The main types of seizures in children are focal seizures (starting in one area of the brain) and generalized seizures (involving both sides), plus special cases like febrile and neonatal seizures. Signs range from staring spells to full-body shaking. Most childhood seizures are treatable, and many children outgrow them.
If you just watched your child have a seizure, take a breath. This guide walks you through what seizures are, what they can look like at different ages, when a seizure is an emergency, and how doctors diagnose and treat them.
What Is a Seizure?
A seizure is a sudden burst of unusual electrical activity in the brain. Brain cells normally send signals in an organized way. During a seizure, many cells fire at once, which can briefly change how a child moves, feels, senses, or behaves.
Not every seizure means shaking or falling. Some seizures are dramatic, while others are so subtle that parents mistake them for daydreaming or clumsiness. A single seizure also does not automatically mean your child has epilepsy, which we explain later in this article.
Seizures are more common in childhood than many parents realize, and having one does not mean something is permanently wrong. To learn how seizures fit alongside other issues we see, visit our overview of common pediatric neurological conditions.
What Causes Seizures in Children?
Parents often ask, “what causes seizures in a child?” The honest answer is that there are many possible reasons, and sometimes no clear cause is ever found. Common contributors can include:
- Fever from an infection (the trigger behind febrile seizures)
- Genetic factors, where seizures or epilepsy run in the family
- Head injury or trauma
- Infections affecting the brain, such as meningitis or encephalitis
- Problems present at birth, including differences in how the brain formed
- Low blood sugar, low sodium, or other chemical imbalances
- Lack of oxygen around the time of birth
In a large number of children, the seizure is described as “idiopathic,” meaning the cause is unknown. That word can feel frustrating, but it often points to a milder, more treatable situation rather than a dangerous one.
Types of Seizures — Comparison Table
Doctors group seizures mostly by where they start in the brain and what they look like. The table below offers a quick snapshot, and the sections that follow explain each type in plain language.
| Type | What It Looks Like | Typical Age |
| Focal seizure | Twitching, staring, odd sensations, or repeated movements on one side or one part of the body; child may or may not stay aware | Any age |
| Generalized tonic-clonic | Stiffening then rhythmic jerking of the whole body, often with loss of consciousness | Any age, more common in older children |
| Absence seizure | Brief blank staring, eye fluttering, sudden pause in activity, then quick recovery | Often ages 4–12 |
| Myoclonic seizure | Quick, shock-like jerks of the arms or body | Varies; some forms appear in adolescence |
| Atonic seizure ("drop attack") | Sudden loss of muscle tone; child may drop or fall | Varies |
| Febrile seizure | Whole-body shaking during a fever | Roughly 6 months to 5 years |
| Infantile spasms | Sudden brief clusters of stiffening or jackknife movements | Usually first year of life |
Focal Seizures
Focal seizures (once called “partial” seizures) begin in one area of the brain. Depending on where they start, a child might twitch on one side, feel a strange smell or taste, sense fear or déjà vu, or make repeated movements like lip-smacking or fumbling with clothing.
Some children stay fully aware during a focal seizure, while others seem confused or “not there” for a short time. Because these seizures can be subtle, they are sometimes mistaken for behavior problems or attention issues.
Generalized Seizures
Generalized seizures involve both sides of the brain from the start. There are several forms:
- Tonic-clonic: The type most people picture. The body stiffens (tonic), then jerks rhythmically (clonic). The child usually loses consciousness and may be sleepy or confused afterward.
- Absence seizures in children: Very brief episodes of staring or blanking out, often with eye fluttering. They can happen many times a day and are easy to miss, sometimes first noticed as trouble paying attention in school.
- Myoclonic: Sudden, brief, shock-like muscle jerks.
- Atonic: A sudden loss of muscle tone that can cause a fall, which is why they are sometimes called “drop attacks.”
Understanding focal vs generalized seizures matters because it helps guide testing and treatment choices.
Febrile Seizures
Febrile seizures happen in young children during a fever, usually between about 6 months and 5 years of age. They can be frightening to watch, but simple febrile seizures are common and are generally considered harmless in otherwise healthy children.
A febrile seizure does not mean your child has epilepsy, and most children who have one never have another. Still, a first febrile seizure should be evaluated by a doctor to rule out serious infection and confirm the diagnosis.
Neonatal / Infantile Spasms
Newborns can have seizures that look different from those in older children, sometimes appearing as subtle eye movements, lip-smacking, or brief stiffening. Infantile spasms are a specific type seen usually in a baby’s first year, often as sudden clusters of stiffening or “jackknife” movements.
Infantile spasms deserve urgent medical attention because early evaluation and treatment matter. If you notice repeated, unusual movements in a baby, contact your pediatrician or a pediatric neurologist promptly.
Seizure Signs by Age (Babies vs. Older Children)
The signs of a seizure in a child can look very different depending on age.
In babies and infants, seizures are often subtle. Watch for:
- Repeated lip-smacking, chewing, or eye fluttering
- Brief stiffening of the body, sometimes in clusters
- Pauses in breathing along with unusual movements
- Sudden jerks of the arms or legs
In older children, signs may include:
- Staring spells with no response when you call their name
- Stiffening followed by rhythmic jerking
- Sudden falls or drops
- Confusion, sleepiness, or headache afterward
- Loss of bladder control during an episode
Because some of these signs overlap with other conditions, it helps to know which symptoms suggest you should see a pediatric neurologist.
When Is It an Emergency? (Call 911)
| âš Call 911 right away if:
• A seizure lasts longer than 5 minutes • Your child has trouble breathing, turns blue, or is choking • One seizure follows another without the child waking up in between • It is your child’s first seizure • The seizure happens in water • Your child is injured during the seizure • Your child does not return to normal or stays very hard to wake afterward During any seizure: stay calm, ease your child to the floor, turn them gently on their side, move nearby objects away, and do not put anything in their mouth. Time the seizure if you can. |
When in doubt, it is always okay to call for help. Emergency responders would rather you call and be reassured than wait too long.
How Seizures Are Diagnosed (EEG, MRI)
Diagnosis starts with a careful history. Your description of what happened, or a phone video of an episode, is one of the most valuable tools a doctor has, so record events if it is safe to do so.
Common tests include:
- EEG (electroencephalogram): Painless sensors on the scalp record the brain’s electrical activity to look for patterns linked to seizures.
- MRI: Detailed brain imaging that can reveal structural causes.
- Blood tests: To check for infection, blood sugar, and chemical imbalances.
Not every child needs every test. A pediatric neurologist tailors the workup to your child’s age, symptoms, and exam.
Treatment Options
The good news is that most childhood seizures respond well to treatment. Options may include:
- Anti-seizure medications: The most common approach; many children become seizure-free on the right medication.
- Dietary therapy: Special medically supervised diets, such as the ketogenic diet, can help certain children.
- Treating the underlying cause: For example, managing an infection or chemical imbalance.
- Surgical evaluation: For a small group of children whose seizures do not respond to medication, surgery may be considered after specialized testing.
Many children eventually outgrow their seizures, and treatment plans are adjusted over time. Not every child needs long-term medication, especially after a single febrile seizure.
Seizures vs. Epilepsy — What’s the Difference
A seizure is a single event. Epilepsy is a medical condition diagnosed when a person has a tendency to have repeated, unprovoked seizures. In other words, having one seizure, especially a febrile seizure, does not mean your child has epilepsy.
For a deeper look at the difference between a seizure and epilepsy and at what age epilepsy tends to start, see our dedicated guide.
It is also worth knowing that not every episode that looks like a seizure is caused by electrical activity in the brain. Some children experience functional (non-epileptic) seizures, which are real, treatable, and approached differently.
Frequently Asked Questions
Are febrile seizures dangerous?
Simple febrile seizures are common in young children and are generally considered harmless in otherwise healthy kids. They can look frightening, but most children recover fully and never have another. A first febrile seizure should still be checked by a doctor to rule out infection and confirm the diagnosis.
What do absence seizures in children look like?
Absence seizures are brief episodes of blank staring, sometimes with eye fluttering, that start and stop suddenly. They can happen many times a day and are often first noticed as daydreaming or trouble focusing in school. Let your child’s doctor know if you see frequent, unexplained staring spells.
What’s the difference between focal and generalized seizures?
Focal seizures start in one area of the brain and may affect one part of the body or cause unusual sensations. Generalized seizures involve both sides of the brain from the start and often cause loss of awareness or whole-body movements. The distinction helps guide testing and treatment.
Will my child outgrow seizures?
Many children do outgrow seizures, especially febrile seizures and certain childhood epilepsy types. Others may need longer treatment. Because outcomes vary widely, a pediatric neurologist can give you the clearest picture based on your child’s specific type of seizure, age, and test results.
Should I video my child’s seizure?
Yes, if it is safe to do so. A short video helps doctors see exactly what happened, which can be hard to describe from memory. Keep your child safe first: ease them down, turn them on their side, and clear the area, then record if someone is available.
Can seizures happen without shaking?
Yes. Many seizures do not involve shaking at all. Staring spells, brief pauses, odd sensations, lip-smacking, or sudden loss of muscle tone can all be seizures. This is one reason subtle seizures are sometimes missed or mistaken for other behaviors.
Ready to Talk With a Specialist?
Watching your child have a seizure is scary, but you do not have to sort it out alone. The pediatric neurology team at the New Jersey Pediatric Neuroscience Institute is here to listen, evaluate, and build a plan that fits your child. Contact NJPNI today to schedule an evaluation and get clear answers and compassionate care.
Sources & References
- Epilepsy Foundation
- American Academy of Pediatrics (AAP)
- National Institute of Neurological Disorders and Stroke (NINDS)
- Cleveland Clinic
- Children’s Hospital of Philadelphia (CHOP)
- National Institutes of Health (NIH)
