Epilepsy Explained: What Caregivers Need to Know About Seizures

A seizure can be frightening to witness, especially if you've never seen one before. But knowing what to look for and how to respond can make a significant difference. In this episode of For Kids’ Sake, M. Scott Perry, M.D., pediatric epileptologist at Cook Children's, explains the different types of seizures and how families can confidently support children living with epilepsy.

Q: What does a seizure look like?

Dr. Perry: Many people think of seizures as full-body shaking, but seizures can look very different from person to person.

Some common seizure types include:

· Tonic-clonic seizures (muscle stiffening followed by rhythmic jerking movements)

· Absence seizures (brief staring spells with a temporary loss of awareness)

· Myoclonic seizures (sudden, brief muscle jerks)

· Atonic seizures (sudden loss of muscle tone, sometimes causing falls)

· Focal impaired awareness seizures (impaired awareness, confusion, staring, or repetitive movements)

Because seizures can appear in many forms, some are easier to recognize than others.

Q: What should someone do if they witness a seizure?

Dr. Perry: Follow the "Stay, Safe, Side" approach:

• Stay with the person
• Keep them Safe by moving them away from hazards
• Place them on their Side

Placing someone on their side helps keep their airway clear and reduces the risk of choking.

Q: What should never be done during a seizure?

Dr. Perry: Never put anything in someone's mouth. Despite the common myth, a person cannot swallow their tongue during a seizure. Attempting to place an object in their mouth can cause injury or increase the risk of choking.

Q: What commonly triggers seizures?

Dr. Perry: Triggers vary by person, but common ones include:

• Lack of sleep
• Illness or infection
• Overheating
• Flashing lights (for some individuals)

Not every person with epilepsy will react to the same triggers.

Q: Should children with epilepsy have a seizure action plan?

Dr. Perry: Absolutely. Every person with epilepsy should have a seizure action plan developed with their health care provider.

The plan outlines:

• What to do during a seizure
• When to administer rescue medication
• When to seek emergency care
• When to call EMS

Q: When should caregivers seek emergency care?

Dr. Perry: Emergency evaluation may be appropriate if:

• It's the person's first seizure
• The seizure lasts longer than five minutes
• Rescue medication doesn't stop the seizure
• Recovery isn't progressing normally afterward
• The seizure occurs in water
• An injury occurs during the seizure
• The seizure appears significantly different from previous seizures

Q: Can seizures happen during sleep?

Dr. Perry: Yes. Certain forms of epilepsy are actually more likely to occur during sleep because of the way brain activity changes throughout sleep cycles.

Q: Does one seizure mean a child has epilepsy?

Dr. Perry: Not necessarily. Many people only experience a single seizure. Epilepsy is generally diagnosed when someone has multiple unprovoked seizures or when testing shows a high likelihood that seizures will continue.

Q: Can children still participate in activities after an epilepsy diagnosis?

Dr. Perry: In most cases, yes. Children should be encouraged to continue participating in activities, sports and social experiences whenever it is safe to do so.

The key is preparation:

• Share seizure action plans
• Educate caregivers and coaches
• Communicate openly about seizure safety

Q: What's one of the biggest misconceptions about epilepsy?

Dr. Perry: Many people assume flashing lights trigger seizures for everyone with epilepsy. While photosensitivity is real, only a small percentage of people with epilepsy are affected by flashing lights. Triggers are highly individualized.

Q: Can children outgrow epilepsy?

Dr. Perry: Some childhood epilepsy syndromes go into remission over time. However, it depends on the specific type of epilepsy, and not every child will outgrow seizures.

Final Thoughts

Dr. Perry: Epilepsy should not define a child's life. With education, a seizure action plan and the right support system, children with epilepsy can participate in school, activities, friendships and family life while remaining safe.