Seizures and Epilepsy in Children

Seizures and Epilepsy in Children Epilepsy is a brain condition that causes a child to have seizures. It is one of the most common disorders of the nervous system. It affects children and adults of all races and ethnic backgrounds. The brain consists of nerve cells that communicate with each other through electrical activity. A seizure occurs when one or more parts of the brain has a burst of abnormal electrical signals that interrupt normal brain signals. Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion. But when a child has 2 or more seizures with no known cause, this is diagnosed as epilepsy. There are different types of seizures. The type of seizure depends on which part and how much of the brain is affected and what happens during the seizure. The 2 main categories of epileptic seizures are focal (partial) seizure and generalized seizure. Focal (partial) seizures Focal seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. Before a focal seizure, your child may have an aura, or signs that a seizure is about to occur. This is more common with a complex focal seizure. The most common aura involves feelings, such as deja vu, impending doom, fear, or euphoria. Or your child may have visual changes, hearing abnormalities, or changes in sense of smell. The 2 types of focal seizures are: • Simple focal seizure. The symptoms depend on which area of the brain is affected. If the abnormal electrical brain function is in the part of the brain involved with vision (occipital lobe), your child’s sight may be altered. More often, muscles are affected. The seizure activity is limited to an isolated muscle group. For example, it may only include the fingers, or larger muscles in the arms and legs. Your child may also have sweating, nausea, or become pale. Your child won’t lose consciousness in this type of seizure. • Complex focal seizure. This type of seizure often occurs in the area of the brain that controls emotion and memory function (temporal lobe). Your child will likely lose consciousness. This may not mean he or she will pass out. Your child may just stop being aware of what's going on around him or her. Your child may look awake, but have a variety of unusual behaviors. These may range from gagging, lip smacking, running, screaming, crying, or laughing. Your child may be tired or sleepy after the seizure. This is called the postictal period. Generalized seizure A generalized seizure occurs in both sides of the brain. Your child will lose consciousness and be tired after the seizure (postictal state). Types of generalized seizures include: • Absence seizure . This is also called petit mal seizure. This seizure causes a brief changed state of consciousness and staring. Your child will likely maintain posture. His or her mouth or face may twitch or eyes may blink rapidly. The seizure usually lasts no longer than 30 seconds. When the seizure is over, your child may not recall what just occurred. He or she may go on with activities as though nothing happened. These seizures may occur several times a day. This type of seizure is sometimes mistaken for a learning or behavioral problem. Absence seizures almost always start between ages 4 to 12. • Atonic seizure. This is also called a drop attack. With an atonic seizure, your child has a sudden loss of muscle tone and may fall from a standing position or suddenly drop his or her head. During the seizure, your child will be limp and unresponsive. • Generalized tonic-clonic seizure (GTC). This is also called grand mal seizure. The classic form of this kind of seizure has 5 distinct phases. Your child’s body, arms, and legs will flex (contract), extend (straighten out), and tremor (shake). This is followed by contraction and relaxation of the muscles (clonic period) and the postictal period. During the postictal period, your child may be sleepy. He or she may have problems with vision or speech, and may have a bad headache, fatigue, or body aches. Not all of these phases occur in everyone with this type of seizure. • Myoclonic seizure. This type of seizure causes quick movements or sudden jerking of a group of muscles. These seizures tend to occur in clusters. This means that they may occur several times a day, or for several days in a row. Causes a seizure in a child A seizure can be caused by many things. These can include: • An imbalance of nerve-signaling brain chemicals (neurotransmitters) • Brain tumor • Stroke • Brain damage from illness or injury A seizure may be caused by a combination of these. In most cases, the cause of a seizure can’t be found. Symptoms of a seizure in a child Your child’s symptoms depend on the type of seizure. General symptoms or warning signs of a seizure can include: • Staring • Jerking movements of the arms and legs • Stiffening of the body • Loss of consciousness • Breathing problems or stopping breathing • Loss of bowel or bladder control • Falling suddenly for no apparent reason, especially when associated with loss of consciousness • Not responding to noise or words for brief periods • Appearing confused or in a haze • Nodding head rhythmically, when associated with loss of awareness or consciousness • Periods of rapid eye blinking and staring During the seizure, your child’s lips may become tinted blue and his or her breathing may not be normal. After the seizure, your child may be sleepy or confused. The symptoms of a seizure may be like those of other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis. Seizures diagnosed in a child The healthcare provider will ask about your child’s symptoms and health history. You’ll be asked about other factors that may have caused your child’s seizure, such as: • Recent fever or infection • Head injury • Congenital health conditions • Preterm birth • Recent medicines Your child may also have: • A neurological exam • Blood tests to check for problems in blood sugar and other factors • Imaging tests of the brain, such as an MRI or CT scan • Electroencephalogram , to test the electrical activity in your child’s brain • Lumbar puncture (spinal tap) , to measure the pressure in the brain and spinal canal and test the cerebral spinal fluid for infection or other problems MD Mkhadar Ali