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Seizures


Definition

  • A seizure is when the brain functions abnormally, resulting in a change in movement, attention, or level of awareness.  There are seizures that can occur in newborns, toddlers, school-aged children and teenagers.  It is especially frightening for parents when their child initially has a seizure.
  • About 3% of all children have a seizure when younger than 15 years
  • About 1.5% of children have febrile seizures.
  • About 1% of children have epilepsy-recurring seizures.
  • There are different types of seizures that could occur in children.

Febrile seizures

  • Occurs when a child contracts an illness accompanied by a fever.  The most common illness associated with febrile seizures is ear infections, colds or chickenpox.
  • 2 to 5% of children have febrile seizures at some point during their childhood.
  • Although the cause of febrile seizures is unknown in some children, there are some risk factors that have been identified;
  • Children with relatives (especially brothers and sisters), who have has febrile seizures.
  • Children who are developmentally delayed or who have spent more than 28 days in a neonatal intensive care unit.
  • 1 out of 4 children who have a febrile seizure will have another, usually within a year.
  • Children who have had a febrile seizure in the past are also more likely to have a second episode.

Neonatal seizures

  • This type of seizures occurs within 28 days of birth.  Most occur soon after the child is born. 
  • They may be due to a large variety of conditions. 
  • With the newborns, the seizures typically do not look like seizures; this is because they do not have convulsions.  Instead their eyes appear to be looking in different directions, may have lip smacking or periods of no breathing.

Partial seizures

  • This type of seizures only involves part of the brain and therefore only a part of the body.
  • Simple partial seizures have a motor (movement) component that is located in one portion of the body.
  • Children with these seizures remain awake and alert.

Complex seizures

  • Complex partial seizures are similar to partial seizures, except that the child is not aware of what is going on. 
  • Children have no memory of this activity and are often disoriented in a state known as the postictal period.

Generalized seizures

  • Generalized seizures involve a much larger portion of the brain.

There are two types of generalized seizures (with subcategories):

Convulsive (muscles jerking)

  • Uncontrollable muscle jerking lasting for a few minutes.  This is usually followed by a period of drowsiness that is called the postictal period.  The child should return to normal, except for the drowsiness, withing 15 minutes.  The child may have wet them self or soiled themselves and do not remember the seizure.  Also, this type of seizure may cause injury to the child, such as biting the tongue or a broken bone.
  • Tonic seizures: continuous muscle contraction and rigidity
  • Tonic-clonic seizures: alternating tonic activity with rhythmic jerking of muscle groups
  • Infantile spasms: commonly occurs in children younger than 18 months; often associated with mental retardation and consists of sudden spasm of muscle groups 

Nonconvulsive

Absence seizures or petit mal seizures

  • Short episodes during which the child stares or eye blinks, with no apparent awareness of their surroundings.  These episodes usually do not last longer than a few seconds and start and stop abruptly.
  • The child does not remember the event at all.

Status epileticus

  • A seizure lasting longer than 30 min or repeated seizures without a return to normal in between them.
  • Most common in children younger than 2 years; most of these children have generalized tonic-clonic seizures
  • This type of seizure is very serious and with any suspicion of a long seizure, you should call 911.

Epilepsy

  • A pattern of chronic seizures of any type over a long period. 
  • 30% of children diagnosed with epilepsy continue to have repeated seizures into adulthood.

Causes of Seizures

Many causes of seizures are unknown for 3 out of 4 children.

Some suspected causes include:

  • Family history
  • Infections (such as meningitis)
  • Developmental problems (cerebral palsy, head trauma)

Febrile seizures causes

  • Infection associated with high fever

Other reasons for seizures

  • Infections
  • Metabolic disorders
  • Drugs
  • Medications
  • Poisons
  • Disordered blood vessels
  • Bleeding in the brain

Symptoms

Generalized convulsions/ febrile seizures

  • Rhythmic jerking and muscle spasms
  • Difficulty breathing
  • Eye rolling
  • Drowsy and confused after seizure
  • No memory of event

Petit mal seizures

  • Loss of awareness with staring or blinking
  • Starts and stops quickly
  • No convulsive movements
  • Children return to normal after seizure stops

Complex partial seizures

  • Repetitive movements such as chewing, lip smacking, or clapping
  • Confusion

Partial seizures

  • Affects one group of muscles, which spasm and move convulsively
  • Spasms may move from group to group (also know as march seizures)
  • Behave strangely during episode
  • May or may not remember seizure afterwards

Treatment

Self-care at home

  • Help the child to lie down
  • Remove glasses or other harmful objects in area
  • Do not put anything in child’s mouth
  • Check to see if child is breathing
  • Call 911 if not breathing
  • After seizure ends, place child on one side or sit with the child until child is fully awake
  • If fever is involved, acetaminophen (Tylenol) may be given
  • Do not give food, liquid or medication by mouth to a child who has just had a seizure

Medical Treatment

  • Medication if seizures are perisistent

Links

            http://www.emedicinehealth.com/seizures_in_children/article_em.htm