Your Child Just Had Their First Seizure: A Parent’s Emergency Action Plan

When a child experiences their first seizure, it can be an intensely frightening experience for everyone involved. Understanding what to do in the moment, what happens next, and how to navigate the medical pathway ahead can help you respond calmly and effectively.

This guide provides structured information to support you through the immediate response, initial medical assessment, and early planning stages.

During and Immediately After the Seizure

What to Do

If your child is having a seizure:

• Stay calm and stay with them
• Time the seizure using your phone or watch
• Protect their head by placing something soft underneath if possible
• Move objects away that could cause injury
• Do not restrain them or try to stop the movements
• Do not put anything in their mouth
• Turn them onto their side when possible (recovery position) to keep the airway clear
• Stay with them until they are fully recovered

When to Call 999

Call for an ambulance immediately if:

• This is their first seizure
• The seizure lasts longer than 5 minutes
• They have another seizure without regaining consciousness
• They have difficulty breathing after the seizure
• They are injured during the seizure
• You are unsure what to do

Even if the seizure stops before the ambulance arrives, paramedics can assess your child and provide guidance on whether hospital attendance is necessary.

After the Seizure Stops

Your child will likely be confused, tired, or disoriented. This is known as the postictal state and is normal.

• Keep them comfortable and safe
• Speak calmly and reassure them
• Do not give food or drink until they are fully alert
• Note how long this recovery period lasts

The First 24 Hours: A&E and Initial Assessment

What Happens at A&E

If your child is taken to hospital following their first seizure, you can expect:

Medical history questions:

• Detailed description of what happened before, during, and after the seizure
• Any recent illness, head injury, or fever
• Family history of epilepsy or seizures
• Any developmental concerns
• Current medications

Physical examination:

• Neurological examination to check responses, coordination, and reflexes
• Temperature check
• Blood pressure and heart rate

Possible tests:

• Blood tests to check for infection, blood sugar levels, or metabolic issues
• In some cases, a CT or MRI scan if a structural cause is suspected

Outcome: Many children are discharged the same day with a neurology referral. Some may be admitted for observation, particularly if the cause is unclear or further seizures occur.

Information to Remember

When describing the seizure to medical staff, try to recall:

• What your child was doing immediately before it happened
• Whether they had any warning signs or unusual behaviour
• What the seizure looked like (movements, eye position, colour changes)
• How long it lasted
• How they were afterwards
• Whether they were incontinent
• If they bit their tongue or injured themselves

If someone witnessed the seizure and you did not, ask them to attend the hospital with you or write down what they saw.

The First Week: Neurology Referral and Diagnostic Pathway

What Happens Next

Following a first seizure, your child should be referred to a paediatric neurologist. Waiting times vary, but urgent cases are typically seen within two weeks.

Diagnostic tests you can expect:

EEG (Electroencephalogram):

• Records electrical activity in the brain
• Completely painless – electrodes are placed on the scalp with paste or a cap
• Usually takes 20-45 minutes
• May be done while awake, drowsy, or asleep depending on your child’s age
• Helps identify abnormal electrical patterns that may indicate epilepsy

MRI (Magnetic Resonance Imaging):

• Detailed scan of the brain structure
• Completely safe – uses magnetic fields, not radiation
• Requires staying still, so young children may need sedation or general anaesthetic
• Helps identify any structural causes for seizures

Not every child will need every test. The neurologist will decide based on the specific circumstances.

At Home During This Time

While waiting for appointments:

• Keep a record of any further seizures or unusual episodes
• Note any potential triggers you observe (lack of sleep, illness, flashing lights)
• Maintain normal routines where possible
• Ensure adequate sleep – sleep deprivation can lower seizure threshold
• Avoid known risks such as unsupervised swimming or bathing
• Monitoring and supervision remains crucial

Talking to Your Child

How you explain what happened depends on your child’s age and understanding.

For Young Children (3-7 years)

Use simple, calm language:

• “Your brain sent some mixed-up messages and your body moved in ways you couldn’t control”
• “The doctors are going to help make sure you’re safe”
• Reassure them they did nothing wrong

For Older Children (8+ years)

Provide age-appropriate information:

• Explain what a seizure is in simple terms
• Answer their questions honestly
• Reassure them about safety measures
• Involve them in tracking and safety planning where appropriate

Avoid using frightening language. Many children worry they might die or that seizures are their fault.

Explaining to Siblings

Brothers and sisters may have witnessed the seizure and can be frightened or confused.

Key messages for siblings:

• Their sibling is safe and being looked after
• It wasn’t anyone’s fault
• The doctors are helping
• It’s okay to feel worried or scared
• They can ask questions

Age-appropriate books about epilepsy can help younger siblings understand.

School Notification

Your child’s school should be informed promptly, even before a diagnosis is confirmed.

Key points to communicate:

• That your child has had a seizure
• What the seizure looked like
• That you are awaiting specialist appointments
• Any immediate safety measures needed (such as supervision during swimming)
• Emergency contact information

Most schools will want to arrange a meeting to discuss a care plan once more is known.

Understanding What Happens Next

Possible Outcomes

After assessment, the neurologist may conclude:

Epilepsy diagnosis: If epilepsy is diagnosed, anti-seizure medications (ASMs) may be recommended. This decision depends on seizure type, frequency, and individual circumstances. Not all children are started on medication after a first seizure.

Single seizure – no epilepsy diagnosis: Some children have a single seizure that never recurs. Diagnosis of epilepsy typically requires two or more unprovoked seizures. Monitoring without medication may be recommended.

Provoked seizure: If the seizure was caused by fever, low blood sugar, or another identifiable and treatable cause, it may not be epilepsy.

Treatment Decisions

If anti-seizure medications (ASMs) are recommended, the neurologist will discuss:

• Which medication is most appropriate
• How it works
• Potential side effects
• How long treatment might be needed
• What to do if seizures continue

You have the right to ask questions, seek a second opinion, and take time to make informed decisions.

Support for Parents

Experiencing your child’s first seizure is emotionally challenging. It is normal to feel:

• Fear and worry
• Guilt (even though seizures are not caused by anything you did or did not do)
• Uncertainty about the future
• Overwhelmed by medical information

Sources of support:

• Your GP can provide support and referrals if needed
• Epilepsy charities such as Epilepsy Action and Young Epilepsy offer helplines and information
• Other parents of children with epilepsy can provide peer support
• School staff can help maintain stability and routine

Key Points to Remember

• Stay calm during a seizure and prioritise safety
• Call 999 for a first seizure
• Keep detailed records of what happened
• Expect a referral to a paediatric neurologist
• Diagnostic tests such as EEG and MRI are standard
• Explain what happened to your child in age-appropriate language
• Inform school promptly
• Not all first seizures lead to an epilepsy diagnosis
• Support is available for both your child and you

The pathway from first seizure to diagnosis and treatment can feel overwhelming, but you are not alone. Medical teams, schools, and support organisations are available to guide you through each stage.

Take information one step at a time, ask questions whenever something is unclear, and prioritise both your child’s wellbeing and your own.