We exist to improve the lives
of everyone affected by epilepsy

Babies and epilepsy

Contents

The causes of epilepsy in babies
Types of seizures
Diagnosis
Treatment
Long-term development
Further information

Introduction

This information relates to babies who are up to one month old.

The causes of epilepsy in babies

There are many causes of seizures in babies. In around seven to eight out of 10 babies with seizures, a cause will be found. These are the most common ones.

  • Being born more than two or three months early. If your baby is born so early, they are at risk of having bleeding inside their brain. This is called intracranial haemorrhage.
  • Being born on time but suffering a lack of oxygen to the brain. This is called perinatal hypoxia and can cause an injury to the brain called ‘hypoxic-ischaemic encephalopathy’.
  • Having low levels of glucose, calcium or sodium in the blood.
  • Having an infection such as meningitis or encephalitis.
  • Being born with an abnormal brain. This is called cerebral dysplasia or dysgenesis. Cerebral means relating to the brain. Dysplasia or dysgenesis means abnormal development.
  • Inheriting a medical condition, such as benign neonatal convulsions.

Epilepsy Action has more information about inheriting epilepsy and benign neonatal convulsions

Types of seizures

Seizures in babies can be difficult to recognise. They are often brief and affect only some parts of the body. 

  • Your baby may have jerking or stiffening of an arm or leg that can switch from side to side. Or their whole upper body may suddenly jerk forward. Or both their legs may jerk up towards their stomach, with their knees bent. These are usually called myoclonic or, if the jerks happen repeatedly in clusters, clonic seizures.
  • Sometimes, only the baby’s face is involved. Their eyes twitch and their head turns to one side. These are usually called focal seizures.
  • If your baby’s body stiffens with or without eyelid flickering, these are usually called tonic seizures.
  • Your baby may go bright red in the face and their breathing and heart rate may change. They will be less alert than usual. You may notice that, for a short time, you can’t attract your baby’s attention. Or you might notice your baby’s eyes are not focusing. These are usually called subtle seizures.

Epilepsy Action has more information about types of seizures.

Diagnosis

It can be difficult to recognise seizures in babies.  That’s why it’s important that they are referred to a doctor who has had specialist training in diagnosing and treating epilepsy. The specialist will ask you about:

  • any behaviour changes that are unusual for babies at that age
  • whether all the seizures look the same, and last the same length of timehether the seizures happen while your baby is awake or  asleep, or both
  • whether the seizures are caused by changes in your baby’s posture or when they are doing different things
  • whether the seizures interfere with, or stop, your baby’s activities such as feeding
  • whether you can stop the seizures after they have started.

If you can record any behaviour changes (maybe on a mobile phone) to show the specialist what happens, this might be very important. It can help with making the diagnosis.

Epilepsy Action has more information about diagnosing epilepsy.

The specialist may then arrange for some, or all, of the following tests.

Electroencephalogram (EEG)

Electrical activity is happening in our brain all the time. A seizure happens when there is a sudden burst of intense electrical activity. This intense electrical activity causes a brief disruption to the way the brain normally works, meaning that the brain’s messages become mixed up. The result is an epileptic seizure.

An EEG gives information about the electrical activity that is happening in your baby’s brain at the time of the test. The electrical activity shows on the EEG as a particular brainwave pattern. EEGs can be very useful in older children and adults, but are less valuable in helping to diagnose epilepsy in babies. This is because the brains of babies are immature, and can’t usually show the changes in brainwave patterns that are seen in older children. This means that even during an epileptic seizure the EEG may not show anything abnormal.

However, if the EEG is very abnormal, it will tell the doctors more about your baby’s epilepsy.

Epilepsy Action has more information about EEGs.

CT scans (computed tomography)

A CT scan is a type of X-ray that shows the physical structure of the brain. It doesn’t show if your baby has epilepsy. However, it may show if there is anything in your baby’s brain, such as a scar, or damaged area, that could cause epilepsy. Not every baby will need to have a CT scan.

Epilepsy Action has more information about CT scans

MRI scans (magnetic resonance imaging)

An MRI scanner uses radio waves and a magnetic field to show the physical structure of the brain. An MRI scanner is more powerful than a CT scanner. An MRI scan has a higher chance than a CT scan of showing something in your baby’s brain that could cause epilepsy. Not every baby will need to have an MRI scan.

Epilepsy Action has more information about MRI scans.

Blood tests

Blood tests are used to check your baby’s general health, and to look for any medical conditions that might be causing their epilepsy. They can also be used to find out if the seizures are not caused by epilepsy, but another medical condition. An example would be low blood sugar (glucose) or low calcium levels. 

Some babies will be referred to a genetics department for further testing. This will depend on the individual baby, whether they have any other medical issues, and their family history. The referral will  be made by the paediatrician or the paediatric neurologist.

Treatment

There is a large range of epilepsy medicines used to treat seizures in babies. The choice of medicine will depend on:

  • the baby’s seizure type
  • the age when the epilepsy began
  • the cause of the epilepsy, if known
  • whether the baby has any other medical conditions, or takes any other medicines
  • the likely outlook for their particular type of epilepsy.

Some of the epilepsy medicines used in babies include phenobarbital, phenytoin, clonazepam, carbamazepine, sodium valproate, levetiracetam, and vigabatrin. Pyridoxine, (vitamin B6) is also sometimes used.

Epilepsy Action has more information about treating epilepsy.

Long-term development

  • If a baby’s seizures are caused by bleeding in their brain or severe lack of oxygen at birth, they will often start having infantile spasms (West syndrome) in their first year of life. They may carry on having seizures that are difficult to treat throughout their childhood. They will also have learning disabilities and many will have cerebral palsy.
  • If a baby’s seizures are caused by meningitis, they may have seizures during childhood and develop learning disabilities and cerebral palsy.
  • Babies who have a low level of glucose in their blood have seizures during childhood and are likely to have learning disabilities. They may also have impairment of their sight.
  • If a baby has seizures caused by cerebral dysplasia or dysgenesis, they are likely to have difficult to control epilepsy. Cerebral dysplasia or dysgenesis means abnormal development of the brain. Most of these infants will also have learning disabilities. These are usually moderate or severe. The outlook for babies who have a genetic abnormality will depend on their particular genetic abnormality.

Epilepsy Action had more information about West syndrome and learning disabilities.

Further information

Your health visitor, epilepsy nurse, or epilepsy specialist may be to give your information about your baby’s condition. 

The UK organisation Contact a Family freephone 0808 808 3555 (UK) or cafamily.org.uk may be able to provide information and details of self-help groups for children with specific conditions, including the less common types of epilepsy.

 

Pay it forward

This resource is freely available as part of Epilepsy Action’s commitment to improving life for all those affected by epilepsy.

On average it costs £414 to produce an advice and information page – if you have valued using this resource, please text FUTURE to 70500 to donate £3 towards the cost of our future work. Terms and conditions. Thank you


We can provide references and information on the source material we use to write our epilepsy advice and information pages. Please contact our Epilepsy Helpline by email at helpline@epilepsy.org.uk.
Code: 
F009.01

Epilepsy Action would like to thank Dr Richard Appleton, consultant paediatric neurologist at Alder Hey Children’s Hospital, Liverpool, UK. He has worked with Epilepsy Action to provide the background information for this page. It is based on his own research, experience and expertise.

This information has been produced under the terms of The Information Standard.

  • Updated January 2013
    To be reviewed January 2016

Comments: read the 11 comments or add yours

Comments

I found this website to be very informative and helpful. keep up the good work!

Submitted by Rebecca on

Please can you help? My grandson was admitted to hospital in November 2013, whilst having a seizure. Following two days of investigations, it was discovered that he had been subjected to Shaken Baby Syndrome, on two separate occasions within the preceding fortnight. He spent 2 weeks on HDU and suffered further seizures, one which lasted for nearly an hour. He has since been discharged from hospital. He has been prescribed Phenytoin, which he takes twice a day. My question is this, As his brain recovers, (the petechial haemorrhaging is diminishing), can he recover from having seizures? or will they be with him forever? Many thanks.

Submitted by Julie on

Hi Julie

I am so sorry to hear about your grandson. And I am also sorry that I’m not in a position to be able to answer your question. We aren’t medically trained. And the answer would depend on what sort of damage was done to his brain, and how that is healing.

Epilepsy can happen because the passage of electrical activity around the brain is interrupted in some way. So if there is remaining damage in the brain that would do this, then it is possible he would continue to have seizures. But even if this is what happens, there is every possibility that his seizures can be controlled by epilepsy medicine.

I hope this information is of some help to you.

Cherry

Advice and Information Team

Submitted by Cherry on

Hi,
My son wajdan is premature baby born just after 180 days of the pregnancy thanks this oct 10th he going to be 3 years old in sha Allah he is alive strugling with his eyesight the issue is not diagnosed yet by the specialists as they asked me that your son has to go through ensthesia i felt this as a risk but he is doing fine his eyesight is developing day by day but last night we observed a very strange and shocking thing while we were going to bed he started shaking all left side of his body his left eye,his mouth ,left arm,and left leg was shaking hard i thought he will be no more as it was very new condition for us we took him to the hospital nearby the doctor gave him injection diazepam and he said that it is because of the high temperature but we did not notice that earlier as he was playing all the day long and he is sleeping late night after 11 PM this morning i was searching gouge for this specific illness they say this epilepsy please advise what should i do about this ???

Submitted by Shah Nawaz on

Hi Shah

Thank you for your message. It must be very difficult time for you right now. We are not doctors and cannot tell you if your son’s episodes are related to epilepsy. But I hope this general information is helpful.

Some children have seizures related to a high fever, known as febrile seizures. These are not epilepsy, but children who have them have a higher chance of developing epilepsy. So, it’s important for you to talk to your son’s doctor, and ask for him to be seen by a children’s epilepsy specialist. They can then decide if any tests and treatment are needed.

If you are not in the UK and you do need an epilepsy specialist, a good place to start is with the International League Against Epilepsy.

Sacha
Epilepsy Action Advice and Information Team

Submitted by Sacha@Epilepsy ... on

My son is 11 months old. Recently he became sick with some sort of throat infection. While he had a fever, he suffered from three febrile seizures. I spoke with his grandmother from his fathers side who told me that she once saw my son's biological grandfather have a seizure when he was young. She told me that he said that he had them sometimes. They were together a number of years after that and she never saw it happen from him again. However, it's led me to believe that he may have somw mild form of epilepsy. Being that my son had the fever seizures and his grandfather seemed to have some for of epilepsy, would this mean my son is more likely to develop epilepsy as well?

Submitted by Carmen on

Hi Carmen

Thanks for your message. It must be very distressing to watch your baby have a seizure. Febrile seizures happen to around three out of every hundred children under five. And as you have seen, they are usually linked to a childhood illness such as tonsillitis, or teething. Febrile seizure do seem to run in families, and children who have had febrile seizures have a slightly higher chance of developing epilepsy later on than children in general. So, your child might have a slightly higher probability of developing epilepsy than the general population, but it is not a certainty.

We have additional information on the epilepsy and inheritance page of our website.

Sacha

Advice & Information Team

Submitted by Sacha-Epilepsy ... on

My daughter has been having what appears to be seizures we have documented what she does n how long they last for she is also on a saturations monitor that monitors her oxygen levels heart rate ect. The nursery she goes to have written tons of details about the seizures and how often she has them. the consultant has asked for video evidence stating he thinks it sounds like epilepsy i have tried my best to get this but its so hard when u dont know when they are coming i have managed to get the end of a few but the ends are much slower and just look like shes banging her head intentionally against the side of her chair its making me physically poorly trying to get them i work full time n even the nursery are struggling because we never know when they will come? n e advice on what to do or n e one been through this? i just want my baby to be sorted

Submitted by sam on

Hi Sam

Thank you for your message. This must be a very frustrating time for you.

Has your daughter’s epilepsy specialist ever considered doing a 24 hour EEG for your baby? If she is having seizures very regularly, that could be one way of deciding whether her events are seizures or not.

If you are happy to tell us where you live, we will try to find an epilepsy nurse for you to speak with. You can contact us  by email helpline@epilepsy.org.uk or the Epilepsy Helpline freephone 0808 800 5050. 

You could also join our online community, forum4e, to speak with other parents, who may have ideas of how you can help your daughter.

Kathy

Advice and Information Team

Submitted by Kathy-Epilepsy ... on

My daughter started with seizures at 6 days old and was put on pyrodoxine and phenobarbital. She is now off the pyridoxine . We we t moths without any seizures then she hit six months and they are back with a vengeance. She has has 3 in the past ten day with episodes of absence, will this have any effect on her development? I'm a first time mum who is terrified of what could happen xx

Submitted by natalie on

Hi Natalie

That sounds like a tough place to be with your baby daughter.

We aren't medically trained, so we won't be able to diagnose what is happening now, or what might happen in the future.

Hopefully you have already read through our information about babies and epilepsy: https://www.epilepsy.org.uk/info/newborn.

As you can see it is quite difficult to make an accurate diagnosis of exactly what might be happening for a baby, as they are at such an early stage in their development.

But it may be that the consultant thinks it would be a good idea for your daughter to go back on the pyridoxine. I am linking you to an article about this as it may be helpful: http://www.webmd.com/epilepsy/pyridoxine-dependent-seizures

It is definitely worth talking to your daughter's consultant again soon though.

I really hope you are able to get good medical advice soon.

Cherry
Epilepsy Action Advice and Information Team

Submitted by Cherry, Epileps... on