Seeing your child have a seizure can be frightening, especially if you do not know why it happened or whether it may happen again. Having one seizure does not necessarily mean that your child has epilepsy.
Epilepsy is a neurological condition in which a person has an enduring tendency to have epileptic seizures. Seizures can look different, from jerking or stiffening to staring or brief unresponsiveness, but with the right specialist care, many children can achieve good seizure control and continue to enjoy everyday life.
Key Takeaways
- A single seizure does not automatically mean your child has epilepsy.
- Seizures can involve obvious jerking or stiffening, but some cause only staring, brief unresponsiveness or unusual sensations.
- Call 999 for a first seizure, a seizure lasting longer than usual or more than five minutes when the usual duration is unknown, repeated seizures without recovery, three or more seizures within 24 hours, serious injury or breathing difficulty.
- Diagnosis is based on the history of the episode and specialist assessment, supported by tests such as EEG or MRI when appropriate.
- Treatment is individualised according to your child’s seizure type, epilepsy syndrome and other health needs.
- Never stop or change your child’s anti-seizure medicine without specialist advice.
What Is Epilepsy in Children?
Epilepsy is a condition affecting the brain that causes a tendency to have epileptic seizures. A seizure happens when there is a temporary change in the brain’s electrical activity, which can affect your child’s movement, awareness, behaviour or sensations.
Epilepsy can begin at any age in childhood, but its symptoms can vary depending on your child’s age, the area of the brain involved and the type of epilepsy. Understanding the seizure type and any related epilepsy syndrome helps doctors choose the right investigations, treatment and follow-up for your child.
What Happens During an Epileptic Seizure?
During an epileptic seizure, unusual electrical activity temporarily affects how your child’s brain works. Depending on where the activity starts and how it spreads, your child may remain aware, become confused or lose awareness.
You may notice stiffening, jerking or twitching, while some seizures cause less obvious changes in sensation, behaviour or emotions. After the seizure, your child may recover quickly or feel sleepy, confused, upset or weak, and noting what happens before, during and after the episode can help their medical team.
What Are the Different Types of Seizures in Children?
Seizures are classified according to their clinical features and what is known about where they begin in the brain. Current international classification includes four main groups: focal, generalised, unknown whether focal or generalised, and unclassified seizures.
Focal seizures begin in networks on one side of the brain and can cause changes in movement, sensation, behaviour or consciousness. Generalised seizures rapidly involve networks on both sides of the brain and can include absence, myoclonic, tonic, atonic and generalised tonic-clonic seizures. Sometimes there is not enough information at first to determine whether a seizure is focal or generalised, and its classification may become clearer after further assessment.
What Causes Epilepsy in Children?
There is no single cause of childhood epilepsy, and sometimes doctors cannot identify a definite reason even after appropriate tests. Possible causes include genetic factors, changes affecting brain development or structure, infections affecting the brain, significant head injuries and strokes.
A genetic cause does not always mean epilepsy has been inherited directly from a parent. Understanding the likely cause can help your child’s doctor plan treatment, discuss their outlook and decide whether further tests or genetic counselling may be helpful.
Is Childhood Epilepsy Genetic?
Genetics can play a role in some types of childhood epilepsy, but this does not simply mean that epilepsy always runs in families. Genetic changes may be inherited or may occur for the first time in your child, affecting how likely their brain is to develop seizures.
Having a family member with epilepsy does not mean your child will definitely develop it, and genetic epilepsy can occur without any family history. Your child’s specialist may recommend genetic testing in certain situations, such as very early-onset epilepsy or features suggesting a specific genetic syndrome.
What Symptoms of Epilepsy Should Parents Look For?
Some seizures are easy to recognise, but others can be much less obvious. You may notice repeated staring, brief unresponsiveness, unexplained falls, sudden jerking, unusual movements or changes in behaviour.
Your child may also experience confusion, unusual sensations or episodes during sleep, such as repeated movements or unexplained waking. These signs do not always mean epilepsy, so recurrent or concerning episodes should be discussed with your child’s doctor.
Does Every Seizure Mean a Child Has Epilepsy?
No, having a seizure does not necessarily mean that your child has epilepsy. Febrile seizures, for example, can happen in young children with a fever and usually do not mean they have epilepsy, while illness or other temporary changes can also trigger seizures.
Some events, such as fainting or certain sleep and movement disorders, can look like epileptic seizures without actually being epileptic seizures. If your child has a suspected first seizure, an eyewitness account or video recording can help their specialist understand what happened. Only record the episode if it is safe to do so, and never delay seizure first aid or emergency help in order to film it.
Myth vs Fact
| Myth | Fact |
| Every seizure means a child has epilepsy. | A single seizure does not automatically mean epilepsy. Fever, illness and other conditions can cause seizures or seizure-like episodes, so specialist assessment is important. |
| All epileptic seizures involve shaking or convulsions. | Some seizures are much less obvious and may cause staring, brief loss of awareness, unusual sensations, repetitive movements or sudden changes in behaviour. |
| You should hold a child still during a convulsive seizure. | Do not restrain your child. Move hazards away, protect their head where possible and allow the seizure to run its course while following appropriate first aid guidance. |
| You should put something in a child’s mouth to stop them biting their tongue. | Never put anything in your child’s mouth during a seizure. This can cause injury or interfere with breathing. |
| A normal EEG means a child cannot have epilepsy. | A normal EEG does not rule out epilepsy. Diagnosis depends on the overall clinical picture, and additional or longer recordings may sometimes be required. |
| Children with epilepsy cannot take part in normal activities. | Many children can attend school, exercise and enjoy social activities. Some activities require individual safety planning depending on seizure type and control. |
What Should You Do If Your Child Has a Seizure?
During a convulsive seizure, focus on keeping your child safe and note when the seizure starts. Move nearby hazards away, protect their head with something soft if possible, and do not try to restrain their movements or put anything in their mouth.
Once the movements stop, place your child in the recovery position when it is safe and stay with them while they recover. Do not give food or drink until they are fully alert, and if your child has diagnosed epilepsy, follow their individual seizure care plan, including any prescribed emergency medication.
Clinical Tip
If your child has recurrent seizures, keeping a record of the date, duration, symptoms and recovery period can help their specialist identify patterns. Information from someone who witnessed the episode may also help your child’s specialist understand what happened.
When Does a Seizure Need Emergency Medical Help?
A first suspected seizure should always be taken seriously, and NHS guidance advises calling 999 if you believe your child is having a seizure for the first time. You should also call 999 if the seizure lasts longer than is usual for your child, or longer than five minutes if you do not know how long their seizures usually last. Call 999 as well if another seizure occurs before your child has recovered. You should also call 999 if your child has had three or more seizures within 24 hours.
Call 999 if your child has difficulty breathing, is seriously injured, does not regain full consciousness or does not recover as usual after the seizure. If your child already has epilepsy, follow their personalised care plan, which should explain when emergency medication or further medical help is needed.
UK Guidance Note
After a first suspected seizure, your child should be referred urgently for specialist assessment even if they have recovered fully. NICE recommends that children with a first suspected seizure are referred for assessment by a clinician with expertise in epilepsy and first seizures, with an appointment within two weeks.
The specialist will decide which investigations are appropriate. If an EEG is requested after a first seizure, NICE recommends carrying it out as soon as possible, ideally within 72 hours. An EEG can support diagnosis but should not be used on its own to rule epilepsy in or out.
How Is Epilepsy Diagnosed in Children?
There is no single test for childhood epilepsy, so your child’s assessment usually begins with a detailed discussion about what happened during the suspected seizure. Their specialist may ask about what happened before, during and after the episode.
Your child’s medical history and neurological examination will also be considered, with NICE recommending a 12-lead ECG after a first suspected seizure to check for heart conditions that can look like seizures. An EEG, brain imaging, blood tests or genetic testing may also be used when needed.
What Tests Might Your Child Need?
An EEG records your child’s brain activity using small electrodes placed on the scalp and can help doctors identify or classify epilepsy. A normal EEG does not rule out epilepsy, so longer or additional recordings may sometimes be needed depending on your child’s symptoms.
Other tests may include an MRI to look for structural changes in the brain, an ECG to check for heart rhythm problems and blood tests to investigate other possible causes. Genetic testing may also be considered when a genetic epilepsy syndrome is suspected, with your child’s specialist explaining why each test is recommended.
How Is Epilepsy in Children Treated?
Treatment is tailored to your child, depending on their seizure type, epilepsy syndrome, age and other health needs. Anti-seizure medicines are commonly used, with treatment adjusted to control seizures and manage possible side effects.
For some children, the first medicine controls seizures well, while others may need a different medicine or a combination of medicines. Sodium valproate has specific UK safety measures because of reproductive risks. Under current MHRA guidance, before valproate is started in a patient under 55, two specialists must independently agree that other suitable treatments are not effective or tolerated and that the benefits outweigh the risks. Never change or stop your child’s medicine without specialist advice.
What Happens If Medicines Do Not Control the Seizures?
Some children continue to have seizures despite taking suitable medicines, and further specialist assessment may then be needed. This can include referral to a tertiary epilepsy service to explore other treatment options, such as dietary therapy, epilepsy surgery or other specialist approaches.
A ketogenic diet may help some children with drug-resistant epilepsy but must be supervised by a specialist team. For selected children, epilepsy surgery or vagus nerve stimulation may also be considered after detailed assessment, so ongoing seizures do not necessarily mean that there are no further treatment options.
Research Insight
Research suggests that ketogenic dietary therapy can help some children whose seizures have not responded adequately to medicines. A 2024 review and meta-analysis included 11 randomised trials involving 788 children with drug-resistant epilepsy and found that ketogenic dietary approaches were associated with improved seizure outcomes.
However, dietary therapy can also cause side effects and requires careful nutritional planning. A ketogenic diet for epilepsy is therefore a medical treatment rather than an ordinary weight-loss diet and should be started and monitored by an experienced epilepsy and dietetic team.
Can Anything Trigger Your Child’s Seizures?
A seizure trigger is different from the underlying cause of epilepsy. It is something that may make a seizure more likely in a child who is susceptible to seizures. Common triggers can include lack of sleep, illness, fever, stress or missed doses of anti-seizure medicine, although they vary from child to child.
Keeping a seizure diary can help you spot possible patterns by recording seizures alongside sleep, illness and medication changes. You do not need to restrict your child’s everyday activities unnecessarily, but taking prescribed medicine consistently and managing any known triggers may help support better seizure control.
How Can Epilepsy Affect School and Everyday Life?
Epilepsy can affect more than your child’s physical health, and you may have concerns about school, sport, swimming, sleepovers or becoming more independent. Your child’s school should understand their condition and know what to do during a seizure, including following their individual care plan if emergency medicine has been prescribed.
Most children should be encouraged to enjoy education, exercise and social activities where these can be done safely. Swimming and water sports should be appropriately supervised, while activities involving heights may require additional precautions depending on your child’s seizures. Changes in concentration, mood, memory or energy should also be discussed with your child’s clinical team.
What Is the Long-Term Outlook for a Child with Epilepsy?
The outlook for childhood epilepsy varies, with some types improving as your child gets older while others may need longer-term treatment and monitoring. Seizure control, your child’s development, the underlying cause and any other health conditions can all influence what you can expect.
Regular follow-up helps the clinical team review seizures, treatment, development and wellbeing as your child grows. After your child has been seizure-free for two years, their specialist may assess whether gradually reducing treatment is appropriate based on their individual risk of seizures returning. Your child’s clinical team should also discuss epilepsy-related risks, including SUDEP, and explain the importance of taking anti-seizure medicines as prescribed.
Frequently Asked Questions
1. Does having a seizure mean my child has epilepsy?
No. A single seizure does not necessarily mean your child has epilepsy. Some seizures can happen because of temporary factors such as fever or illness, while other conditions can cause episodes that look like seizures but are not epileptic seizures.
2. What are the most common signs of epilepsy in children?
Signs can include staring spells, brief periods of unresponsiveness, stiffening, jerking, sudden falls, unusual movements or changes in awareness. Some seizures are subtle, so recording what happens before, during and after an episode can help your child’s doctor assess it.
3. What should I do if my child has a seizure?
Keep your child safe by moving nearby hazards away and protecting their head with something soft. Do not restrain them or put anything in their mouth, and once the seizure has stopped, place them in the recovery position when it is safe to do so.
4. When should I call 999 if my child has a seizure?
Call 999 if you believe your child is having a seizure for the first time, if the seizure lasts longer than is usual for them, or longer than five minutes if you do not know their usual seizure duration. You should also call 999 if another seizure occurs before they have recovered, if they have had three or more seizures within 24 hours, if they have breathing difficulties or a serious injury, or if they do not recover as usual afterwards. If your child already has epilepsy, follow their individual seizure care plan.
5. How is epilepsy diagnosed in children?
Diagnosis usually involves a detailed account of what happened during the suspected seizure, along with your child’s medical history and neurological assessment. Depending on the circumstances, your child may have an EEG, MRI scan, ECG, blood tests or genetic testing.
6. Can children with epilepsy become seizure-free?
Yes, some children become seizure-free as they get older and may eventually be able to gradually reduce or stop medication under specialist supervision. The outlook varies according to the type and cause of epilepsy, the child’s development and how well their seizures respond to treatment.
7. Can my child still go to school and take part in activities with epilepsy?
Yes. Most children with epilepsy can attend school, exercise and take part in social activities, although some activities may require additional safety measures. Your child’s school should understand their condition and know what to do if a seizure occurs.
8. What can trigger seizures in children with epilepsy?
Triggers vary between children but may include lack of sleep, illness, fever, stress or missed doses of anti-seizure medicine. Keeping a seizure diary can help you identify patterns and discuss possible triggers with your child’s specialist.
9. What happens if anti-seizure medicines do not control my child’s epilepsy?
If seizures continue despite appropriate medicines, your child may be referred to a specialist epilepsy service for further assessment. Depending on their epilepsy, options may include dietary therapy, epilepsy surgery, vagus nerve stimulation or other specialist treatments.
10. Can children outgrow epilepsy?
Some childhood epilepsy syndromes improve or resolve as children get older, while other forms require longer-term treatment and monitoring. Your child’s specialist can give you a more personalised idea of their outlook based on their seizure type, epilepsy syndrome, underlying cause and response to treatment.
Final Thoughts: Supporting Your Child with Epilepsy
A diagnosis of epilepsy can feel overwhelming at first, but understanding your child’s seizures, treatment options and individual care needs can make the condition easier to manage. With the right specialist support, regular follow-up and a clear seizure care plan, many children with epilepsy can continue learning, playing and taking part in everyday activities.
Your child’s epilepsy may change as they grow, so ongoing monitoring is important. If you’re considering children’s epilepsy treatment in London, you can get in touch with us at London Paediatric Clinic.
References
- National Institute for Health and Care Excellence (NICE) (last updated 5 August 2026) Epilepsies in children, young people and adults. NICE guideline NG217. Available at: https://www.nice.org.uk/guidance/ng217
- NHS (2025) Epilepsy. Page last reviewed: 6 March 2025. Available at: https://www.nhs.uk/conditions/epilepsy/
- NHS (2023) What to do if someone has a seizure (fit). Page last reviewed: 19 December 2023. Available at: https://www.nhs.uk/symptoms/what-to-do-if-someone-has-a-seizure-fit/
- NHS (2023) Febrile seizures. Page last reviewed: 21 June 2023. Available at: https://www.nhs.uk/conditions/febrile-seizures/
- Medicines and Healthcare products Regulatory Agency (MHRA) (2025) Valproate – reproductive risks. GOV.UK. Published 10 June 2025, updated 23 September 2025. Available at: https://www.gov.uk/guidance/valproate-reproductive-risks
- Lee, S., Karp, N., Zapata-Aldana, E., Sadikovic, B., Yang, P., Balci, T.B. and Prasad, A.N. (2021) ‘Genetic testing in children with epilepsy: Report of a single-center experience’, Canadian Journal of Neurological Sciences, 48(2), pp. 233–244. Available at: https://pubmed.ncbi.nlm.nih.gov/32741404/
- Mustafa, M.S., Shafique, M.A., Aheed, B., Ashraf, F., Ali, S.M.S., Iqbal, M.F. and Haseeb, A. (2024) ‘The impact of ketogenic diet on drug-resistant epilepsy in children: A comprehensive review and meta-analysis’, Irish Journal of Medical Science, 193(3), pp. 1495–1503. Available at: https://pubmed.ncbi.nlm.nih.gov/38315271/
- Dwivedi, R. et al. (2017) ‘Surgery for drug-resistant epilepsy in children’, The New England Journal of Medicine, 377(17), pp. 1639–1647. Available at: https://pubmed.ncbi.nlm.nih.gov/29069568/
- Whitney, R., Sharma, S. and Ramachandrannair, R. (2023) ‘Sudden unexpected death in epilepsy in children’, Developmental Medicine & Child Neurology, 65(9), pp. 1150–1156. Available at: https://pubmed.ncbi.nlm.nih.gov/36802063/
- Beniczky, S. et al. (2025) ‘Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy’, Epilepsia, 66(6), pp. 1804–1823. Available at: https://www.ilae.org/updated-classification-epileptic-seizures-2025