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Seizures after Traumatic Brain Injury in Children

Medically reviewed by Last updated on Dec 2, 2022.

What do I need to know about seizures after a traumatic brain injury (TBI)?

Your child is at higher risk for a seizure after a TBI. A seizure is an episode of abnormal brain activity. A seizure may happen within hours after a TBI or weeks to years later. A seizure within a week of a TBI is called an early posttraumatic seizure. This may be caused by bleeding between your child's brain and skull. Brain swelling can also cause a seizure. Seizures that happen at least 1 week after the TBI is called a late posttraumatic seizure. This may be caused by permanent damage to your child's brain. Late posttraumatic seizures increase your child's risk for developing epilepsy. Epilepsy is a brain disorder that causes repeated seizures.

What are the signs and symptoms of a seizure?

Your child's seizure may be defined as one type of a seizure or a combination. Each type of seizure may have different symptoms. Your child may have symptoms before the seizure starts. This is called an aura. Examples include dizziness, anxiety, or flashing bright lights.

  • A generalized seizure may affect both sides of the brain. After a generalized seizure, your child may have a headache or feel irritable. The following are different types of generalized seizures:
    • A tonic, clonic, or tonic-clonic seizure usually involves the whole body. A clonic seizure involves jerking body movements. A tonic seizure involves stiffening of the body. A tonic-clonic seizure is a combination of clonic and tonic seizures. It is also called a grand mal seizure. During any of these types of seizures, your child may lose consciousness. His or her eyes may roll up and back into his or her head. Your child may sweat all over his or her body.
    • A myoclonic seizure involves a sudden jerk of all or part of the body.
    • An atonic seizure is usually brief and causes a sudden loss of posture. Your child may fall suddenly to the ground.
    • An absence seizure is also known as a petit mal seizure. Your child may stare blankly into space, and will not pay attention to anything happening around him or her. Your child's eyes may flutter or blink repeatedly. He or she may smack his or her lips. Your child may have several absence seizures throughout a day.
    • An atypical absence seizure looks like an absence seizure but with repetitive behaviors. These behaviors include eye opening and closing, eyes rolling outward or inward, and body stiffening.
  • A partial seizure may affect one part of the brain. The symptoms may depend on where in the brain the abnormal activity is happening. It may be simple or complex. A simple partial seizure may not cause a loss of consciousness. A complex partial seizure may cause your child to be less awake or alert. Both types of partial seizures may cause jerky muscle movements, confusion, hallucinations, sweating, or repetitive behaviors.

How are seizures diagnosed?

A seizure may be diagnosed based on your child's symptoms. Your child may need an electroencephalogram (EEG) to measure the electrical activity in his or her brain. An EEG may help healthcare providers decide what treatments your child needs.

How are seizures treated or prevented?

Medicine may be given to prevent a seizure. Medicine may also be given during a seizure to stop it. Your child may be given seizure medicine through his or her IV, or as a pill.

What can I do to help my child manage or prevent seizures?

  • Keep a seizure diary. Include when the seizure started and how long it lasted. Also include what your child was doing before the seizure started and if he or she had an aura. Ask anyone who saw your child have the seizure what he or she did during and after the seizure. Bring the seizure diary with you to all follow-up visits.
  • Set a regular sleep schedule. A lack of sleep can trigger a seizure. Try to have your child go to sleep and wake up at the same times every day. Keep your child's bedroom quiet and dark. Talk to your child's healthcare provider if he or she is having trouble sleeping.
  • Ask what safety precautions your child should take. Talk with your adolescent's healthcare provider about driving. Your adolescent may not be able to drive until he or she is seizure-free for a period of time. You will need to check the law where your adolescent lives. Also talk to your child's healthcare provider about swimming and bathing. Your child may drown or develop life-threatening heart or lung damage if he or she has a seizure in water.
  • Tell your child's friends, family members, and babysitters, and school officials about the seizure. Give them written instructions to follow if your child has another seizure.

How can I keep my child safe during a seizure?

Give the following instructions to your child's family, babysitters, friends, and school officials:

  • Do not panic.
  • Gently guide the child to the floor or a soft surface.
  • Do not hold the child down or put anything in his or her mouth.
  • Place the child on his or her side to help prevent him or her from swallowing saliva or vomit.
  • Protect the child from injury. Remove sharp or hard objects from the area, or cushion his or her head.
  • Loosen clothing around the child's head and neck.
  • Time how long the seizure lasts. Call 911 if a seizure lasts longer than 5 minutes or if the child has a second seizure.
  • Stay with the child until the seizure ends. Let him or her rest until fully awake.
  • Perform CPR if the child stops breathing or you cannot feel his or her pulse.
  • Do not give the child anything to eat or drink until he or she is fully awake.

Call 911 for any of the following:

  • Your child has a seizure that lasts longer than 5 minutes.
  • Your child has a second seizure within 24 hours of the first.
  • Your child has trouble breathing after a seizure.
  • Your child cannot be woken after a seizure.
  • Your child has more than 1 seizure before he or she is fully awake or aware.

When should I seek immediate care?

  • Your child is injured during a seizure.

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • Your child starts to have seizures more often.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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