Children's Hospital Colorado

Epilepsy and Seizures in Children

What is a seizure in a child?

A seizure is caused by a brief, strong surge of extra electrical activity between the cells in the brain. This activity causes physical or behavioral changes, which range from intense full body shaking to mild staring and lip smacking.

What is epilepsy in children?

Epilepsy is the name of the chronic medical condition in which a child has repeated seizures. It’s also called a seizure disorder. When a child has two or more seizures that are not the result of another medical condition, they are considered to have epilepsy. There are many types of epilepsy, ranging from benign to intense.

What causes epilepsy in children?

There are many causes of epilepsy, including:

  • Genetic or metabolic disorders present at birth
  • Infections such as meningitis and encephalitis
  • Trauma or brain injury
  • Brain abnormality
  • Drug use or drug withdrawal
  • Metabolic levels, including low glucose and calcium and high ammonia and lactate
  • Stroke

Who gets epilepsy?

  • There are more than three million people in the United States with epilepsy; most of them are children and elderly people, and more than 200,000 new cases of epilepsy are diagnosed each year.
  • New cases of epilepsy are most common among children, especially during the first year of life.
  • The basic, underlying risk of developing epilepsy is about 1%.
  • Individuals in certain populations are at higher risk. For example, it is estimated that epilepsy can be expected to develop in:
    • 25.8% of children with intellectual disability
    • 13% of children with cerebral palsy
    • 50% of children with cerebral palsy and intellectual disability

Helpful resources:

    • Epilepsy.com is a resource for medical information about epilepsy and its treatments. The website is sponsored by the Epilepsy Foundation, an advocacy group for people with epilepsy.
    • Seizure Tracker provides a way to track seizures in children using online tools and a smart phone app.
    • The Centers for Disease Control has information on seizures and seizure disorders in children.
    • The Epilepsy Foundation also provides information to help school professionals and other caregivers learn about working with children with epilepsy.

What are the signs and symptoms of a seizure in a child?

The symptoms of a seizure depend on the location of electrical activity in the brain. Symptoms can vary in intensity and may be subtle (like staring into space) or intense (such as full body shaking).

Types of generalized seizures

During a generalized seizure, the surge of electrical activity affects the whole brain.

There are several types of generalized seizures in children, including:

  • Generalized tonic-clonic seizure (also called a "grand mal" seizure): During this type of seizure, a child will suddenly lose consciousness, fall to the floor (if standing) and stiffen. The child’s arms and legs will shake. The child may turn blue or pale, bite the tongue or urinate. This type of seizure usually lasts 1 to 5 minutes. Often the child will be sleepy after the seizure and wants to rest.
  • Absence seizure (also called a "petite mal" seizure): A child will stare with a glazed look, often accompanied by blinking, chewing and facial twitching. During this type of seizure, the child does not realize what is happening. When the seizure ends, the child is immediately alert. These seizures typically only last for a few seconds and may happen several times throughout the day.
  • Myoclonic seizures are characterized by sudden jerks of muscle groups. During this type of seizure, one or more part of the body jerks suddenly and briefly.
  • Atonic seizures cause the muscles of the body go limp, and the child is at a high risk for falling. These are sometimes called "drop attacks."

Types of partial seizures

Partial seizures in children are caused by excess electrical activity in just one part of the brain. The electrical activity may stay in one area or travel to other areas of the child’s brain.

  • A simple partial seizure varies from child to child. It can involve movement (jerking one part of the body), abnormal sensation or a premonition called an “aura” where the child can sense that a seizure is coming. The area of the body affected depends on what part of the brain is affected. During simple partial seizures, the child always stays alert and aware.
  • A complex partial seizure (psychomotor/temporal lobe) may look similar to a simple partial seizure but will always involve loss of awareness. The child may have a simple partial seizure (starting in just one part of the brain) that spreads to a different area of the brain and causes a loss of awareness. You may see the child lip smacking, picking at clothes, wandering, making chewing motions, or it may suddenly become hard to understand the child’s speech. Both types of partial seizures last only for a few minutes.

What are the signs and symptoms of epilepsy in children?

Epilepsy is a medical condition that produces seizures in children. Epilepsy is defined as two or more seizures that cannot be traced to another brain event like a concussion or an extremely high fever. The two seizures are usually separated in time by 24 hours.

What tests are used to diagnose epilepsy in children?

Our Neuroscience Institute has a variety of high-tech evaluations to test and diagnose epilepsy in kids. Tests include long-term video electroencephalogram (EEG) monitoring, intraoperative EEG monitoring, neuroimaging, brain mapping and in-depth neuropsychological testing.

We also have state-of-the-art equipment used for determining where the seizures start in the brain; this is often used to prepare children with difficult-to-treat epilepsy for epilepsy surgery. We offer a variety of imaging services and will work with you to determine the best testing for your child.

When do doctors diagnose epilepsy?

Usually, a child is diagnosed with epilepsy after two or more seizures separated by 24 hours that are not related to a high fever, concussion or other event.

How is epilepsy in a child treated?

We provide different types of treatment for epilepsy in children including traditional anticonvulsant medications, dietary therapies, access to ongoing drug studies, vagal nerve stimulation (an epilepsy therapy designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain) and epilepsy surgery.

Most children with epilepsy are able to control their seizures with medications:

  • 60% of children with epilepsy respond well to their first medication.
  • 10% will have seizures treated by their second or third medicine.
  • 30% will have intractable seizures, or those that are difficult to control with medication alone. For children who have epilepsy that is very localized or difficult to treat, surgery may be an option.

Rescue medications

Rescue medications are sometimes given for the family to use at home for epileptic seizures that occurs despite the use of medication that has otherwise successfully prevented seizures in the patient previously. These medications can include midazolam nasal spray or a rectal suppository such as Diastat.

Watch this video for step-by-step directions on how to administer intranasal midazolam if it has been prescribed by your provider.

How to administer midazolam



The Surgical Epilepsy Program at Children's Colorado

If surgery is needed, our Pediatric Surgical Epilepsy Program provides the only comprehensive treatment program for chronic seizure disorders in the region. Brain Lab® image-guidance surgery allows our neurosurgeons to perform complex brain operations with virtual visualization of the critical brain structures and the location of seizure onset.

Our pediatric neurosurgeons use state-of-the-art laser technology to target deep brain lesions through very small openings. Our surgeons also use robotics to precisely place electrodes that can localize a hard to find seizure onset zone.

Why choose Children’s Colorado for your child's epilepsy?

Experts at our Pediatric Epilepsy Program provide comprehensive care for babies, kids and young adults who suffer from seizures and epilepsy. Our patients range from children who have just experienced their first seizure, to those suffering from chronic and debilitating epilepsy.

We offer state-of-the-art treatment and evaluation by a multidisciplinary team consisting of neurosurgeons, neuropsychologists, social workers, nurses, dieticians and epileptologists (doctors who specialize in the treatment of epilepsy) who are all trained in pediatric epilepsy. We're also closely affiliated with local organizations and epilepsy resources to meet the needs of our patients.

In addition, Children's Colorado is located on the Anschutz Medical Campus, a major medical campus that provides access to comprehensive, high-quality care for pediatric patients, as well as education and research efforts in epilepsy.

Contact our Pediatric Epilepsy Program

For more information about the Pediatric Epilepsy Program at Children's Hospital Colorado, please contact us at 720-777-6895.


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