What Are Seizures in Children?
A seizure is a sudden and abnormal surge of electrical activity in the brain that can happen to anyone. Seizures can vary in symptoms, from dramatic loss of consciousness and convulsions to more subtle feelings like déjà vu. While seizures are common and often stop on their own, they can be a sign of a more serious condition called epilepsy.
Epilepsy is a condition where a person has a tendency to have seizures regularly. It affects about one in 26 people who have experienced seizures. However, many children outgrow their tendency to have seizures as they get older.
It's important to seek medical help if you or someone you know has had a seizure. A proper diagnosis can help doctors find the best treatment options to manage and possibly prevent future seizures. Seizures are treatable, and with the right care, many people with epilepsy can live normal, healthy lives.
Read more: What Does It Feel Like to Parent a Child With Epilepsy?
What Are The Most Common Types of Seizures in Children
- Focal (partial) seizures
Focal seizures occur when there is abnormal electrical activity in one or more areas of the brain. Before a focal seizure, your child may experience an aura, which is a warning sign that a seizure is about to happen. This is more common with complex focal seizures. Auras can include feelings like deja vu, fear, euphoria, or impending doom. Your child may also have visual, auditory, or olfactory changes. There are two types of focal seizures:
- Simple focal seizure.
A simple focal seizure occurs when there is abnormal electrical activity in a specific area of the brain. The symptoms can vary depending on which part of the brain is affected. If the seizure occurs in the occipital lobe, which is responsible for vision, your child may experience changes in their sight. More commonly, the muscles are affected, with the seizure activity limited to a specific muscle group such as the fingers, arms, or legs. Your child may also experience symptoms like sweating, nausea, or paleness. Importantly, your child will not lose consciousness during a simple focal seizure.
- Complex focal seizure.
A complex focal seizure is a type of seizure that often occurs in the region of the brain responsible for emotions and memory (temporal lobe). During this seizure, your child may lose consciousness, although they may not necessarily pass out. They may appear to be awake, but exhibit unusual behaviors such as gagging, lip smacking, running, screaming, crying, or laughing. After the seizure, your child may feel tired or sleepy, which is known as the postictal period.
- Generalized seizure
Also known as a grand mal seizure, this type of seizure is characterized by five distinct phases. The body, arms, and legs of the individual will contract, extend, and tremor. This is followed by muscle contractions and relaxations, known as the clonic period, and then the postictal period. During the postictal period, the individual may feel sleepy and experience vision or speech problems, along with a headache, fatigue, or body aches. It's important to note that not everyone will experience all of these phases during a grand mal seizure.
- Absence seizure .
Pediatric absence seizures, also known as petit mal seizures, are characterized by brief episodes of altered consciousness and staring. During these seizures, the child may maintain their posture and exhibit movements of the mouth, face, or eyes. The seizure typically lasts no longer than 30 seconds, after which the child may not remember what happened. It is common for these seizures to occur multiple times a day. It is important to note that absence seizures can be mistaken for learning or behavioral problems. These seizures usually begin between the ages of 4 and 12.
- Atonic seizure.
Atonic seizures, also known as drop attacks, can occur in children and involve a sudden loss of muscle tone. This can cause the child to fall from a standing position or drop their head abruptly. During the seizure, the child will be limp and unresponsive.
- Generalized tonic-clonic seizure (GTC).
Generalized tonic-clonic seizures, also known as GTC or grand mal seizures, involve five distinct phases in children. These phases include muscle flexing, extension, tremors, clonic muscle movements, and a postictal period. During the postictal period, the child may experience sleepiness, vision or speech difficulties, headaches, fatigue, or body aches.
- Myoclonic seizure.
A type of seizure characterized by rapid movements or sudden jerking of a specific group of muscles is known as myoclonic seizures. These seizures typically occur in clusters, meaning they can happen multiple times a day or persist for several consecutive days.
- Infantile spasms
Infantile spasms are a rare type of seizure disorder that typically affects infants under six months of age. These seizures often occur when the child is waking up or going to sleep. During an episode, the infant may experience brief periods of movement in their neck, trunk, or legs that last only a few seconds. It is not uncommon for infants to have hundreds of these seizures in a single day. This condition can be quite serious and may lead to long-term complications if not properly addressed.
- Febrile seizures
Febrile seizures in children are often linked to a fever and are most commonly seen in kids between 6 months and 5 years old. There may be a family history of these seizures. Seizures that last less than 15 minutes are considered 'simple' and usually do not cause lasting neurological issues. However, seizures lasting longer than 15 minutes, known as 'complex' seizures, may result in long-term neurological changes in the child.
What causes a seizure in a child?
When thinking about seizures, many people imagine a person having a violent shaking episode on the ground. However, seizures can also be subtle and hard to detect, especially in infants.
Common symptoms of seizures include a change in lip or face color, as well as a strange feeling that the person may not be able to describe.
Seizures can be caused by various factors such as an imbalance of brain chemicals, a brain tumor, stroke, or brain damage from illness or injury. Sometimes, seizures can be a result of a combination of these factors. In many cases, the exact cause of a seizure remains unknown.
What are the signs & symptoms of a seizure in a child?
Seizures can be very different from what we see in movies and on TV. They can be subtle and hard to recognize, especially in infants. Some common symptoms to look out for include:
Non-motor Symptoms:
- A change in color of the lips or face
- A strange feeling that the child can't explain
- Decreased awareness or responsiveness, with staring
- Eyes or head turned in one direction
- Staring with eye fluttering
- Seeing shapes or stars
- Excessive drooling
- Loss of control over bowel or bladder
Motor Symptoms:
- Repetitive actions like fiddling with clothing, grunting, lip-smacking, and clumsy movements
- Convulsions (shaking uncontrollably)
- Drooping facial features
- Jerking or stiffness in arms and legs
- Sudden loss of muscle control
- Twitching or jerking of the face, arm, or leg
After the seizure ends, the child may feel tired and need to rest. It's important to be aware of these symptoms and seek medical help if needed.
How are seizures diagnosed in a child?
Seizures in children are diagnosed by a healthcare provider through a thorough assessment of symptoms and health history.
- Factors such as recent fever, head injury, congenital conditions, preterm birth, and medications will be considered.
- A neurological exam may be conducted to evaluate the child's condition.
- Blood tests may be done to check for abnormalities in blood sugar and other factors.
- Imaging tests, such as an MRI or CT scan, may be used to examine the brain.
- An electroencephalogram (EEG) may be performed to assess the electrical activity in the brain.
- In some cases, a lumbar puncture (spinal tap) may be done to measure pressure in the brain and spinal canal and test the cerebral spinal fluid for infection or other issues.
How are seizures treated in a child?
Seizures in children are typically treated by a team of specialists who work together to address the underlying cause of the seizures. Here are some key points to consider when treating seizures in a child:
- Specialists experienced in the specific condition that is triggering the seizures will collaborate with seizure and epilepsy specialists to provide comprehensive care.
- Treatment not only focuses on managing the seizures themselves, but also on addressing any potential complications that may arise.
- Neuropsychologists play a vital role in the treatment process by assessing your child's cognitive abilities, learning, behavior, emotional well-being, and social function.
- Based on these assessments, strategies are developed to help your child reach their full potential and function at their highest level.
- The goal of treatment is to provide holistic care that addresses both the physical and emotional well-being of the child.
Overall, a multidisciplinary approach involving various specialists is crucial in ensuring the best possible care for a child experiencing seizures.
How can I help my child live with epilepsy?
To support your child living with epilepsy, ensure they understand their seizure type and medication. Keep track of doses and side effects, and consult their healthcare provider before giving other medications. Help them avoid triggers, prioritize sleep, and attend regular check-ups. Encourage safe activities with proper supervision and protective gear.
When should I call my child’s healthcare provider?
Contact your child's healthcare provider if their symptoms worsen or fail to improve, or if they experience any side effects from medication. It is important to seek medical advice if you have any concerns about your child's health.
