Neurological and medical
Seizures in Children: What to Do, and When It's an Emergency
What to do while it is happening, when to call 911, and what most seizures actually look like.
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A seizure is a burst of abnormal electrical activity in the brain. Most seizures in children last between one and three minutes and stop on their own, and most are not medical emergencies. A seizure lasting five minutes or longer, or a second seizure before the child fully recovers, is an emergency requiring 911 — this is status epilepticus, and the longer it continues the harder it becomes to stop and the higher the risk. During any seizure, keep the child safe, turn them on their side, time it, and never put anything in their mouth or restrain them. Any first seizure should be assessed by a doctor to determine the cause.
If a seizure is happening right now
Call 911 if:
- The seizure lasts 5 minutes or longer2
- Another seizure begins before the child fully wakes up
- Seizures are closer together than usual for this child
- The child has trouble breathing, or seems to be choking, afterward
- The seizure happened in water
- The child was injured
- This is the child's first seizure
- The child doesn't wake up afterward
What to do
- STAY — with the child until they're fully awake and alert. Time the seizure.
- SAFE — move hard or sharp objects away. Put something soft under their head.
- SIDE — turn them onto their side. Loosen anything tight around the neck.1
What NOT to do
- Do not put anything in their mouth. Not your fingers, not a spoon, not anything. They cannot swallow their tongue. Objects in the mouth cause broken teeth, choking, and injuries to you.
- Do not hold them down or try to stop the movements.
- Do not give food, drink, or medication until they are fully awake.
- Do not attempt mouth-to-mouth during the seizure. If they are not breathing after it ends, call 911 and begin CPR.
What most seizures actually look like — including the ones that get missed
Not all seizures involve whole-body shaking, and the subtler kinds are frequently missed for months.
Tonic-clonic (previously called grand mal) — the type most people picture. The body stiffens and consciousness is lost, then rhythmic jerking follows, then a period of confusion or sleepiness. The stiffening phase usually lasts under a minute.
Absence (previously petit mal) — brief blank staring, often only a few seconds, sometimes with eyelid fluttering. These are routinely mistaken for daydreaming or inattention, sometimes for years. A child who "zones out" many times a day, who can't be interrupted during it, and who has no memory of the gap is worth mentioning to a doctor.
Focal — starting in one area of the brain. May involve jerking of one limb, unusual sensations, repetitive movements such as lip-smacking or picking, or altered awareness without collapse.
Atonic — sudden loss of muscle tone, causing a fall. Sometimes called drop attacks.
Myoclonic — brief, shock-like jerks, often on waking.
Infantile spasms — don't wait on these
In babies, usually between three and twelve months, infantile spasms appear as sudden brief clusters of head nodding, body stiffening, or arms flinging out — often on waking, often repeating every few seconds for several minutes.
They look mild and are frequently mistaken for colic, startle, or reflux. They are a neurological emergency in which earlier treatment is associated with better outcomes.
If you think you've seen this, film it on your phone and contact your pediatrician the same day. Video is genuinely diagnostic here, and clinicians will want to see it.
After a seizure
The period afterward — the postictal phase — can last minutes to hours. What's normal: confusion, sleepiness, headache, aching muscles, temporary weakness, difficulty speaking, no memory of the event, emotional upset.
Stay with them. Speak calmly, explain what happened, let them rest. Don't offer food or drink until they're fully alert.
Write it down while it's fresh. How long it lasted, what it looked like, what happened just before, and how long recovery took. This is the information a clinician most needs and the hardest to reconstruct later. Video, if someone else is present and the child is safe, is more useful than any description.
What causes seizures in children
Febrile seizures — triggered by fever, most often between six months and five years. They are common, frightening to watch, and usually harmless. A first febrile seizure should still be assessed, and the five-minute rule still applies.
Epilepsy — a tendency toward recurrent unprovoked seizures. Diagnosed after two or more unprovoked seizures more than 24 hours apart, or one seizure with a high likelihood of recurrence.
Other causes: head injury, infections such as meningitis or encephalitis, low blood sugar or electrolyte imbalance, structural brain differences, genetic conditions, and lack of oxygen at birth.
Conditions where seizures are more common — worth knowing if your child has one:
- Cerebral palsy
- Down syndrome
- Rett syndrome
- Fragile X syndrome
- Autism
- Traumatic brain injury
- Tuberous sclerosis and other genetic conditions
A note on regression. If a child loses skills they previously had, seizure activity is one of the things a clinician will want to rule out — including seizures that aren't visible to observers. See developmental regression.
How are seizures diagnosed?
After a first seizure, a doctor will take a detailed history — which is why your written account or video matters — and examine your child.
- EEG records electrical activity in the brain, using scalp electrodes. It's painless. A normal EEG doesn't rule out epilepsy, and an abnormal one doesn't confirm it on its own.
- MRI or CT may be used to look at brain structure.
- Blood tests check for infection, metabolic causes, and electrolyte imbalance.
- Video EEG monitoring — sometimes over several days in hospital — is used where events are hard to characterize.
Who assesses: a pediatrician initially, usually referring to a pediatric neurologist. Epilepsy centers offer specialist multidisciplinary care for complex or difficult-to-control seizures.
How are seizures treated?
Anti-seizure medication is the usual first-line treatment. Many children achieve good control, and some outgrow seizures entirely. Finding the right medication and dose can take time.
Rescue medication may be prescribed for prolonged seizures, to be given at home or school under specific written instructions. If your child has one, make sure everyone who cares for them knows where it is and when to use it. Dosing and administration come from your child's neurologist, not from a website.
Other options where medication doesn't control seizures: ketogenic and modified diets under medical supervision, vagus nerve stimulation, and in selected cases surgery.
Never stop or change anti-seizure medication without medical advice. Sudden withdrawal can trigger prolonged seizures.
The seizure action plan
If your child has had a seizure, ask their doctor for a written seizure action plan. It's the single most useful document you'll have, and it should cover what your child's seizures typically look like, what to do step by step, when to give rescue medication (if prescribed), when to call 911, emergency contacts and your neurologist's details, and current medications and allergies.
Give copies to school, nursery, coaches, babysitters, grandparents, and anyone else who cares for your child alone. Keep one on your phone. Ask specifically: "At what point should we call an ambulance for my child?" Some children have individualized thresholds that differ from the general five-minute rule.
School and daily life
- Give the school a copy of the action plan and check they've read it.
- Confirm who is trained to give rescue medication, and what happens if that person is absent.
- Ask about supervision for swimming and bathing — water is a specific risk.
- Discuss what happens after a seizure at school: rest, then who to call.
- Most children with well-controlled seizures participate fully in school and activities.
Children who witness a classmate's seizure benefit enormously from a simple, calm explanation. Schools that handle this well prevent a lot of unnecessary fear.
Physical, occupational, and speech therapists work with many children who have seizure disorders. Browse providers by city and state.
Browse the DrSensory Therapy Directory →Frequently Asked Questions
Can seizures be missed?
Yes, frequently. Absence seizures look like daydreaming and are often missed for months or years. Focal seizures may involve only unusual sensations or small repetitive movements. In babies, infantile spasms are subtle and urgent — film them and contact your doctor the same day.
What is status epilepticus?
A seizure lasting five minutes or longer, or repeated seizures without full recovery between them. It is a medical emergency — the longer it continues, the harder it becomes to stop with medication and the higher the risk. Call 911.
Are febrile seizures dangerous?
Most are harmless, though frightening to watch. They are common between six months and five years. A first febrile seizure should still be assessed by a doctor, and the five-minute rule still applies.
Will my child grow out of seizures?
Many children do, particularly with certain childhood epilepsy syndromes, and many others achieve good control with medication. Your child's neurologist can give a more specific picture based on the type and cause.
Should I hold my child still during a seizure?
No. Restraining can cause injury. Clear the space around them, cushion their head, turn them on their side, and let the seizure run its course while you time it.
What should I do after my child's seizure ends?
Stay with them, keep them on their side, let them rest, and don't give food or drink until they are fully alert. Write down how long it lasted, what it looked like, and what happened beforehand — then contact their doctor.
How long should a child's seizure last before calling 911?
Five minutes. Call 911 if a seizure lasts five minutes or longer, if another begins before the child fully wakes, if they have trouble breathing afterward, if it happened in water, if they were injured, or if it's their first seizure.
Should I put something in my child's mouth during a seizure?
No. Never. It is impossible to swallow your tongue, and objects in the mouth cause broken teeth, choking, and injuries to the person helping. Turn the child on their side instead.
Sources
- Epilepsy Foundation — seizure first aid (Stay, Safe, Side), developed with CDC support. Checked August 18, 2026.
- Epilepsy Foundation — getting emergency help and managing prolonged seizures. Checked August 18, 2026.
- Centers for Disease Control and Prevention — about epilepsy and seizure first aid. Checked August 18, 2026.
- American Academy of Pediatrics, HealthyChildren.org — seizures and febrile seizures. Checked August 18, 2026.
- Child Neurology Foundation — seizure action plans. Checked August 18, 2026.
Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It does not include medication dosing. If a seizure lasts five minutes or longer, or your child is not breathing, call 911 immediately. Always follow your child's individual seizure action plan where one exists.