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Seizure -- Child

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Definition

A seizure is a sudden change in behavior. It is caused by sudden, abnormal, and excessive electrical activity in the brain. A neonatal seizure occurs in newborn babies.

Seizures may be severe or mild. They may cause physical changes like convulsions. It may affect only part of the body or the entire body. A short seizure itself does not cause serious health conditions. Prolonged seizures can lead to permanent damage. The damage is due to decreased oxygen and excessive brain cell activity.

Generalized Seizure
Generalized seizure
Abnormal and excessive electrical activity in the brain.
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Causes

There are a variety of causes of seizures in children, which include:

  • Conditions like epilepsy
  • An injury or trauma to the head
  • Infections, including meningitis and abscesses in the brain
  • Brain tumor
  • Stroke
  • Accidental poisoning
  • Certain medical conditions, including:
    • Low blood sugar
    • Very high fever (especially in children)—called febrile seizures
    • Electrolyte abnormalities
  • Hydrocephalis
  • Congenital diseases or deformities

Sometimes seizures occur for unknown reasons.

Risk Factors

Factors that may increase your child's risk of having a seizure include:

  • Having had a previous seizure
  • Having a very high fever
  • Having health conditions like:
    • Epilepsy
    • Brain tumors
    • Brain infections
  • Having a family history of seizures.

Symptoms

Seizure symptoms may include:

  • Confusion
  • Unconsciousness
  • Staring, or a dazed look
  • Jerking movements of the limbs and/or body (convulsions)
  • Difficulty breathing
  • Eyes rolling back in the head
  • Crying or moaning
  • Vomiting
  • Urinating

If you suspect your child is having a seizure, act quickly:

  • Protect from physical injury—Place your child on the floor or bed. Make sure they are not near any hard or sharp objects.
  • Protect airway—Do not place anything in your child's mouth during the convulsion. Turn your child’s head to the side. This will allow saliva or vomit to drain from the mouth.
  • Watch the time—The length of the convulsions should be less than five minutes.
  • Unless the doctor has told you otherwise, call 911.

Diagnosis

Your doctor will ask about your child‘s symptoms and medical history. A physical exam will be done. Tests may be done to look for the cause of the seizure.

Tests to look for infections may include the following:

  • Lumbar puncture —removal of a small amount of cerebrospinal fluid for testing to look for infection in brain or spinal cord
  • Blood tests—to look for infections, low blood sugar, abnormal electrolytes, or poison

Tests to look for abnormalities in brain may include:

  • CT scan of the head —a type of x-ray that uses a computer to make pictures of structures inside the head
  • MRI scan of the head —a test that uses magnetic energy to make pictures of structures inside the head
  • Electroencephalogram (EEG) —a test that records the brain’s activity by measuring electrical currents through the brain

Treatment

Treatment for the seizures depends on the cause of the seizures. Some seizures will not require treatment. If the seizure is caused by an underlying condition your child's doctor will create a plan to treat that condition. Resolving the underlying condition will likely stop the seizures.

Talk with your doctor about the best treatment plan for your child. You may also be referred to a pediatric neurologist.

Medications

Anticonvulsant medication can help to prevent seizures. The medication that is used will depend on the type of seizure. These medications do have some side effects. As a result, they are often only used for severe or frequent seizures.

Medications are not usually prescribed for febrile seizures . These seizures are associated with a rapid increase in temperature due to a fever. Children will outgrow these seizures by about 5 years of age. They are rarely associated with long term problems so anticonvulsant medication is rarely recommended.

Surgery

Some severe seizures may be treated with brain surgery. This may occur in some children with epilepsy. During this type of surgery certain nerve fibers may be separate or a section of the brain may be removed. This surgery may help to reduce or eliminate seizures. Surgery is not done very often.

If your newborn is diagnosed with neonatal seizures, follow your doctor's instructions .

If your newborn is diagnosed with neonatal seizures, follow your doctor's instructions .

Prevention

Medicine, if recommended, can usually prevent seizures. It is important to take anticonvulsant medication as needed.

Febrile seizures are may be the first sign of a fever. This can make it difficult to prevent. About 30% of children that have had a febrile seizure will have another seizure when they have a fever. Your doctor may advise that you give your child medicine to keep fever down whenever he/she gets sick. Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.

Seizures can still happen despite treatment. Take the safety steps listed above if you notice your child's behavior changing.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 09/2013 -
  • Update Date: 09/30/2013 -
  • American Academy of Family Physicians

    http://familydoctor.org

  • American Academy of Pediatrics

    http://www.healthychildren.org/

  • British Columbia Ministry of Health

    http://www.bchealthguide.org

  • Epilepsy Ontario

    http://www.epilepsyontario.org

  • Febrile seizure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 11, 2012. Accessed July 20, 2012.

  • Hogan T. Seizure disorders in childhood. Loyola University Medical Education Network website. Available at: http://www.meddean.luc.edu/lumen/MedED/pedneuro/epilepsy.htm. Accessed Accessed July 20, 2012.

  • Neonatal seizures. Intensive Care Nursery Staff House Manual. The University of California San Francisco Children's Hospital website. Available at: http://www.ucsfhealth.org/childrens/health%5Fprofessionals/manuals/48%5FSeizures.pdf. Accessed. Accessed July 20, 2012.

  • Seizure in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 9, 2012. Accessed July 20, 2012.