Pediatric Seizures

Seizures are a sudden and uncontrollable abnormality is muscle tone or movement, behavior, sensations, or consciousness/state of awareness.   Almost 5% of individuals will have at leave 1 seizure during childhood.  Symptoms may include loss of consciousness, uncontrolled shaking or twitching of the entire body or a body part (such as a single arm or leg), confusion, staring spells, head nodding/bobbing, flexing or stiffening of the body.  Seizures are caused by abnormal electrical and chemical changes in the brain.  Some seizures only last for a few seconds, while others last multiple minutes.  Epilepsy is a disorder where multiple seizures occur over time in a child when they are not a result of brain injuries or fevers.

Types of Seizures in Children 

Generalized Seizures involve the entire brain and include both convulsive and absence seizures.

Convulsive seizures (also called generalized tonic-clonic seizures or grand mal seizures) are the most recognizable seizures in which the entire body rhythmically, rapidly, violently shakes or jerks.  The child is unconscious and unaware of the episode.  The seizure usually lasts 2-3 minutes and almost always stops on its own.

Febrile seizures are included in the generalized convulsive seizure category.  They happen in some children, generally under 5 years of age, when fevers occur.  Fortunately, although potentially scary and stressful for parents, febrile seizures are usually harmless and have no after effects.

Absence seizures (or Petit Mal) are sudden and brief lapses in consciousness.  The child will often appear to lose attention or stare off into space for a few seconds.  These seizures don’t often cause injury or harm to the child and can sometimes be difficult to spot.

Focal Seizures involve abnormal electrical signals to a single part of the brain.

They can involve jerking of one or more parts of the body and the child may be fully aware of what is going on.  In the past these seizures were also called simple partial seizures.

Other focal seizures involve altered consciousness, confusion, repetitive activities and movements such as walking around in circles, wringing of the hands, or other gestures without purpose.  These seizures typically last 1-2 minutes.  In the past, these seizures were also called complex partial seizures.

Sometimes focal seizures can start in 1 part of the brain and spread to other parts or the entire brain resulting in a generalized convulsive seizure.

What to do?

Fortunately, most seizures stop on their own within a couple minutes and do not require emergency medical attention.

If your child has convulsions, or what appears to be a seizure, the best thing you can do is prevent them from injuring themselves by laying them on their side with their hips higher than the head to prevent choking.

Once the episode stops, call your pediatrician, or seek medical care, especially if this is your child’s first seizure.

Call 911 if:

• The seizure or convulsions last longer than 5 minutes
• The seizure occurs in water
• Your child has diabetes
• The seizure occurs after a head injury
• The child appears to have difficulty breathing, choking, very pale or blue skin
• More than 1 seizure occurs

Seek medical attention if a seizure occurs and your child has a fever.  While febrile seizures are relatively common and almost always harmless, determining the cause of the fever or infection may be helpful to prevent repeat episodes and rule out more serious infections as the cause.  More than 1 febrile seizure in a 24-hour period should also be considered a potential emergency and warrants immediate medical attention.

Resources:

Healthychildren.org Seizure

Kids Health – Seizures