Epilepsy and Seizures in Pediatrics
Some children have Epilepsy or Seizures as a consequence of neurological disease or injury. They may be present at birth or develop over time.
Seizures are episodic, uncontrolled bursts of nerve activity in the brain. A seizure is one single episode of this burst of brain activity.
Epilepsy is an ongoing condition where nerve activity in the brain is disrupted. Two or more seizures at least twenty-four hours apart are considered to be epilepsy. Epilepsy is the diagnosis of a series of seizures.
Often, tone or spasms may be confused with seizures. Tone is the updated word for the familiar term spasms. Tone (spasm) is the involuntary contraction of a muscle or group of muscles. It typically has a rhythmic pattern that can be mistaken for seizures. However, with tone, the issue is local to that particular body part although tone can engulf the entire body. With tone or spasms, mental activity is not affected as with a seizure. It is best to have the input of a healthcare professional to determine if tone or a seizure is occurring.
Seizures are due to a chemical imbalance in the brain. Common causes of seizures in children include high fever or infection, metabolic or chemical imbalances, birth trauma, head injury including concussion, stroke, degenerative brain disorders, brain tumor, congenital and genetic conditions, illness during pregnancy, poisoning, alcohol, drugs, some reactions to prescription medications, among others. Sometimes, the source of a seizure is unknown.
There are two basic groups of seizure activity.
Generalized seizures affect both sides of the brain. These may appear as absence seizures which include rapid blinking or staring into space. Tonic-clonic seizures may include crying out, loss of consciousness, falling, and muscle jerks and spasms generally throughout the body.
Focal seizures arise in one area of the brain. Simple focal seizures may produce a twitch in the body, a change in sensation, or an odd taste or smell. These types of seizures are most often confused as tone (spasms). Complex focal seizures lead to the inability to respond for several minutes. Secondary generalized seizures begin in one part of the brain but spread throughout the body or become a generalized seizure.
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How to Assist During a Seizure
- A first seizure in a child is quite frightening for a parent or caregiver. Try to remain calm even in this difficult situation.
- Provide safety by laying the child down on their side and removing anything constrictive around their mouth, throat, and chest to help them breathe.
- Move anything they may bump into and remove eyeglasses if worn.
- Note the time of onset of the seizure and resolution of the seizure, where it started in the body, and how it progressed.
- Call 911 if it is a first-time seizure, if breathing is impaired, or if it lasts more than five minutes.
What you should do during a seizure is as important as what you should not do. The CDC recommends NOT doing these outdated and unsafe measures during your child’s seizure:
Never do any of the following things:
- Do not hold the child or teen down or try to stop movements.
- Do not put anything in their mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow their tongue.
- Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.
- Do not offer the person water or food until they are fully alert.
Your healthcare provider will give you a treatment plan specific to the needs of your child. This may include medication treatment or other options to reduce seizure activity. As you become proficient, you will learn other measures for the safety of your child.
More information about seizures can be found here:
Centers for Disease Control and Prevention: https://www.cdc.gov/epilepsy/index.html
Epilepsy Foundation: https://www.epilepsy.com/