid and can often be distinguished from seizures since they subside quickly.

Breath-holding spells are very common and can happen to children from 6 months to 6 years old. Since certain signs and symptoms of pediatric seizures can be difficult to identify, it is important to know the difference between a seizure and breath-holding spell.

What to Do If Your Child Is Having a Seizure

It is very crucial to be alert and to prevent the child from harming themselves during a seizing episode.

Follow these steps if you witness your child having a seizure:

• Place the child on their side to keep the throat clear and to drain any bodily fluids such as saliva or vomit.
• Do not hold the child down to try to stop the convulsions.
• Do not try to hold the child’s tongue. Some children may bite their tongue causing minor bleeding, but it does not cause any serious harm.
• Time the child’s seizure. If the seizing lasts over five minutes, they may require immediate treatment.
• During a seizing episode, move the child away from any potential hazards, such as open flames, furniture, stairs, traffic, etc.
• Stay with the child to monitor their safety until the seizure ends.

It’s okay if your child falls asleep after a seizing episode — it is important to allow their body to rest. When they wake up, reassure your child that they are safe, as they may be a bit shaken up.

After your child experiences a seizure, it is important to discuss a post-seizure care plan with their health care provider to determine if and when to call for emergency help. Your doctor may also want to administer additional anti-seizure medicine after an episode to prevent relapse.

What to Do in the Event of a Severe Seizure

Unfortunately, severe seizures require immediate care in emergency situations. It is important to know which situations require a call to 911.

Call an ambulance during these situations:

• If a seizure lasts more than five minutes (one person should monitor the child while another calls for emergency assistance)
• If the child is seriously injured during a seizure, such as falling and hitting their head
• If the child is having difficulty breathing and/or their skin is blue
• If another seizure immediately occurs or if the child is unconscious after the first seizure

Status epilepticus are seizures that last over ten minutes or clusters of seizures in which a child does not awaken. It is important that you do not attempt to drive a child with status epilepticus to the hospital. These types of seizures require immediate medical attention and ambulance transportation.

If your child has a history of status epilepticus, your doctor may suggest having emergency treatment at home to treat severe seizures.

Living With Seizures

Children living with a birth injury and epilepsy may have to live differently than other children to avoid harm that may trigger a seizure. Besides the use of medication, there are several ways children with birth injuries can manage their seizures.

If your child is able to eat orally without a feeding tube, switching to a ketogenic diet may help decrease the frequency of seizures. According to Angus Wilfong, MD, ketogenic diets have been used as a treatment for some children who do not respond well to anti-seizure drugs. The ketogenic diet consists of high fat, relatively low carbohydrates, and adequate protein.

Though the diet is not a cure, it lowers the likelihood of seizures by at least 50% in approximately 40% of patients. The diet works particularly well with children ages one to ten years-old.

Another vital factor in pediatric seizure management for children with birth injuries is avoiding harm. If your child is able to move freely, it is important to avoid any activities that may trigger a seizure. Parents should consider having their children avoid activities at heights, such as climbing trees or ropes. This will prevent any serious falls that may trigger a seizure.

It is important to supervise a child who suffers from seizures around water, including bathtubs, beaches, and pools, to prevent drowning.

Your child should also wear a medical identification bracelet or necklace, especially if they are non-verbal or unable to explain their condition. This can help responders give proper treatment immediately during a seizing episode.

Will My Child’s Seizures Get Worse With Age?

Both cerebral palsy and epilepsy do not necessarily better or worsen over time. That said, signs and symptoms of seizures may change as your child ages. Seizures in infants have specific unrecognizable symptoms, but your child may show common signs of seizures such as convulsing as they get older.

Proper treatment and proactive prevention through medications and lifestyle changes can decrease the frequency of episodes. In some severe cases, your child may require surgery to lessen the frequency of seizures.

If you have any additional questions about pediatric seizure management or birth injuries, contact our team today to learn more.