What Is Epilepsy In Children
Epilepsy is a brain condition that causes a child to have seizures. Itis one of the most common disorders of the nervous system. It affectschildren and adults of all races and ethnic backgrounds.
The brain consists of nerve cells that communicate with each otherthrough electrical activity. A seizure occurs when one or more parts ofthe brain has a burst of abnormal electrical signals that interruptnormal brain signals. Anything that interrupts the normal connectionsbetween nerve cells in the brain can cause a seizure. This includes ahigh fever, high or low blood sugar, alcohol or drug withdrawal, or abrain concussion. But when a child has 2 or more seizures with no knowncause, this is diagnosed as epilepsy.
There are different types of seizures. The type of seizure depends onwhich part and how much of the brain is affected and what happensduring the seizure. The 2 main categories of epileptic seizures arefocal seizure and generalized seizure.
Epilepsy Seizures And Seizure Disorders
Please know that the HIE Help Center is owned by a medical malpractice law firm that focuses on cases involving HIE and other birth injuries. We try to provide useful medical information to our readers, but we cannot provide treatments or medical advice. If you think your child may be having a seizure, please call 911/your countrys emergency number or your doctor.
One of the most common signs that a baby might have hypoxic-ischemic encephalopathy is the presence of seizures after birth. These can cause involuntary jerking motions and visible symptoms, but in some cases, the signs are very subtle. The best way to detect a baby having a seizure is using an EEG monitor to look for abnormal electrical activity in the brain. About half of newborn seizures are subtle seizures, which can be hard to see. An additional quarter of infant seizures are clonic seizures, marked by a slow rhythmic jerking or twitching of one body part. 5% of infants have tonic seizures, marked by sustained contractions, sometimes accompanied by rolling eyes and apnea. The most severe type of seizures is myoclonic, because myoclonic seizures indicate very severe brain damage. These are marked by very fast twitching or jerking, and are most often found in premature babies.
Seizures can actually worsen brain damage in cases of hypoxic-ischemic encephalopathy.
What Causes Seizures In Newborns
If youre the parent of a newborn, few things are more frightening than your child having a seizure. What caused it? Will it happen again? Did it cause any lasting harm to the baby? Are there underlying problems that led to the seizure?
True neonatal seizures are those that occur within 28 days of birth, but of course, any seizure in an infant or child is a matter worth checking out with a doctor. Some seizures may be difficult to detect in newborns, because they are brief and because newborns, of course, dont have control over their muscles as an adult or older child would. In fact, many of the signs of seizures are also movements that a typical newborn might make. A good rule of thumb is to not panic, but to speak with your pediatrician. If you are able, videotape the suspected seizure activity to show your doctor in case he or she isnt able to witness a suspected seizure.
Some indications of a seizure in a newborn or young infant include:
If you start to get a feeling that your babys movements are not normal, or someone else comments on it, dont ignore it. It is worth checking out with your babys doctor. If it turns out to be nothing, you will have peace of mind if what you are witnessing turns out to be seizure activity, your doctor can begin guiding you through the process of diagnosis and treatment.
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Causes Of Febrile Seizures
The cause of febrile seizures is unknown, although they’re linked to the start of a high temperature .
There may also be a genetic link to febrile seizures, as the chances of having a seizure are increased if a close family member has a history of them.
In most cases, the child’s high temperature is caused by an infection. Common examples are chickenpox, flu, a middle ear infection or tonsillitis.
In very rare cases, febrile seizures can happen after a child has a vaccination.
First Aid For Absence Seizures
When a child experiences an absence or staring seizure, the most important thing to do is to stay with the child to ensure they stay safe. Make sure they are fully conscious and aware before being left on their own.
If your child has an absence seizure, follow these steps for seizure first aid:
- Stay calm and stay with your child
- Time the seizure
- Don’t grab or hold your child
- Explain to others what is happening
- Protect child from any hazards
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When To Seek Medical Help
If youve been diagnosed with epilepsy or have frequent seizures, you probably dont need to seek medical care for each episode. If your seizures are limited, and dont impair your ability to breathe, you can take safety precautions, including recording the duration and your triggers, and follow a safety plan.
Medical emergency
If you or someone else experiences the following during a seizure, call 911 or seek immediate medical attention:
- difficulty breathing or stopped breathing
- loss of consciousness that continues after the seizure has ended
- traumatic injuries from seizure activity
- seizures last more than 2 minutes
- if you or the person having the seizure has diabetes
- if you or the person having the seizure is pregnant
- if a state of confusion continues for a long period after the seizure has ended
Can Babies Have Seizures In Utero
You begin to experience fetal movements when you enter the 20 weeks pregnancy. These movements may be kicks, rolls, and even hiccups. As your baby grows, the movements will continue to grow stronger and become more frequent. They are signs that your baby is getting enough oxygen. However, there are expectant mothers who experience a different kind of movement which feels more like spasming or twitching. Can this be seizures?
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More About Febrile Seizures
About 3 in every 100 children have febrile seizures, and most of these children only ever have one febrile seizure.
Children who have their first febrile seizure before the age of one year or who have a family history of febrile seizures are more likely to have 2 or more febrile seizures. Febrile seizures tend to run in families and affect boys more than girls.
Epilepsy is when a child has or is at risk of having repeated, unpredictable seizures that are not triggered by fever. Children whove had a febrile seizure are slightly more likely to develop epilepsy than other children. There isnt any way to reduce the risk of epilepsy after a febrile seizure.
What To Do If Your Child Is Having A Seizure
If your child is having a seizure, remain calm and do not panic. Heres what you should do if your child appears to be having a seizure:
- To keep the child safe, trying placing them on a soft surface, like a bed
- To prevent choking, lay the child on their side or their stomach
- Check the childs breathing
- During a seizure, dont place anything in the childs mouth
- If necessary, use a soft cloth to clean saliva from the childs mouth
- Monitor the time when the convulsions start and when the seizure stops
If the seizure does not stop within three to five minutes, or if the child does not regain consciousness, call 911. After the convulsions end, you can give the child a pain-reliever to reduce their fever.
After a child has a seizure, even if the convulsions stop within a few minutes, tell your childs doctor about the incident. They will likely recommend coming in for a visit within the next day or two.
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What Causes Seizures In Infants
- Structural causes – Being born on time but having a lack of oxygen to the brain. This is called perinatal hypoxia and can cause an injury to the brain called hypoxic-ischaemic encephalopathy Or being born with some damage to their brain. This is called cerebral dysplasia or dysgenesis. Cerebral means relating to the brain. Dysplasia or dysgenesis means unusual development
- Metabolic causes – Having low levels of glucose, calcium or magnesium in the blood
- Infectious causes – Having an infection such as meningitis or encephalitis
- Genetic causes – Inheriting a medical condition, such as self-limiting familial infantile seizures or having a disorder such as GLUT 1 deficiency, or a genetic disorder, such as Dravet syndrome
When To Seek Emergency Help For Seizures In Children
Many seizures in children will resolve on their own, and in those cases, children often do not require emergency care. However, if your child is experiencing their first seizure, you must take them to the emergency room or to your doctor to determine why it happened.
- Lasts more than 5 minutes
- Is the child’s first seizure
- Causes an injury due to a fall
- Causes breathing difficulty
- Is convulsive and changes to a staring seizure and the parent isn’t sure if the child is still having a seizure
If your child does not return to full awareness, seek medical assistance or call 911.
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Life Expectancy Of People With Epilepsy
In 2013, researchers from the University of Oxford and University College London, both in the United Kingdom, reported that people with epilepsy are 11 times more likely to experience premature death than people without it..
The risk appears to be greater if the person also has a mental health condition. Suicide, accidents, and assaults accounted for 15.8% of early deaths. Most people affected by these had also received a diagnosis of a mental health condition.
Lead researcher Seena Fazel says, Our results have significant public health implications, as around 70 million people worldwide have epilepsy, and they emphasize that carefully assessing and treating psychiatric disorders as part of standard checks in with epilepsy could help reduce the risk of premature death in these patients.
Our study, he adds, also highlights the importance of suicide and nonvehicle accidents as major preventable causes of death in people with epilepsy.
Several factors may have links to an increased risk of epilepsy. According to a 2017 research review in the journal NeuroToxicology, these factors include:
- age, with new cases occurring more frequently in young children and older adults
- brain injuries and tumors
- central nervous system infections, such as bacterial meningitis, viral encephalitis, and neurocysticercosis
Some risk factors, such as alcohol consumption, are modifiable when trying to prevent the development of epilepsy.
This can have long-term benefits. In one
Types Of Seizures In Infants
Infant seizures are often overlooked because of how different they are from adult and childhood seizures. Infants brains are not fully developed and therefore dont behave the same way as a childs or adults brain during an episode. Furthermore, because an infants brain develops rapidly, the way seizures appear can change as an infant grows. For example, in contrast with older children, babies do not usually experience a postictal period . The line between focal seizures, where part of the brain is involved, and generalized seizures, where the entire brain is involved, is blurred. Infants do not have classic tonic-clonic seizures, which is a seizure when a person loses consciousness, then has a period of extremely stiff limbs , followed by a few minutes of bending and straightening of the arms and legs .
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What To Do If A Child Has A Seizure
Seizures can be frightening for a parent or loved one. But when a child has a seizure, it’s important to remain calm and to focus on keeping the child safe.
The most important thing, and the hardest, is not to panic. Seizures can be scary to watch, but many times they will stop on their own, and seizures that stop in less than five minutes are not usually dangerous to the child.
Follow the recommendations below to help your child through the seizure safely.
Etiology Of Neonatal Seizure Disorders
The abnormal central nervous system electrical discharge may be caused by a
-
Primary intracranial process
-
Systemic problem
Seizures resulting from an intracranial process usually cannot be differentiated from seizures resulting from a systemic problem by their clinical features .
Neonatal seizures may be familial some have genetic causes. Benign familial neonatal convulsions is a potassium channelopathy inherited in an autosomal dominant pattern. Early infantile epileptic encephalopathy is a rare disorder associated with a variety of mutations.
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What Causes Seizures In Pre
Babies born prematurely are highly vulnerable to brain injury and susceptible to seizures in the first weeks of life.
The most common causes of seizures in pre-term babies are brain haemorrhages and infections, although the cause is not known for all babies. Babies with a low birth weight seem to be especially at risk of seizures.
Symptoms And Signs Of Neonatal Seizure Disorders
Neonatal seizures are usually focal and may be difficult to distinguish from normal neonatal activity because they may manifest as chewing or bicycling movements. Common manifestations include migratory clonic jerks of extremities, alternating hemiseizures, and primitive subcortical seizures . Generalized tonic-clonic seizures are uncommon.
Clinically silent electrical seizure activity is often present after a hypoxic-ischemic insult and in neonates with CNS infections, especially after initial antiseizure drug treatment, which is more likely to stop clinical manifestations than electrical seizure activity.
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Can You Predict When Someone Else Is About To Have A Seizure
If youre with someone who indicates they are about to have a seizure, or has signs of an oncoming seizure that you recognize, you can help keep them safe. Maybe the other person begins to shake or breathe differently, or they become suddenly confused. If youre close to someone who has seizures, chances are you will become familiar with their warning signs. Take the following steps if you have a warning that a seizure is about to begin:
- Help ease the person to the ground if they are standing.
- Clear the area of any objects on which they could become injured.
- Loosen clothing, especially around the neck.
- Stay with the person for the duration of the seizure.
Prevention Of Febrile Seizures
Theres no guaranteed way to prevent febrile seizures.
If your child has a fever thats making them hot and uncomfortable, you can use paracetamol or ibuprofen in recommended doses and take off your childs extra clothing.
If your child has a lot of febrile seizures, your GP might refer you to a paediatrician or neurologist to consider antiseizure medicine. Children might need to take this medicine continually for several years to prevent seizures. But this is a rare treatment.
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How I Can I Be Sure My Child Is Having A Seizure
Because many signs and symptoms of seizures are similar to the normal movements and actions of infants, it may be difficult to tell if your infant is experiencing one. It is imperative that you speak to a doctor if you think your child may be having seizures. If possible, one parent may be able to take a video of the child having a seizure to show the doctors while the other parent takes the necessary precautions to ensure the babys safety during a seizure. If a camera is not available, or only one parent/adult is present, it is important to remain as calm as possible, prioritize the babys immediate safety, and observe the baby carefully so that you can report what you see to the doctor. Your observations can help doctors determine whether a baby is having a seizure, what type of seizure they are having, what caused it, and what sort of treatment the baby may require. Of course, physicians should also run diagnostic tests such as electroencephalogram , rather than relying exclusively on parents observations.
If you believe your child may be having their first seizure, call 911 or take them to the emergency room. If they have had seizures before, your doctor can provide you with information on how to distinguish between seizures that warrant a trip to the hospital and those that do not.
What Does A Febrile Seizure Look Like
During a febrile seizure, a kid will usually lose consciousness and tremble wildly with both arms and legs. Eye rolling, inflexible limbs, or twitching on only one side or a section of the body, such as an arm or a leg, are less frequent symptoms. There may be vomiting after a febrile seizure.
Other symptoms include:
A dull ache in the head when waking up after sleeping through a fever
Changes in behavior or mood during or after a fever
Sore throat, cough, runny nose, earache, stomach pain, or constipation/diarrhea during or after a fever
A red blotchy rash that comes and goes within 24 hours of a fever
Falling down or becoming stiff due to heat exhaustion or stroke
Breathing problems due to lung infection, asthma, or bronchitis
Eating disorders such as anorexia or bulimia
Memory problems such as forgetting things recently learned or events that have happened previously
Confusion about where you are or what day it is
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Can Subsequent Febrile Seizures Be Prevented
The majority of children with febrile seizures to not need medication. Experts recommend that children who have experienced a febrile seizure not take any antiseizure medication to prevent future seizures, as the side effects of these daily medications outweigh any benefits. This is especially true since most febrile seizures are brief and harmless.
Children especially prone to febrile seizures may be treated with medication, such as diazepam, when they have a fever. This medication may lower the risk of having another febrile seizure. It is usually well tolerated, although it occasionally can cause drowsiness, a lack of coordination, or hyperactivity. Children vary widely in their susceptibility to such side effects.
A child whose first febrile seizure is a prolonged one does not necessarily have a higher risk of having reoccurring prolonged seizures. But if they do have another seizure, it is likely to be prolonged. Because very long febrile seizures are associated with the potential for injury and an increased risk of developing epilepsy, some doctors may prescribe medication to these children to prevent prolonged seizures. The parents of children who have experienced a long febrile may wish to talk to their doctor about this treatment option.
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