Early Signs of Epilepsy in Babies
The short answer
Seizures in babies can look very different from seizures in older children or adults. Subtle signs may include repeated eye blinking or deviation, lip smacking, cycling leg movements, brief stiffening episodes, or clusters of head drops (infantile spasms). Infantile spasms are a neurological emergency that requires urgent evaluation. Not all unusual movements are seizures - babies commonly have benign tremors and startle reflexes - but any movement pattern that seems involuntary, repetitive, and cannot be interrupted deserves medical evaluation.
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By Age
What to expect by age
0-3 months
Neonatal seizures can be very subtle and difficult to recognize. Signs may include rhythmic eye movements, lip smacking or chewing movements, cycling or pedaling leg movements, or brief episodes of stiffening or arching. These may be confused with normal newborn reflexes. The key difference is that seizures tend to be stereotyped (the same pattern each time), cannot be stopped by holding or repositioning the baby, and may be accompanied by changes in breathing or color. If you suspect seizure activity, video record an episode and seek medical evaluation promptly.
3-12 months
Infantile spasms typically begin between 3-8 months and are characterized by sudden, brief clusters of body flexion or extension - often described as a jackknife movement or a brief startle. They commonly occur in clusters upon waking and may initially be dismissed as colic or startles. Infantile spasms are a medical emergency requiring prompt evaluation with an EEG, as early treatment significantly improves outcomes. Other seizure types at this age may include focal seizures (stiffening or jerking of one side) or episodes of sudden behavioral arrest.
12-36 months
Seizures in toddlers may be more recognizable, presenting as staring episodes, rhythmic jerking of limbs, sudden falls (drop attacks), or classic tonic-clonic (generalized stiffening and shaking) episodes. Febrile seizures - triggered by fever - are the most common type in this age group and are usually benign. However, seizures without fever, seizures affecting only one side of the body, or seizures associated with developmental regression should be evaluated by a pediatric neurologist. An EEG and possibly brain MRI may be recommended.
What Should You Do?
When to take action
- Your newborn has trembling or jittery movements that stop when you gently hold the limb - these are likely benign tremors, not seizures.
- Your baby startles easily (Moro reflex) - this is a normal newborn reflex that fades by 4-6 months.
- Your baby occasionally stares briefly but responds when you touch them or call their name.
- Your baby has repetitive, stereotyped movements that you cannot interrupt by touch or repositioning.
- Your baby has brief episodes of staring with subtle eye movements, lip smacking, or unresponsiveness.
- Your baby had a single brief episode of stiffening or unusual movement that resolved but concerned you - try to capture a video for your doctor.
- Your baby has clusters of brief head drops, body flexion, or sudden stiffening episodes, especially upon waking (possible infantile spasms - seek urgent evaluation).
- Your baby has a seizure lasting more than 5 minutes or has difficulty breathing during or after a seizure.
- Your baby has seizures accompanied by developmental regression - losing previously acquired skills.
- Your baby is having multiple seizures in one day or seizures are becoming more frequent.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
My Baby Has Staring Spells - Could It Be Absence Seizures?
Brief moments of staring or "zoning out" are very common in babies and toddlers and are usually a normal part of processing their environment. True absence seizures are rare in children under 4 years old and typically begin between ages 4 and 14. However, some types of seizures in infants can involve staring episodes. If your baby has repeated episodes of unresponsive staring that you cannot interrupt by touch or voice, a medical evaluation is recommended.
What to Do During Your Baby's First Febrile Seizure
If your baby is having their first febrile seizure, stay calm. Place them on their side on a safe surface, do not put anything in their mouth, and time the seizure. Most febrile seizures last less than 5 minutes and stop on their own. Call 911 if the seizure lasts more than 5 minutes. After a first febrile seizure, your baby should always be evaluated by a doctor to confirm it was a febrile seizure and rule out other causes. Febrile seizures affect about 1 in 25 children and almost never cause lasting harm.
My Baby Had a Febrile Seizure
Febrile seizures are frightening to witness but are usually harmless. They affect about 1 in 25 children, typically between 6 months and 5 years, and almost never cause lasting harm. Most children who have one febrile seizure never have another, and they don't increase the risk of epilepsy significantly.
My Baby Lost Skills They Previously Had
Temporary regression in skills can be normal during periods of rapid growth, illness, stress, or when a baby is intensely focused on developing a new skill. However, true developmental regression - the sustained loss of previously acquired skills such as words, social engagement, or motor abilities - is always a reason to seek prompt medical evaluation. This is especially concerning if multiple skill areas are affected simultaneously.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.