Pediatric Seizures: What They Can Look Like and When to Get Help

When people picture a seizure, they often imagine a child collapsing and shaking. That can happen, but pediatric seizures do not always look so obvious. A child may simply stare, stop responding, make a few unusual movements, or suddenly lose muscle control.

A seizure happens when abnormal electrical activity temporarily disrupts the brain’s normal function. One seizure does not necessarily mean a child has epilepsy. Fever, infection, low blood sugar, head injury, and other medical problems can also cause seizures.

Focal seizures

Focal seizures begin in one area of the brain. Because different parts of the brain control different functions, their symptoms vary widely.

A child may remain conscious but experience jerking on one side of the body, tingling, flashing lights, an unusual smell or taste, sudden fear, or a strange rising feeling in the stomach. Younger children may not be able to describe these sensations. They might suddenly look frightened, grab a parent, or say that something feels “weird.”

In other focal seizures, the child’s consciousness is impaired. The child may stare, stop responding, smack their lips, chew, pick at clothing, or wander without purpose. Afterward, they may be confused, tired, or unable to remember what happened.

A focal seizure can also spread to both sides of the brain and become a focal-to-bilateral tonic-clonic seizure, causing loss of consciousness, stiffening, and rhythmic jerking of the body.

Absence seizures

Absence seizures are easy to mistake for daydreaming. A child suddenly stops what they are doing and stares for several seconds. They may blink rapidly, flutter their eyelids, or make small chewing movements. Then they immediately return to their activity, often without realizing anything happened.

These seizures usually begin and end abruptly and may occur many times a day. Unlike ordinary daydreaming, the child generally cannot be brought out of the episode by calling their name. Frequent absence seizures can interfere with learning because the child repeatedly misses small pieces of conversation or instruction.

Tonic-clonic seizures

A generalized tonic-clonic seizure is the type most people recognize. The child loses consciousness and becomes stiff during the tonic phase. This is followed by rhythmic jerking during the clonic phase.

The child may drool, bite their tongue, lose bladder control, or briefly appear bluish around the lips because their breathing has become irregular. Afterward, they may be confused, sleepy, sore, or have a headache. This recovery period can last from several minutes to a few hours.

Myoclonic seizures

Myoclonic seizures cause very brief, shock-like muscle jerks. A child’s arms may suddenly jump, causing them to throw or drop whatever they are holding. These seizures can occur in clusters and are sometimes more noticeable shortly after waking.

Not every muscle jerk is a seizure. Healthy children may jerk while falling asleep, for example. Repeated jerks that happen while the child is awake or follow the same pattern should be discussed with a doctor.

Tonic, clonic, and atonic seizures

A tonic seizure causes sudden muscle stiffening. If the child is standing, they may fall. A clonic seizure causes repeated rhythmic jerking without the initial stiffening seen in a tonic-clonic seizure.

An atonic seizure does the opposite: the muscles suddenly lose their tone. The child’s head may drop, an arm may fall limp, or the entire body may collapse. These are sometimes called “drop attacks.” Because they happen without warning, repeated atonic seizures can cause serious facial or head injuries.

Epileptic spasms in infants

Epileptic spasms are an especially important seizure type in babies. A spasm may look like a quick head drop, a sudden body crunch, or brief stiffening and extension of the arms and legs. The movements often occur in clusters every few seconds, particularly after the baby wakes.

Because each movement is so brief, parents may mistake the spasms for reflux, colic, or a normal startle reflex. Development may also slow or move backward—for example, a baby may stop smiling, rolling over, or interacting as they did before.

Suspected epileptic spasms require urgent medical evaluation. Early diagnosis and treatment can make a major difference to a child’s development. The National Institute of Neurological Disorders and Stroke notes that these spasms usually begin during early infancy.

Febrile seizures

Febrile seizures occur in young children during an illness with fever. The child may lose consciousness, become stiff, shake on both sides of the body, and then feel tired or confused.

A simple febrile seizure affects the whole body, lasts less than 15 minutes, and happens only once in 24 hours. A complex febrile seizure lasts 15 minutes or longer, affects one side or part of the body, or happens more than once within 24 hours.

Febrile seizures are frightening, but most are brief and do not cause brain damage or mean that the child has epilepsy. However, a child’s first seizure should always be medically assessed. More information is available from NINDS.

Seizures in newborns

Seizures in newborns can be extremely subtle. Instead of obvious shaking, a baby may repeatedly turn their eyes to one side, blink unusually, make sucking or chewing movements unrelated to feeding, move their legs as if pedaling, become suddenly stiff, or have unexplained pauses in breathing.

Many normal newborn behaviors can resemble seizures, so appearance alone is not enough for a diagnosis. Repeated, unexplained movements—especially when they look the same each time—need prompt medical attention.

When is a seizure an emergency?

Call emergency services if a seizure lasts more than five minutes, another seizure begins before the child recovers, the child has difficulty breathing, the seizure happens in water, or the child is seriously injured. Emergency help is also appropriate for a first known seizure unless a healthcare professional has already provided different instructions.

During a convulsive seizure, place the child on a safe surface, clear away nearby objects, cushion the head, and turn the child onto their side when possible. Do not restrain them and never put anything in their mouth. Time the event and, if it is safe to do so, record a short video for the medical team.

The most important point is that seizures can be subtle. Sudden episodes that are brief, repetitive, and look similar each time deserve attention—even when the child never falls or shakes. When in doubt, record what you observe and speak with the child’s healthcare professional.

This article is for general education and does not replace medical advice or an individual evaluation.