Seizures & Convulsions
Seizure-like events in children; differential diagnosis, safe work-up, and follow-up.
Families often use “seizure” or “convulsion” for shaking, staring, or collapse episodes. Causes range from epilepsy and febrile seizures to fainting, breath-holding spells, or benign paroxysmal events. Accurate classification avoids unnecessary treatment and defines emergency steps. Video recordings, event duration, and post-event behavior accelerate diagnosis; families receive clear guidance on first aid and when to call emergency services.
Scope of assessment
Event duration, body parts involved, eye position, cyanosis, foaming, incontinence, and post-event sleepiness or confusion are reviewed in detail. Fever, infection, trauma, and medications are noted. Examination and targeted EEG, ECG, or blood tests distinguish epileptic seizures from mimics. Home video, when available, is reviewed carefully.
When to seek evaluation
First prolonged stiffening, loss of consciousness, or recurrent brief “collapse” movements need urgent or prompt assessment. Even when a child recovers well after a febrile seizure, pediatric neurology follow-up should be planned. Repeated sudden falls or brief confusion at school or play should be documented.
- First convulsion longer than five minutes
- Repeated seizure-like events in one day
- Prolonged unresponsiveness after an event
- Recurrent stiffening or falls without fever
- Serious injury during an event
Visit and follow-up process
An event diary and video sharing are requested at the first visit. Pediatric or sleep EEG may be planned when indicated. Families learn seizure first aid, timing, and when to call emergency services. If events do not recur and tests are reassuring, intervals may widen; if suspicion remains, close follow-up continues. General online information does not replace a personal medical plan.
Clinical approach
Not every convulsion is an epileptic seizure; families receive this distinction in plain examples. Unnecessary medication is avoided, but treatment is not delayed when epilepsy is likely. Short school guidance can be prepared with consent. Event diaries and videos are updated at follow-up visits; some benign patterns never require long-term medication.