What is Seizure in Children

A seizure is caused by a sudden burst of abnormal electrical activity in the brain. This activity temporarily interrupts normal brain function. A seizure can cause:

• Involuntary movements.
• Changes in awareness or consciousness.
• Uncontrollable shaking (convulsions).

Many types of seizures can affect children. The two main types are:

• Generalized seizures. These involve the entire brain and include:
  • Convulsions.
  • Absence seizures. These are short episodes of complete loss of attention.
  • Atonic seizures. These involve the body going limp and can result in a fall.
  • Tonic seizures. These involve a brief whole-body contraction of muscles.
• Focal seizures. These involve only one part of the brain. These may cause spells of confusion or shaking on one side of the body. A focal seizure may spread to the entire brain and become a general convulsive seizure.

Seizures usually do not cause brain damage or permanent problems. When a child has repeated seizures over time without a clear cause, he or she has a condition called epilepsy.

What are the causes?

The most common cause of seizures in children is fever (febrile seizure). Other possible causes include:

• Injury (trauma) at birth or lack of oxygen during delivery.
• A brain abnormality that your child is born with (congenital brain abnormality).
• Brain infection.
• Head trauma or bleeding in the brain.
• Developmental disorders.
• Low blood sugar.
• Metabolic disorders that are passed from parent to child (hereditary).
• Reaction to a substance, such as a drug or a medicine.
• Genetic conditions.
• Stroke.

In some cases, the cause of this condition may not be known.

What increases the risk?

This condition is more likely to develop in children who:

• Have a family history of epilepsy.
• Have had one tonic-clonic seizure in the past.
• Have autism, cerebral palsy, or other brain disorders.
• Have a history of head trauma, lack of oxygen at birth, or strokes.

What are the signs or symptoms?

Symptoms vary depending on the type of seizure that your child has. Most seizures last from a few seconds to a few minutes.

Right before a focal seizure, your child may have a warning sensation (aura) that a seizure is about to occur. Symptoms of an aura may include:

• Fear or anxiety.
• Nausea.
• Feeling like the room is spinning (vertigo).
• Changes in vision, such as seeing flashing lights or spots.

Symptoms during a seizure may include:

• Convulsions.
• Stiffening of the body.
• Involuntary movements of the arms or legs.
• Loss of consciousness.
• Breathing problems. The lips may turn blue due to lack of oxygen.
• Falling suddenly.
• Confusion.
• Head nodding.
• Eye blinking or fluttering.
• Lip smacking or tongue biting.
• Drooling.
• Rapid eye movements.
• Grunting.
• Loss of bladder and bowel control.
• Staring.
• Unresponsiveness.

Symptoms after a seizure may include:

• Confusion.
• Sleepiness.
• Headache.

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. Video of the seizures can be helpful to show your child’s health care provider.
• A physical exam.
• Tests, which may include:
  • Blood tests.
  • CT scan.
  • MRI.
  • EEG. This test measures electrical activity in the brain. An EEG can predict whether seizures will return (recur).
  • Removal and testing of fluid that surrounds the brain and spinal cord (lumbar puncture).

How is this treated?

In many cases, no treatment is necessary, and seizures stop on their own. However, in some cases, treating the underlying cause of the seizure may stop the seizures. Depending on your child’s condition, treatment may include:

• Medicines to prevent or control future seizures (anticonvulsants).
• Medical devices to prevent and control seizures.
• Surgery.
• Having your child eat a diet low in carbohydrates and high in fat (ketogenic diet).

Follow these instructions at home:

During 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.
• Do not hold your child down. Holding your child tightly will not stop the seizure.
• Do not put objects or fingers into your child’s mouth.
• Stay with your child until he or she recovers.

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child aspirin because of the association with Reye syndrome.

General instructions

• Have your child avoid activities that could cause danger to your child or others if your child were to 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.
• Follow instructions from your child’s health care provider about any eating or drinking restrictions.
• Educate others, such as caregivers 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 has:

• A history of seizures, and the seizures become more frequent or more severe.
• Side effects from medicines.

Get help right away if your child:

• Has a seizure for the first time.
• Has a seizure that:
  • Lasts longer than 5 minutes.
  • Is followed by another seizure within 20 minutes.
• Has a seizure after a head injury.
• Has trouble breathing or waking up after a seizure.
• Gets a serious injury during a seizure, such as:
  • A head injury. If your child bumps his or her head, 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 (911 in the U.S.).

Summary

• A seizure is caused by a sudden burst of abnormal electrical activity in the brain. This activity temporarily interrupts normal brain function.
• There are many causes of seizures in children and sometimes the cause is not known.
• To keep your child safe during a seizure, lay your child down, cushion his or her head, loosen tight clothing, and turn your child on his or her side.
• Seek immediate medical care if your child has a seizure for the first time or a seizure lasting longer than 5 minutes.