The first time your child has a seizure, everything you know about being a parent collapses into a single thought: make it stop. Your hands shake. Time distorts. You cannot remember what you are supposed to do. This guide exists so that when that moment comes, you do not have to think. You just follow the steps. Read it now. Print it. Put it on the fridge.
How Common Are Seizures in Children with CP?
Epilepsy co-occurs in 30 to 50% of children with cerebral palsy (Sellier et al., DMCN, 2012). The risk is highest in children with spastic quadriplegia (affecting all four limbs), those with moderate to severe brain injury from HIE, and those whose CP involved cortical malformations. If your child has CP, the possibility of seizures is something you must be prepared for, even if they have never had one.
Types of Seizures in Children with CP
| Seizure Type | What It Looks Like | Duration |
|---|---|---|
| Tonic-clonic (grand mal) | Body stiffens, then rhythmic jerking of arms and legs | 1 to 3 minutes |
| Focal seizure | Jerking or stiffening of one side or body part, may spread | Seconds to minutes |
| Absence seizure | Brief staring spell, unresponsive, may blink rapidly | 5 to 30 seconds |
| Myoclonic | Sudden brief muscle jerks, usually arms or upper body | 1 to 2 seconds |
| Infantile spasms | Clusters of sudden flexion (jackknife) movements in infants | 1 to 2 seconds each, clusters of 10 to 20 |
Step-by-Step Seizure First Aid
If HIE or oxygen deprivation caused your child’s CP and seizures, understanding what happened is the first step.
When to Call 911
Call emergency services immediately if:
- The seizure lasts longer than 5 minutes
- Your child stops breathing or turns blue
- It is your child’s first seizure ever
- Your child is injured during the seizure
- A second seizure follows without full recovery from the first
- The seizure occurs in water
- Your child does not return to their normal state within 15 to 30 minutes after the seizure ends
Rescue Medication
If your child has a diagnosed seizure disorder, their neurologist may prescribe rescue medication to stop a prolonged seizure:
- Diazepam rectal gel (Diastat): Administered rectally. Pre-dosed syringe. Your neurologist will specify the dose and when to give it (usually at 5 minutes).
- Midazolam nasal spray (Nayzilam): Sprayed into one nostril. Faster to administer than rectal options. Increasingly preferred by families and schools.
Both medications require a prescription, training on use, and a clear seizure action plan. Practice the administration steps before you ever need to use them.
If a birth injury caused your child’s CP and epilepsy, our team can help.
Creating a Seizure Action Plan
Every child with epilepsy should have a written seizure action plan that includes: your child’s seizure type(s) and what they look like, step-by-step first aid instructions, when and how to administer rescue medication, when to call 911, emergency contact information, and your child’s current anti-epileptic medications and allergies.
Give copies to every caregiver, grandparent, babysitter, daycare provider, and school nurse. The Epilepsy Foundation provides free, downloadable seizure action plan templates.
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