Cheryl Martin (Host): This is Children's Health Checkup, where we answer parents most common questions about raising healthy and happy kids. I'm Cheryl Martin. We're continuing our series on Epilepsy in Kids by discussing seizure first aid and precautions with our expert, Dr. Elisa Geraldino. She's a Pediatric Neurologist at Children's Health and UT Southwestern.

Whether you're a parent of a child with epilepsy or not, it's important to know how to spot the signs of a seizure and what to do in case someone you know experiences one. Dr. Geraldino, so glad you're on to discuss this vital topic.

Elisa Geraldino Castillo, MD: Thank you so much for having me.

Host: So first, what are some common signs or symptoms to know when a child is about to have a seizure?

Elisa Geraldino Castillo, MD: Yes, unfortunately, sometimes there are no signs or warnings right before someone's going to have a seizure. But some children or people with epilepsy actually do experience what we call seizure auras, which are brief sensory changes or feelings that can happen just before they're about to have a full seizure.

 Some of them that we can mention today, so people are on the lookout include altered mentation, like them being unresponsive or staring off into space, changes in their speech, or some focal mild twitching that can start, let's say, with a facial twitch or an arm twitching that then goes on to progress to a generalized seizure.

So those things we can, the moment we spot them, we can make sure that we're placing them in a safe space.

Host: So, what are the essential seizure first aid steps to be aware of when a child with epilepsy experiences a seizure?

Elisa Geraldino Castillo, MD: Yes, so this is very, very important. I think the key first step is to try to stay calm. That way, whoever's experiencing that with the kid or the person having a seizure can help. First, it's just clearing the area from any potential hazards like furniture, or objects that they could bump their head into, and removing them from dangerous spaces like if they're at the bottom of the stairs or close to a wall.

 Then the second next step, uh, important thing is going to be to place them on the side. That way if they're draining anything from their mouth or nose, all the secretions can drain to the side and avoid aspiration. Then we have to start counting the seizure and that way the seizure is lasting five minutes or longer, we can call the emergency services or 911 to get help. One of the other most important things that we always talk about in emergency situations with seizures, is making sure that they're grabbing their emergency medication or have that handy. In that moment when the seizure is lasting five minutes is usually when we say to go ahead and give the emergency medication as instructed by your providers.

Host: Any other tips when it's an emergency situation?

Elisa Geraldino Castillo, MD: Yeah, so, speaking a little bit more about those emergency medications, sometimes if your kid is too young to have emergency medications, usually we say if they're younger than two years old, we usually do recommend that parents go ahead and call 911 even if a seizure is lasting a little bit less than five minutes as we don't have any emergency medication to administer at the home.

 And then the other important thing to keep in mind with emergency medications is that they are very specific for each child and they come pre sampled with the dose for that specific child or patient. So if you have more than one kid in a household that has epilepsy and emergency medications, we have to have them labeled for each one of them. That way, in case of an emergency, you grab the correct one for your child, as the dose can be different for one kid to the other.

Host: Are there any common seizure precautions that parents can implement at home to create a safer environment for their children with epilepsy?

Elisa Geraldino Castillo, MD: Yes, we call that seizure proofing, similar to when your child proofing your home. There are a couple potential hazards to look out for to try to protect your kid from, including sharp corners, loose rugs, slippery surfaces, that they can bump into for example, if they're having a big seizure and falling to the ground. Another important one is stairs and pools.

Make sure that we're using stair gates and gates around pool areas. Also very important that if someone has epilepsy, especially if they're not very well controlled or having seizures frequently, that they avoid very, like, high risk house chores. For example, ironing or cooking, using electric tools without supervision just in case they were to have a seizure while using one of those objects.

Host: Now, are there specific triggers or factors that parents should be mindful of to help prevent seizures in their children, anything they can do?

Elisa Geraldino Castillo, MD: Yes, it is important first of all to work with your child's doctor to identify triggers that are specific for them. But some of the common triggers that we see include missing your medication, illnesses, viral infections, sleep deprivation. Those three I would say are the most common ones that we can work towards avoiding. There are specific types of epilepsy that we call photosensitive epilepsies, and that's when people with epilepsy have seizures that are triggered by flashing lights.

 Not everyone has that photosensitivity, but it's just important to remember in case someone has that specific type of epilepsy to avoid big flashing lights at specific frequencies, brightness, and speeds.

Host: Are there any advancements or technologies available that parents can leverage to monitor and respond effectively to their child's seizures, enhancing overall seizure management at home?

Elisa Geraldino Castillo, MD: Yes, we have new devices or wearable devices, also smartphone apps that can be very helpful tools for monitoring and detecting seizures. Some of the devices even allow for emergency contacts to be notified to their phone when someone that is using the device is having a seizure.

 Something that is very important to keep in mind is that these devices only detect motor seizures. That means, seizures usually that are generalized tonic clonic with a lot of movement because they are detecting movement patterns. And some of them might require subscriptions. But you can always work with your doctors in your clinics, to figure out which patients or, if your child can have that approved by insurance and investigate the cost through the clinic as well.

Host: Doctor, how important is it for parents to educate other caregivers, teachers, and friends about seizure first aid and precautions to ensure supportive network for their child?

Elisa Geraldino Castillo, MD: It is essential, I would say. Educating our teachers, caregivers, friends, it just empowers them to react appropriately when someone is having a seizure and not only ensures your child's safety, but also is fostering a supportive environment for them. One thing that I wanted to mention, especially in Texas, we have something that's called Sam's Law, which is a Texas law that mandates that teachers or any personnel that has regular contact with students in Texas public schools have training in seizure recognition and first aid.

 Private schools can actually opt in of this option as well and they can get training through the Epilepsy Foundation of Texas. So their website is also really, really helpful. They offer educational videos and training for family members or caregivers as well that can be accessed through their webpage.

Host: This has been some great information. Thank you so much, Dr. Elisa Geraldino, for sharing your expertise on this topic. Thank you.

Elisa Geraldino Castillo, MD: Thank you so much for having me and talking about this important topic today.

Host: This concludes our series on epilepsy in children. For more information, visit childrens.com/epilepsy. Thanks for listening to Children's Health Checkup. If you found this podcast helpful, please rate, review, and share the episode on your social media and follow Children's Health on your social channels.