Self-Care at Home
Your initial efforts should be directed first at protecting the child from additionally injuring himself or herself.
- Help the child to lie down.
- Remove glasses or other harmful objects in the area.
- Do not try to put anything in the child’s mouth. In doing so, you may injure the child or yourself.
- Immediately check if the child is breathing. Call 911 to obtain medical assistance if the child is not breathing.
- After the seizure ends, place the child on one side and stay with the child until he or she is fully awake. Observe the child for breathing. If he or she is not breathing within 1 minute after the seizure stops, then start mouth-to-mouth rescue breathing (CPR). Do not try to do rescue breathing for the child during a convulsive seizure, because you may injure the child or yourself.
- If the child has a fever, acetaminophen (such as Tylenol) may be given rectally.
- Do not try to give food, liquid, or medications by mouth to a child who has just had a seizure.
- Children with known epilepsy should also be prevented from further injury by moving away solid objects in the area of the child. If you have discussed use of rectal medication (for example, Valium) with your child’s doctor, give the child the correct dose.
Treatment of children with seizures is different than treatment for adults. Unless a specific cause is found, most children with first-time seizures will not be placed on medications.
- Important reasons for not starting medications
During the first visit, many doctors cannot be sure if the event was a seizure or something else.
Many seizure medications have side effects including damage to your child’s liver or teeth.
Many children will have only one, or very few, seizures.
- If medications are started
The doctor will follow the drug levels, which require frequent blood tests, and will watch closely for side effects. Often, it takes weeks to months to adjust the medications, and sometimes more than one medicine is needed.
If your child has status epilepticus, he or she will be treated very aggressively with antiseizure medications, admitted to the intensive care unit, and possibly be placed on a breathing machine.
When to Seek Medical Care
All children who seize for the first time and many with a known seizure disorder should be evaluated by a doctor.
- Most children with first seizures should be evaluated in a hospital’s emergency department. However, if the seizure lasted less than 2 minutes, if there were no repeated seizures, and if the child had no difficulty breathing, it may be possible to have the child evaluated at the pediatrician’s office.
- After the seizure has stopped and the child has returned to normal, contact your child’s doctor for further advice. Your pediatrician may recommend either an office or an emergency department visit. If you do not have a pediatrician or none is available, bring the child to the emergency department. If you are worried about possible absence seizures, evaluation at the pediatrician’s office is appropriate.
- Caregivers of children with epilepsy should contact the child’s pediatrician if there is something different about the type, duration, or frequency of the seizure. The doctor may direct you to the office or to the emergency department.
- Take the child to the emergency department or call 911 if you are concerned that your child was injured during the seizure or if you think that he or she may be in status epilepticus (seizures of any kind that do not stop).
Most children who have seized for the first time should be taken to the emergency department for an immediate evaluation.
- Any child with repeated or prolonged seizures, trouble breathing, or who has been significantly injured should go to the hospital by ambulance.
- If the child has a history of seizures and there is something different about this one, such as duration of the seizure, part of body moving, a long period of sleepiness, or any other concerns, the child should be seen in the emergency department.
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