A child falls to the ground, thrashing her arms and legs uncontrollably. It’s one of the most frightening scenes a parent can imagine.
Seizures affect as many as three percent of American children, often occurring in the first few months of life. Parents are typically not only worried about their child’s safety but puzzled as to what is taking place and what they should do.
A seizure is an abnormal and intense wave of electricity that overwhelms the brain temporarily just as a muscle spasm overwhelms the body. It causes involuntary changes in body movement, behavior and awareness that can take a number of forms.
A partial seizure starts in one localized area of the brain and does not always involve loss of consciousness. A child may repeat an action such as hand clapping throughout the seizure but in some cases is unaware of what is going on and unable to remember it later. It’s easy to mistake a partial seizure for bad behavior. Sometimes a partial seizure can spread to other parts of the brain, causing abnormal movements in other parts of the body.
An absence seizure is a brief episode when a child stares or blinks but apparently has no awareness of what is going on. In most cases when a child appears to be day dreaming, he is. In a few cases, such as when the child drops a pencil in the midst of an activity to stare into space, he may be having an absence seizure.
The kind of seizure that most parents recognize immediately–the kind described above–is known as a generalized seizure. It involves a much larger portion of the brain and involves loss of consciousness as well as uncontrollable convulsions, muscle contractions and rigidity lasting for a few minutes–usually less than five–followed by a period of drowsiness.
Not Painful
Although seizures look painful, they are not, unless the child suffers injuries from the fall or from the thrashing around. Whether seizures cause long-term damage is not really known, but it’s important to get the child to a doctor for diagnosis and treatment.
The most well known seizure disorder is epilepsy, characterized by repeated unprovoked seizures–ranging from several times a day to once every few months. Epilepsy can develop at any time in life, but about a third of new cases each year involve children.
The majority of seizures suffered by children are not epilepsy but caused by something specific: a fever or illness, lack of oxygen, a blow to the head, a sudden drop in blood sugar, changes in heart rhythm, emotional stress or drug toxicity.
In 70 percent of cases involving children, doctors can’t identify the cause; it may just be a problem in the way the brain is wired or in the amount of brain chemicals produced at that particular moment.
FEBRILE SEIZURES: By far the most common type of childhood seizure is one brought on by fever. By definition, a febrile seizure occurs between three months and five years of age “associated with fever but without evidence of intracranial infection or defined cause for the seizure.”
Children may be more vulnerable to such seizures because their brains are in an early stage of development. Febrile seizures also tend to run in families, with vulnerability passed on by either parent.
About a third of children who experience a febrile seizure will have another, usually within 6 to 18 months. For parents, of course, one seizure is more than enough: many live in anxiety about the prospect of witnessing another fever and another seizure.
Most seizures last only a few minutes, and parents should concentrate their efforts on protecting the child from further harm by removing eyeglasses, loosening tight clothing around the neck and removing tables and hard objects from the area.
Make sure the child is breathing, and call 911 if she is not. Contrary to belief, a person having a seizure is not in danger of swallowing his tongue; don’t try to put anything in his mouth and don’t try to control his movements.
After convulsive movements stop, place the child on one side with chin up to maintain breathing and prevent choking on secretions or vomit. Stay with the child until she is conscious. If possible, time the seizure and take note of unusual features so you can describe it accurately to your doctor.
A trip to the emergency room may not be necessary if the seizure lasts only a minute or two and the child hasn’t suffered an injury. An extended seizure–one lasting five minutes or longer–should be considered an emergency, however.
Once the seizure is over, you can call your doctor or emergency medical services for instructions, followed by a visit to the doctor in the next day or so. A correct diagnosis is important, and this requires a good report from family members who were present. In most cases, the fever that provokes a seizure is associated with a viral upper respiratory or ear infection.
Doctors usually recommend that the fever be reduced through sponging the body with tap water that is neither hot nor cold plus over-the-counter pain medications such as acetaminophen and ibuprofen.
In their desire to head off additional seizures, parents may ask their doctors to prescribe anti-seizure medications. But these drugs have serious side effects, including damage to the liver and teeth, and are not recommended for uncomplicated cases.
Studies show that the risk of a serious illness, such as meningitis is no greater with a febrile seizure than it is with any other fever. Nevertheless, the doctor may want to rule out serious bacterial infections as well as exposure to toxic substances or a reaction to a medication or immunization.
Seizures can also be associated with developmental disorders such as cerebral palsy, brain tumors and brain injuries. In the vast majority of cases, no specific cause can be found–except for the fever.
From 3 to 12 percent of children who suffer febrile seizures go on to develop epilepsy, but doctors don’t believe there is a causal relationship.
Having one or more seizures during childhood is a relatively common occurrence. As their brains mature, most children outgrow the tendency with no lasting effects.
