Finding out your baby is having seizures can be very scary. You probably have more questions than you can process.

Arming yourself with knowledge is the best way to help your infant, your loved ones, and yourself. The right knowledge will allow you to work with your medical team to give your little one the best possible outlook for the future.

What Do Seizures Look Like in Babies?

Seizures, or convulsions, are sudden bursts of abnormal electrical activity in the brain. During a seizure, brain cells send abnormal electrical signals, which can result in a wide variety of symptoms you might notice during a baby’s seizure.

This abnormal electrical activity can cause many different visible effects like jerking or shaking. Other seizures may be harder to notice. A baby may stare, seem less responsive, or make small repeated movements. Depending on the type, seizures can last from just a few seconds to several minutes.

Depending on the seizure type, you might notice signs like:

• Stiffening limbs
• Jerking movements of the arms and legs
• Hunched shoulders
• Staring or unusual eye movements

Signs of a Seizure in a Newborn

During a newborn’s first 28 days of life, seizures may be hard to notice and may look a little different than a seizure in an older baby. Signs of a seizure in a newborn can include:

• Changes in breathing patterns
• Unusual eyelid or lip movements
• Stiffening or jerking limbs
• Turning the head to one side
• Reduced responsiveness

Seizures are usually first noticed after a baby is born. Seizures in a baby that is still in the womb during pregnancy are extremely rare.

Types of Seizures in Babies

Seizures in babies are often overlooked because of how different they are from adult and childhood seizures. A baby’s brain is still developing, so seizures can change as a baby grows.

After a seizure, newborns may not have an obvious postictal period, which is the recovery period after a seizure when older children may feel tired or confused.

Doctors also classify seizures in newborns somewhat differently from seizures in older children. Many neonatal seizures have a focal onset, meaning they begin in one area of the brain.

The distinction between focal seizures and seizures involving wider areas of the brain may be less straightforward in newborns, so doctors use a classification system designed specifically for neonatal seizures.

Common Causes of Seizures in Babies

Seizures in babies can have many causes. Some causes are related to an injury or difference in the brain, while others are linked to genetic conditions, problems with metabolism, or fever. Sometimes the cause remains unknown.

Brain Injury and Lack of Oxygen

Changes or structural damage in the brain can cause seizures. These changes may result from an injury, infection, lack of oxygen, or differences in how the brain developed.

One important cause of seizures in newborns is neonatal hypoxic-ischemic encephalopathy (HIE), which happens when the brain receives too little oxygen and blood flow around the time of birth. HIE can lead to seizures and, in some babies, long-term developmental or movement problems.

Genetic and Metabolic Conditions

Several genetic and metabolic conditions can cause seizures during infancy.

West Syndrome

West syndrome is associated with infantile spasms, an abnormal EEG, and developmental delays. Spasms usually begin during the first year. West syndrome can have several underlying causes, including genetic conditions or brain injury.

Dravet Syndrome

Dravet syndrome is a rare genetic epilepsy that usually begins during the first year of life. Seizures may be prolonged, sometimes involve one side of the body, and be triggered by changes in body temperature. Status epilepticus can occur. Children often have normal early development, and genetic testing can help support the diagnosis.

Self-Limited Familial Neonatal Epilepsy

Self-limited familial neonatal epilepsy is a genetic condition that causes brief seizures beginning shortly after birth. It is often inherited but can also result from a new genetic change. Seizures often stop during early childhood.

Early Infantile Developmental and Epileptic Encephalopathy

Babies with early infantile developmental and epileptic encephalopathy (EIDEE) may develop frequent tonic or myoclonic seizures within the first three months of life along with significant developmental difficulties. Seizures may be difficult to control with medicine, and some children may be considered for epilepsy surgery.

GLUT1 Deficiency Syndrome

GLUT1 deficiency syndrome is a genetic condition that affects how the brain gets glucose (sugar) for energy. Seizures may begin during the first months of life, sometimes along with developmental delays or unusual head and eye movements. A supervised ketogenic diet is an important treatment.

Febrile Seizures

Febrile seizures, or seizures associated with fever (at least 100.4 degrees Fahrenheit or 38 degrees Celsius), can occur in young children during illnesses such as the flu, COVID-19, or an ear infection.

Febrile seizures most often happen between 6 months and 5 years of age. A child may lose consciousness, roll their eyes, shake, or stiffen, usually for one to two minutes. Simple febrile seizures last less than 15 minutes and occur no more than once a day. Complex febrile seizures last 15 minutes or more and can happen multiple times in a single day.

Febrile seizures aren’t the same as epilepsy and usually don’t cause lasting harm. However, prolonged febrile seizures are associated with a somewhat higher risk of epilepsy later.

Sometimes the Cause Is Unknown

Sometimes doctors can’t identify a clear cause for a baby’s seizures. These have historically been described as cryptogenic seizures. Doctors may use EEG, MRI, blood tests, genetic testing, and other tests to look for possible causes and guide treatment.

What To Do During a Baby’s Seizure

If your baby is having a seizure, stay as calm as you can and note when it starts. Move them to a safe surface where they can’t fall and gently turn them on their side. Don’t put anything in their mouth or try to prevent their movements.