About Epilepsy
Epilepsy is a neurological condition characterised by a tendency to have recurrent seizures. It is one of the most common serious neurological conditions in childhood, affecting approximately 1 in 200 children in the UK.
Seizures occur when there is a sudden burst of excessive electrical activity in the brain. There are many different types of epilepsy and seizure, and the condition affects each child differently. Most children with epilepsy have their seizures well controlled with medication and can participate fully in school life.
Every pupil with epilepsy should have an Individual Healthcare Plan that details their specific seizure type, triggers, medication, emergency procedures and any impact on learning.
Types of Seizures
Focal Seizures (previously called partial seizures)
These start in one area of the brain. The child may remain conscious (focal aware seizure) or their awareness may be affected (focal impaired awareness seizure). Signs may include unusual sensations, repetitive movements (e.g. lip smacking, picking at clothes), confusion or appearing to daydream.
Generalised Seizures
- Tonic-clonic seizures: The child loses consciousness, the body stiffens (tonic phase) and then the limbs jerk rhythmically (clonic phase). These are the most commonly recognised type of seizure.
- Absence seizures: Brief episodes (usually 5-15 seconds) where the child appears to blank out or stare. They may be mistaken for daydreaming. These can occur many times a day and may go unnoticed.
- Myoclonic seizures: Sudden, brief jerks of a muscle or group of muscles.
- Atonic seizures (drop attacks): A sudden loss of muscle tone causing the child to fall.
- Tonic seizures: The muscles suddenly stiffen.
- Stay calm and note the time the seizure started
- Protect the child from injury by clearing the area around them; cushion their head if possible
- Do NOT restrain the child or put anything in their mouth
- When the jerking stops, place the child in the recovery position
- Stay with the child and reassure them as they come round; they may be confused, tired or emotional
- Call 999 if: the seizure lasts longer than 5 minutes (or the time stated in the IHP), it is the child's first seizure, the child is injured, the child has difficulty breathing afterwards, or seizures occur in rapid succession
Emergency Medication
Some children with epilepsy are prescribed emergency medication (such as buccal midazolam) for prolonged or cluster seizures. This should only be administered by staff who have received specific training. The details, including the circumstances in which emergency medication should be given, must be clearly documented in the child's IHP.
SUDEP Awareness
Sudden Unexpected Death in Epilepsy (SUDEP) is rare, but schools and families should be aware of it. Good seizure management, taking medication as prescribed and having a well-managed IHP all help to reduce risk. Epilepsy Action and Young Epilepsy provide guidance on SUDEP awareness.
Classroom and School Strategies
Seizure Management
- Ensure all staff who work with the pupil know their seizure type and first aid response
- Display the pupil's seizure care plan in relevant areas (with parental consent)
- Train designated staff to administer emergency medication if prescribed
- Record all seizures and share information with parents and the medical team
- Risk assess activities such as swimming, climbing and science practicals; most can be adapted rather than avoided
Impact of Medication and Seizures on Learning
- Anti-epileptic medication can cause drowsiness, reduced concentration, memory difficulties and slowed processing
- Absence seizures may cause the child to miss short bursts of information; check understanding regularly
- After a tonic-clonic seizure, the child may be confused, tired and need time to recover
- Be alert to changes in behaviour, mood or learning that may indicate seizure activity or medication effects
- Provide catch-up support after absences related to seizures or medication changes
General Support
- Maintain high expectations; epilepsy does not in itself affect intelligence
- Be sensitive to the emotional impact, including anxiety about having a seizure at school
- Educate peers age-appropriately to reduce stigma and promote understanding
- Allow the pupil to leave the room discreetly if they feel a seizure coming on (if they have auras)
- Provide a quiet, safe space for recovery after a seizure
- Support the pupil's independence and inclusion in all activities where safe to do so
- Be aware that tiredness, illness, stress and flashing or flickering lights can be triggers for some pupils
Further Information and Resources
Epilepsy Action provides schools resources, training and a helpline.
Young Epilepsy offers specialist education support and guidance for schools.
NHS information on epilepsy offers accessible medical information.