Sudden Seizures in Children: Common Causes and Immediate Actions

A first-time seizure in a child requires urgent medical evaluation. Common causes include:

1. Febrile seizures: Ages 6 months–5 years, fever >100.4°F (38°C). Usually brief, self-limiting; most outgrow by age 6.
2. Head trauma: Concussion or skull fracture; seizures may occur immediately or weeks later.
3. CNS infections: Meningitis, encephalitis.
4. Genetic/epilepsy syndromes: Epilepsy, tuberous sclerosis, neurofibromatosis.
5. Metabolic disturbances: Hypoglycemia, electrolyte imbalances (hyponatremia, hypocalcemia).
6. Perinatal injury: Hypoxic-ischemic encephalopathy, stroke.
7. Structural brain abnormalities: Tumors, vascular malformations, cortical dysplasia.
8. Toxic/metabolic: Medication side effects, drug ingestion, lead poisoning.

Immediate Steps

• Ensure safety: place on side, clear area, do not restrain or put anything in mouth.
• Time the seizure; call emergency services if >5 minutes, recurrent, or breathing difficulty.
• Seek medical evaluation always after a first seizure for workup (neurological exam, labs, EEG, imaging).

Not all seizures indicate epilepsy, but all warrant investigation.