Generalized Tonic Clonic Seizure Disorder in Children

Generalized Tonic Clonic Seizure Disorder in Children

Generalized Tonic Clonic Seizure Disorder is a type of disorder in which a person has repeated seizures over time (epilepsy). A seizure is a sudden burst of abnormal electrical and chemical activity in the brain. This activity temporarily interrupts normal brain function.

A tonic-clonic seizure is a type of seizure that involves the entire brain (generalized seizure). Tonic-clonic seizures usually last 1–3 minutes, and they have two phases:

• The tonic phase. During this first phase of the seizure, your child’s muscles stiffen and your child may pass out (lose consciousness).
• The clonic phase. In this second phase of the seizure, your child may have convulsions. Convulsions are episodes of uncontrollable movement caused by sudden, intense tightening (contraction) of the muscles.

What are the causes?

In many cases, the cause of this condition may not be known. Possible causes include:

• Abnormal genes (gene mutations) that have been passed along from parent to child.
• An injury, infection, or growth in the brain that changes the structure of the brain.
• A brain abnormality that your child is born with (congenital brain abnormality).

What increases the risk?

This condition is more likely to develop in children:

• Who have a family history of epilepsy.
• Who have had one tonic-clonic seizure in the past.
• Who have autism, cerebral palsy, or other brain disorders.
• Who have had abnormal results from an electroencephalogram (EEG). This is a test that measures electrical activity in the brain. An EEG can predict whether seizures will return (recur).

What are the signs or symptoms?

The symptoms, frequency, and severity of tonic-clonic seizures vary. A tonic-clonic seizure usually begins with the following symptoms:

• Falling.
• Stiffening of the body.
• Bending (flexing) of the arms, wrists, and fingers.
• Straightening of the legs, head, and neck.
• Crying out or making a noise.
• Jaws clamping shut.
• Loss of consciousness.

Other symptoms during a tonic-clonic seizure may include:

• Convulsions.
• Buildup of saliva in the mouth and drooling.
• Loss of bladder control.
• Difficulty breathing.

Symptoms after a tonic-clonic seizure may include:

• Sleepiness.
• Confusion.
• Lack of memory of the seizure.

How is this diagnosed?

This condition may be diagnosed based on:

• Symptoms of your child’s seizure. It is important to watch your child’s seizure very carefully so that you can describe how it looked and how long it lasted.
• A physical exam.
• Tests, which may include:
  • CT scan.
  • MRI.
  • EEG.

How is this treated?

This condition is treated with medicines to prevent or control seizures (anticonvulsants). Treatment may also include:

• Giving foods that are low in carbohydrates and high in fat (ketogenic diet). This helps your child’s body produce substances (ketones) that may help to prevent seizures.
• Vagus nerve stimulation or deep brain stimulation. In these procedures, a device is inserted into the body. The device sends out electrical signals that may block seizures.

Follow these instructions at home:

• Give your child over-the-counter and prescription medicines only as told by his or her health care provider.
  • Do not let your child stop taking medicine unless your child’s health care provider approves.
  • Do notgive your child aspirin because of the association with Reye syndrome.
• Have your child return to his or her normal activities as told by his or her health care provider. Have your child avoid activities that could cause danger to your child or others if your child would have a seizure during the activity. Ask your child’s health care provider which activities your child should avoid.
• Make sure that your child gets enough rest. Lack of sleep can make seizures more likely.
• If your child starts to have a seizure:
  • Lay your child on the ground to prevent a fall.
  • Put a cushion under your child’s head.
  • Loosen any tight clothing around your child’s neck.
  • Turn your child on his or her side.
  • Stay with your child until he or she recovers.
  • Do nothold your child down. Holding your child tightly will not stop the seizure.
  • Do notput objects or fingers in your child’s mouth.
• Educate others, such as babysitters and teachers, about your child’s seizures and how to care for your child if a seizure happens.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child begins to have new kinds of seizures or new symptoms.
• Your child has a rash or other side effects from medicines, such as drowsiness or loss of balance.
• Your child has seizures more often than usual.
• Your child has problems with coordination.
• Your child is very confused for a long period of time.
• Your child shows unusual behavior, such as eating or moving without being aware of it.

Get help right away if:

• Your child has a seizure that lasts longer than 5 minutes.
• Your child gets a serious injury during a seizure, such as:
  • A head injury. If your child bumps his or her head, it is important to get help right away to determine how serious the injury is.
  • A bitten tongue that does not stop bleeding.
  • Severe pain anywhere in the body. This could be the result of a broken bone.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help for your child right away. Call your local emergency services.