A focal onset seizure starts in one part of the brain. Doctors used to call them partial seizures.
What it looks like depends on where in the brain it happens. Your child may have symptoms like twitching or tingling in the hand, a sense of dread, or feeling like time slows down.
Focal onset seizures tend to be very short.
As you get a handle on what to expect from your child's focal onset seizures, you may start to think longer term. Can my child go on field trips? Play sports? Travel? The answer to those questions is yes, yes, and yes.
There may be some limits, but it's important for your child to do the same things as all the other kids. And that's usually possible with a little extra planning.
Create a Plan of Action
If your child gets focal onset seizures, anyone who cares for them needs to know:
- What your child's seizures look like
- What to do during one
- What's an emergency and how to handle it
- When and how to get in touch with you
That's where a plan of action comes in. It's like a checklist you and your child create with help from your doctor. Print out a bunch of copies and go over them with teachers, family members, baby sitters, friends' parents, bus drivers, coaches, and anyone else responsible for your child.
Make Your Home Safe
Think about what your child is like during a focal onset seizure and what you can do to make your house safer. You may want to:
- Add handrails to stairs.
- Have soft carpet to cushion falls.
- Remove area rugs since they might slip or cause tripping.
- Keep your home neat and uncluttered so there's less to trip over.
- Pad furniture, counters, or walls that have sharp edges.
- Put safety gates near stairs.
- Remove glass tables.
- Use guards to block hot objects like fireplaces or stoves.
It's best to have your child skip baths and go with showers instead, since a seizure that happens in water can lead to drowning.
If your child tends to fall during seizures, a shower seat and shower bars can be a big help. If your child does take a bath, someone has to be in the bathroom at all times.
As your child gets older, privacy becomes a concern. You might have to be creative on this one, like using a baby monitor or asking your kid to sing in the shower. And make sure your child knows to never lock the bathroom door. You might want to have an "In Use" sign instead.
Consider a Smart Watch
The FDA has approved a smart watch that can detect when your child is having a seizure and can alert you as well as help you locate where they are. When it senses a seizure, the Embrace sends a text and phone message to caregivers. Th GPS location feature tells you where they are.. The watch stores data to help doctors understand possible seizure patterns.
Get a Medical Alert Bracelet
This is a simple bracelet that tells people your child gets seizures. It's something that first responders like EMTs and paramedics look out for. It's especially important as your child gets older and spends more time away from you.
Sports and hobbies are important for your child. They help avoid depression, boost self-esteem, and build friendships.
The better controlled seizures are, the more your child can do. If you're not sure an activity is safe, check with the doctor.
Many kids have few limits. From baseball and gymnastics to basketball, bowling, and horseback riding, you can encourage your child to try all kinds of things. Even contact sports, like hockey and football, are typically fair game.
Swimming is fine, but your child can't swim alone. Someone needs to be there who knows what to do in case of a seizure in the water. Wearing a life jacket, even for a strong swimmer, is a smart idea.
Your child will need to avoid things like scuba diving, skydiving, and rock climbing without a harness. In activities like those, your kid just can't afford to lose attention, even for a moment.
Field Trips, Camp, and Travel
Your child can typically do all these activities, too. Here are a few things to keep in mind:
- Give adults on the outing a plan of action.
- If traveling across time zones, check in with your doctor about how to adjust the schedule for your child's medicine.
- Learn about emergency services in the area you're visiting.
- Make sure your child has a medical alert bracelet.
- Pack enough medicine, including some extra, and make sure it's stored the right way.
How to Help Prevent Seizures
To lower the odds of a seizure, make sure your child:
Can I Leave My Child Alone?
As your child gets older and wants more privacy and independence, this is a tough question to answer. Work with your child and doctor to figure out what's safe.
If you decide that it can work, you may want to put some safeguards in place. You can make sure friends and neighbors have a copy of your key. You could use a lockbox, where you put your key in a lock on the door. Only someone with the code can get the key out.
You could also look into alarms and personal care hotlines. Some can detect falls in the house and send emergency help.
Recently, the FDA approved a watch that detects tonic-clonic seizures and sends alerts to caregivers. Keep an eye out for new technologies like this that might someday detect focal seizures as well.
What to Do During Your Child's Focal Onset Seizure
When your child has a focal onset seizure, your role boils down to three basic things: stay calm, offer comfort, and keep them safe. If you start there and keep in mind some important dos and don'ts, you'll be in good shape. Give it some time and practice, and it'll become second nature.
Things to Do
When a focal onset seizure starts in your child, follow these tips:
- Keep your cool. It might be hard at first, but it gets easier as you learn what to expect. Staying calm lets you think clearly, and you'll find that your attitude has a way of spreading. Your child and anyone else who might be around will take their cues from you. So speak gently and offer plenty of reassurance.
- Keep your child company. Seizures can be scary, so just being there matters. You'll also help prevent injury during one and give them comfort afterward. Plus, you can see how the seizure played out and share those details with your child's doctor.
- Keep your child safe. Move any hazards out of the way, like hot objects, furniture with sharp edges, and anything your child might trip over. If they wander around, you might need to act as a moving barrier to steer them away from stairs, traffic, or anything else harmful.
- Try to make your child comfortable. If possible, guide your child to a safe place to sit, but don't force it. If they wear glasses, remove them if you can. If your child is on the ground, try to get them on their side with their mouth facing down. It makes breathing easier and keeps them from choking on saliva.
- Time it. How long a seizure lasts and how long it takes your child to return to normal is good information for the doctor to have. Also, a seizure that goes on for over 5 minutes is an emergency. If your doctor gave you rescue treatment medicine for these cases, you'll need to use it and call 911.
- Help your child recover. After a seizure, the last thing any kid wants is a crowd of anxious faces looking in. When you have things under control, calmly ask people to make room. Then, let your child know what happened. Keep it simple. Tell them where they are, that you're there, and that they're safe.
- Keep a log. When your child first starts having seizures, write down as much as you can about them. If you're able to, taking a video can help your doctor, too. Note things like the time of day, the length of the seizure, and what happened before, during, and after. Try to be specific about symptoms. Maybe you notice your child's head turns to the side. If you see any twitching or jerking, write down which side of the body it was on.
Things to Avoid
Here are some things you don't want to do:
- Don't put anything in your child's mouth. Food, water, and medicine are all choking hazards. Wait until your child totally gets back to normal before you offer anything.
- Don't shout or make quick movements. It can seem threatening or alarming. Slow, calm, and steady is the way to go.
- Don't restrain or try to move your child. If your child wanders around, try to make the area as safe as possible. Only move them if they're in danger where they are, like near stairs or in the water.
Those last two don'ts are especially important for kids who have focal onset impaired awareness seizures, which used to be called complex partial seizures. During one, your child may not know what they're doing or what's happening around them. Because of that, you don't know how they'll respond if you talk to them or try to touch them.
If you need to touch your child for any reason, approach gently from the side and softly speak to them first. You want to do your best to make sure they don't feel threatened or alarmed.
If your child has a seizure in the water, support their body and keep their head above the surface. Try to get them out of the water as soon as possible. And even if your child seems fine afterward, it's smart to have a doctor check things out.
When to Call 911
There are times when you need to get emergency medical help right away. Call 911 if your child:
- Has a seizure that lasts more than 5 minutes
- Never had a seizure before
- Doesn't come to after a seizure
- Has trouble breathing or seems to be choking
- Gets several seizures in a row and can't recover between them
- Gets hurt
- Doesn't get better from a rescue treatment (medicine used in emergencies)