Types of Seizures in Babies and What They Look Like
The short answer
Seizures in babies can look very different from seizures in adults. Types include subtle seizures (eye deviation, lip smacking, bicycling movements), tonic seizures (stiffening), clonic seizures (rhythmic jerking), myoclonic seizures (quick jerks), and infantile spasms (clusters of brief body flexion). Any suspected seizure in a baby needs medical evaluation. Video-recording the episode on your phone is extremely helpful for your doctor to determine if it was truly a seizure.
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By Age
What to expect by age
Neonatal seizures may be subtle: eye deviation, repetitive sucking or chewing movements, swimming or pedaling movements, or brief episodes of stiffening. These can be difficult to distinguish from normal newborn movements. Any suspected seizure in a newborn needs urgent evaluation including EEG monitoring, blood tests, and possibly brain imaging.
Infantile spasms (West syndrome) typically begin between 3-8 months. These look like sudden, brief clusters of body flexion (the baby bends at the waist or brings arms together) that often occur upon waking. They may be subtle initially. Infantile spasms are a neurological emergency requiring prompt treatment.
Seizures at this age may include febrile seizures (with fever), focal seizures (affecting one side or one area), and continued risk of infantile spasms. Focal seizures may cause eye deviation to one side, jerking of one arm or leg, or brief staring. Video-record any suspicious episode.
Febrile seizures are most common between 6 months and 5 years. Generalized tonic-clonic seizures (stiffening followed by rhythmic jerking of the whole body) and absence seizures (brief staring spells) may occur. Not all staring is a seizure - true seizure staring cannot be interrupted by touch or noise.
Seizure types include febrile seizures, focal seizures, generalized seizures, and absence seizures. If your child has had multiple seizures, your neurologist will classify the seizure type and epilepsy syndrome to guide treatment. An EEG helps identify the type of seizure activity.
What Should You Do?
When to take action
- Normal newborn movements: jitteriness that stops when you hold the limb, sleep myoclonus (jerks only during sleep)
- Brief startling or Moro reflex in young babies
- Shuddering attacks (brief tremor-like episodes without altered consciousness)
- You observed unusual repetitive movements that you suspect may be a seizure - show any video to your pediatrician
- Your baby has brief clusters of flexion (bending) movements, especially upon waking (possible infantile spasms)
- Your child has staring spells that seem uninterruptible
- Any seizure lasting more than 5 minutes - call 911
- Your baby is having a first-time seizure, turns blue, has difficulty breathing during or after a seizure, or does not return to normal within 30 minutes
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
Understanding an Epilepsy Diagnosis in My Baby
Epilepsy is diagnosed when a child has two or more unprovoked seizures or one seizure with a high likelihood of recurrence (such as an abnormal EEG). The diagnostic process involves detailed history, EEG (brain wave test), and often MRI. Many childhood epilepsy syndromes have excellent prognoses, with many children outgrowing their epilepsy. Treatment with anti-seizure medication controls seizures in about 70% of children. A pediatric neurologist guides diagnosis and management.
Concerns About Anti-Seizure Medication for My Baby
Anti-seizure medications (also called anticonvulsants or AEDs) are effective at controlling seizures in about 70% of children. Common medications for babies include levetiracetam (Keppra), phenobarbital, and oxcarbazepine. All medications have potential side effects, but uncontrolled seizures also carry risks. Your neurologist will choose the medication best suited to your baby's seizure type and monitor for side effects with regular check-ups and blood tests.
EEG Testing for My Baby - What to Expect
An EEG (electroencephalogram) is a painless test that measures electrical activity in the brain using small sensors (electrodes) placed on the scalp. It helps diagnose seizures and epilepsy. The test typically takes 30-60 minutes for a routine EEG, though some require overnight monitoring. Preparation may include sleep deprivation to encourage sleep during the test. The electrodes are attached with a washable paste and do not hurt your baby.
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'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.