Seizures in children can be frightening and confusing for parents and caregivers. While a single seizure might be linked to fever or an isolated incident, recurring seizures could be a sign of an underlying neurological condition such as epilepsy. Understanding the different types of pediatric seizures and their symptoms is essential for early detection and effective treatment.
This blog provides a detailed overview of the various seizure types in children, what symptoms to watch for, and why early intervention is so important.
What Is a Seizure?
A seizure is a sudden surge of abnormal electrical activity in the brain. Depending on the part of the brain involved, seizures can manifest in different ways—ranging from momentary staring spells to full-body convulsions.
Seizures can be triggered by multiple factors including high fever (febrile seizures), infections, metabolic disorders, genetic factors, or head trauma. When a child experiences multiple unprovoked seizures, it is often classified as pediatric epilepsy.
Main Categories of Pediatric Seizures
Seizures are generally classified into focal (partial) and generalized types.
1. Focal Seizures
These begin in one specific area of the brain and may be divided into:
- Focal Aware Seizures (Simple Partial):
The child remains conscious but may report odd sensations—like tingling, flashing lights, or strange tastes. There may also be minor muscle movements or twitching. - Focal Impaired Awareness Seizures (Complex Partial):
These involve altered awareness or responsiveness. Children might appear confused, dazed, or perform repetitive movements like hand rubbing or lip-smacking.
2. Generalized Seizures
These affect both sides of the brain and often involve loss of consciousness. Types include:
- Absence Seizures (Petit Mal):
Characterized by brief staring episodes that last only a few seconds. These often go unnoticed and may be mistaken for daydreaming. - Tonic-Clonic Seizures (Grand Mal):
These are the most recognized type, involving stiffening (tonic phase) followed by jerking movements (clonic phase). The child may lose consciousness and experience confusion afterward. - Myoclonic Seizures:
Sudden, brief jerks or twitches in the muscles. These typically occur in clusters, often after waking up. - Atonic Seizures (Drop Attacks):
A sudden loss of muscle tone leads to the child collapsing or nodding forward abruptly. Helmets may be recommended to prevent injury. - Tonic Seizures:
Muscle stiffening, typically occurring during sleep, which may cause falls if the child is standing. - Clonic Seizures:
Rhythmic jerking movements, typically involving the face, neck, and arms. Less common than tonic-clonic seizures.
Febrile Seizures
Febrile seizures are associated with a rapid rise in body temperature, commonly affecting children between 6 months and 5 years of age.
- Simple Febrile Seizures: Last less than 15 minutes and don’t recur within 24 hours.
- Complex Febrile Seizures: Last longer than 15 minutes, may recur the same day, or affect only one part of the body.
While these are usually harmless, repeated episodes should be evaluated by a healthcare provider.
Infantile Spasms (West Syndrome)
This rare and serious type of seizure usually appears between 3 to 12 months of age. Spasms often occur in clusters and involve sudden, jerky movements of the neck, trunk, or limbs. Timely diagnosis is crucial because the condition is associated with developmental delays and other neurological issues if left untreated.
Lennox-Gastaut Syndrome (LGS)
LGS is a severe form of epilepsy that typically begins between ages 3 and 5. Children often experience a mix of seizure types, especially tonic and atonic, and may also have learning and behavioral difficulties. Treatment can be complex, often requiring a multidisciplinary approach.
Childhood Absence Epilepsy
A common condition in school-aged children, this type involves frequent absence seizures that may happen dozens of times a day. Children may appear to be zoning out or staring into space, affecting their learning and attention. Fortunately, many outgrow this condition with proper treatment.
Benign Rolandic Epilepsy
Also known as benign epilepsy with centrotemporal spikes, this type usually affects children between ages 3 and 13 and often occurs during sleep. Symptoms may include facial twitching, drooling, and difficulty speaking. Most children outgrow it by adolescence.
Symptoms of Seizures in Children
Identifying a seizure can be difficult, especially if it presents subtly. Common symptoms include:
- Blank staring or unresponsiveness
- Sudden muscle jerks or twitching
- Repeated blinking or lip-smacking
- Loss of consciousness or awareness
- Sudden falls or head drops
- Confusion after episodes
- Strange tastes, smells, or visual hallucinations
If you notice any of these signs, especially if they happen repeatedly, consult a healthcare professional.
Diagnosis
Diagnosing seizure disorders in children involves several steps:
- Electroencephalogram (EEG): Detects abnormal brain wave activity.
- MRI or CT Scans: Reveal structural abnormalities in the brain.
- Blood Tests: Check for infections, metabolic disorders, or genetic issues.
- Video EEG Monitoring: Allows doctors to observe and record seizures in real-time.
Early and accurate diagnosis helps ensure effective treatment and better long-term outcomes.
Treatment Options
Treatment depends on the type, frequency, and cause of the seizures. Options include:
- Medications: Anti-seizure drugs (ASMs) are the most common treatment.
- Ketogenic Diet: A high-fat, low-carb diet that can reduce seizure frequency in some children.
- Vagus Nerve Stimulation (VNS): A device implanted under the skin to reduce seizure activity.
- Surgery: For severe or drug-resistant epilepsy, surgical intervention may be considered.
- Lifestyle Changes: Ensuring adequate sleep, avoiding known triggers, and managing stress can help minimize seizures.
Living with Pediatric Seizures
Managing seizures is often a team effort involving healthcare providers, parents, teachers, and the child. Education about the condition, medication adherence, and having an emergency plan in place are all essential.
Children with well-controlled epilepsy can participate in most activities, including school and sports, with minimal limitations.
When to Seek Medical Help
Seek immediate medical attention if:
- A seizure lasts more than 5 minutes
- Seizures happen in clusters
- The child has trouble breathing or waking up afterward
- There is a seizure after a head injury
- Seizures begin to occur more frequently or change in type
Expert Neurological Care for Children
If your child is experiencing seizures or unusual neurological symptoms, early diagnosis and specialized care can make all the difference. The New Jersey Pediatric Neuroscience Institute offers comprehensive neurological evaluation and treatment tailored to the needs of young patients. From routine monitoring to advanced care plans, the team is dedicated to supporting your child's health and development.
Schedule a Consultation Today
Visit New Jersey Pediatric Neuroscience Institute or call (973) 326-9000 to book an appointment with a pediatric neurology expert.
Conclusion
Seizures in children vary widely in type, cause, and severity. By understanding the differences and recognizing the signs early, parents and caregivers can take the right steps toward diagnosis and treatment. With appropriate medical support, most children with seizure disorders can lead healthy, active lives.
