Epilepsy and Seizures at School: What Families and Staff Need to Know

A student has a generalized tonic-clonic seizure in the middle of a classroom. The teacher has never witnessed a seizure before. The school nurse is in a meeting at the other end of the building. The student has a seizure action plan on file in the health office that no one in that classroom has ever read.

That scenario is preventable. The school nurse's preparation work before the school year starts, in partnership with the student's family and medical team, determines what happens in that classroom when it matters most.

Get an updated seizure action plan on file

Every student with epilepsy or a seizure disorder needs a current seizure action plan completed by their physician before the school year begins. The plan must describe what the student's specific seizures look like, because seizures present very differently across individuals. A teacher who has only seen convulsive seizures in media depictions will not recognize an absence seizure or a focal seizure that looks like unusual behavior.

Request updated plans annually and whenever the student has a change in diagnosis, seizure frequency, or medication. A plan from two years ago may describe a seizure pattern that no longer reflects the student's current condition.

Staff training is not optional

Classroom teachers, PE teachers, cafeteria staff, and any adult who regularly supervises students with epilepsy need seizure first aid training. This training takes about 30 minutes and can be delivered by the school nurse. It covers what different seizures look like, what to do and not do during a seizure, when to call 911, and how to support the student during the postictal recovery period.

Training should occur every year, not just when a new student with epilepsy enrolls. Staff turnover and memory fade mean that annual training is the only reliable approach.

Rescue medications require advance authorization

If a student's neurologist has prescribed a rescue medication for prolonged seizures, the authorization process, training, and medication storage must all be in place before school starts. Waiting until after the first prolonged seizure to address the authorization paperwork is too late.

Invite families of students with rescue medication orders to meet with the nurse before school starts to complete all required forms, demonstrate the medication administration procedure, identify which staff will be trained as backup administrators, and store the medication appropriately.

Academic accommodations for seizure disorders

Epilepsy affects learning beyond the seizure events themselves. Fatigue from nighttime seizures, side effects from antiepileptic medications, and the cognitive aftermath of seizures all affect academic performance. Students with epilepsy typically qualify for 504 accommodations or an IEP if seizures significantly affect their school performance.

Connect families with the school counselor or special education coordinator if academic impact is a concern. The school nurse's role is to document the health dimension of that impact and advocate for accommodations that reflect what the student actually needs to participate fully.

Privacy and reducing stigma

Many students and families are reluctant to disclose epilepsy because of stigma. The school nurse has a responsibility to handle health information confidentially while also ensuring the adults who need to know do know. Work with families to determine which staff should be informed and what language to use, so that staff are prepared without the student feeling exposed to classmates or unnecessary scrutiny.