Epilepsy In Children

Epilepsy In Children

Epilepsy is the name of a group of disorders. Children with epilepsy have epileptic seizures.

Key points to remember about epilepsy in children

  • an epileptic seizure happens when your child's brain has abnormal electrical activity that causes unusual movements, behaviour or funny feelings
  • although seizures can be frightening and awful to watch, most stop on their own
  • when children have more than one epileptic seizure, this may result in a diagnosis of epilepsy

What is epilepsy?

Epilepsy is the name of a group of disorders. Children with epilepsy have epileptic seizures.

Epilepsy is quite common. It affects 1 in every 200 children.

Anti-epileptic medicines are usually very effective in controlling seizures.

What are epileptic seizures?

Our brains think and control our bodies using electrical messages. An epileptic seizure happens when there is abnormal electrical activity in your child's brain. This can cause unusual movements, behaviour or funny feelings. Normal brain function cannot continue until this abnormal electrical activity stops.

Types of seizures

Sometimes this abnormal electrical activity starts only in certain areas of the brain, which is why only certain body parts may twitch or shake. These types of seizures are called focal seizures.

When the start of the abnormal electrical activity involves the whole brain these seizures are called generalised seizures.

Some seizures can be quite subtle. For example, a seizure may involve only blank staring for a few seconds. Seizures can also sometimes be quite bizarre and children can have quite inappropriate behaviour or feel very scared. Other seizures have obvious movement changes where one part or the whole body can go stiff and/or jerk quite violently. 

For more detail see Types of epileptic seizures.

Some older children may experience an unusual feeling called an 'aura' which is the start of a seizure. You may notice this before a more obvious epileptic seizure. This feeling may be a funny smell, a headache, a taste in their mouth or a stomach pain. If they have an 'aura' at the beginning of their seizures they may have time to tell you how they feel. Or, they may be able to lie on the floor so they are less likely to injure themselves.

Seizures can be frightening but remember they will stop

It may seem like the epileptic seizure goes on forever but most epileptic seizures last less than 5 minutes. Although they can be very frightening and awful to watch, epileptic seizures that last less than 5 minutes do not cause any damage to the brain.

What can trigger an epileptic seizure?

There are some environmental influences such as flashing lights or deep breathing that can trigger an epileptic seizure in some types of epilepsy. Tiredness, illness, fever, stress or excitement can also increase the chance of an epileptic seizure.

It is important that you know what to do if a major seizure should ever happen.

Can my child's seizure type change?

Even though your child experiences their own particular kind of seizure, seizure types can change from time to time. So it is important that you know what to do if a major seizure should ever happen.

See Types of epileptic seizures.

Why does my child have epilepsy?

The cause of most epilepsy is genetic. The genetic abnormality that causes epilepsy in your child may be an inherited genetic change and other members of the family may also have epilepsy. Or, it may be a genetic change only in your child with epilepsy.

Epilepsy can also happen when there is an injury to the brain cells such as:

  • a severe injury to the head
  • an infection in the brain like meningitis
  • an infection during pregnancy which has affected the growing brain

When should I seek help for my child with epilepsy?

See Seizure first aid for advice about what to do during and after your child's seizure.

Will my child need tests and investigations after an epileptic seizure?

A boy being prepared for an EEG.

If your doctor thinks your child has had an epileptic seizure, they will contact the paediatric department at your local hospital. The hospital doctor who sees your child may arrange for some tests.

Electroencephalogram or EEG

If your child has had an epileptic seizure they may need an electroencephalogram (EEG). An EEG is a recording of their brain's electrical activity. Your child can have an EEG as an outpatient. They don't need to stay in hospital. See the EEG page.

Boy about to have an MRI with his brother and the radiologist looking on.

Magnetic resonance imaging or MRI

Your child may also need an MRI scan to look at the structure of the brain. Whether your child needs an MRI will depend on the type of seizure they have and the results of the EEG. See the MRI page.

Will my child need to take medicine for epilepsy?

The aim of anti-epileptic medicines is to prevent epileptic seizures.

There are many different kinds of anti-epileptic medicines for children with seizures. Each one works differently to prevent seizures.

See the page on anti-epileptic medicines.

Will my child need rescue medicine for epileptic seizures?

If your child has had an epileptic seizure which lasted for more than 5 minutes, your doctor may prescribe medicine to stop a long seizure. This is called 'rescue' medicine and comes in 2 forms:

  • midazolam - you give this into your child's cheek
  • diazepam (Stesolid) - you give this to your child in their bottom (rectal diazepam)

After you have given the medicine, if your child's seizure continues for a further 5 minutes please call an ambulance. While you are waiting for the ambulance, continue to lie your child on their side in the recovery position and stay with them.

You may need to teach other people who care for your child how to use this medicine. This might include your child's teacher. 

What is status epilepticus?

Status epilepticus is the name for seizures that go on for a long time (30 min or more).

It is either:

  • a single seizure that continues non-stop or
  • many seizures happening one after the other without the child recovering in between

Long seizures can be bad for the brain. It is unclear exactly how long a seizure needs to be to cause damage but it is likely to be 60 min or more.

Call an ambulance if your child's epileptic seizure lasts for more than 5 minutes. Your child can receive further treatment in hospital.

If your doctor has prescribed rescue medicine, use it for any seizure that lasts for more than 5 minutes.  

After you have given the medicine, if your child's seizure continues for a further 5 minutes please call an ambulance. While you are waiting for the ambulance, continue to lie your child on their side in the recovery position and stay with them.

The majority of children will not experience 'status'. It is not clear why some children get status epilepticus. It depends on their type of epileptic seizure, how well medicine controls their seizures and the reason for their epilepsy.

Can my child die from epilepsy?

Sudden unexplained death in epilepsy (SUDEP) is a very rare but sad event. In any 1 year, it affects 1 in 4,500 children with epilepsy. In other words, every year, 4,499 of 4,500 children will not die from epilepsy. The best way to prevent SUDEP is to stop convulsive seizures and this is one of the reasons your doctor may recommend anti-epileptic medicine for your child.

Call Epilepsy New Zealand for support - 0800 37 45 37.

Who can I contact for more information about epilepsy or for help?

Epilepsy New Zealand has educators who can answer any questions you may have and can act as a support person for you. You can contact your local educator at 0800 37 45 37.

What about safety for my child with epilepsy?

Your child's healthcare team will give you advice about increasing safety for your child with epilepsy. The advice will depend on the type and frequency of your child's seizures. 

See Safety for children with epilepsy.

The content on this page has been developed and approved by the Paediatric Neurology Clinical Network, Paediatric Society New Zealand.

This page last reviewed 08 July 2018.
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