Seizures are one of the most common medical emergencies parents are likely to go through, and also one of the most frightening. “A seizure is very scary to witness,” says Sucheta Joshi, M.D., a pediatric neurologist at the University of Michigan in Ann Arbor. “Many parents believe their child is dying.” (Stevenson, 2012, p. 62) The good news is that most seizures are harmless, and most children eventually out grow them.

What is a seizure?

Basically, a seizure is some type of disruption of electrical activity in the brain, caused either by a surge in activity or a short-circuit in the brain’s current. Imagine your child’s brain as if it were Las Vegas – a bustling city filled with lots of lights and electronic devices all hooked up to the same grid. If for some reason there’s an electrical surcharge or other anomaly, all those circuits might go haywire at once.

“The brain has billions of neurons creating and receiving electrical impulses,” says Jing Kang, M.D., Ph.D., who researches seizures at Vanderbilt University. “These impulses are how different parts of the brain communicate with each other. But any abnormal electrical discharge can result in a seizure.” (Stevenson, 2012, p. 64)

What causes seizures?

To a large degree, seizures are still a medical mystery. We know that certain things like high temperatures or certain types of viruses can trigger them. Some types of stimulus, such as strobe lights or other electronics that confuse the brain, can also trigger a seizure. But beyond that, the specific causes are still a mystery. Everything from environmental factors to a child’s unique biology play a role, and seizures appear to be the result of multiple factors coming together at once, since they are so unpredictable and no single factor can predict their occurrence.

A particular brain circuit can only tolerate so much stimulation before it overloads, what scientists refer to as the “seizure threshold.” It’s not exactly clear why seizures are more likely to occur in young children, but it likely has to do with the rapid pace of brain development and all the changes that are taking place. From EEG’s and brain scans we know that a 3-year-old’s brain is about twice as active as the brain of an average adult, and so they’re more likely to be pushed past the seizure threshold.

What to do if your child has a seizure

The first time a child has a seizure, parents are typically too panicked to do much of anything. But preparing yourself now will ensure you’re ready if it happens again.

  1. Never try to put anything into your child’s mouth if they are having a seizure. This outdated advice is based on the myth that a child can swallow their tongue (something that’s anatomically impossible), and is far more likely to cause injury than prevent it.

  1. Don’t try to restrain a child. Allow the seizure to run its course.

  1. It is okay to clear the area of other objects. If a child fell to the floor and is shaking violently, you can place your hands under their head (without holding their head), so that they aren’t banging their noggin against the hard floor. But don’t try to restrain them.

  1. If feasible, try to lay him on his side, preferably on a firm, flat surface. This can keep them from choking on saliva that collects in the mouth, and many kids become nauseas right after a seizure, so this will keep them from choking on their vomit.

  1. Try to remove any obstructions your child already had in her mouth, such as any food or her pacifier. You also might loosen any zippers or buttons that are close to her neck.

  1. Note the time it started (to the best of your knowledge) and the time that it stops. Your doctor may want to know this information.

Anytime a child has a seizure they should be evaluated by a doctor afterwards. But there’s no reason to call 911 or rush them to the hospital unless they stop breathing or somehow injure themselves during the seizure (or if the seizure is still going after 15 minutes). Call your doctor as soon as it’s over. He or she will ask you some questions to try and determine whether your child should be seen right away, but in most cases, they’ll simply wait and address it at your next well-child checkup.

See also: First Aid for Seizures