Seizures in Children

Growing YearsSeizures affect about 2 to 3 million people in the United States. About 10% of Americans will experience a seizure sometime during their lives. Seizures are episodes of altered brain function that cause motor, cognitive, and sensory changes thought to result from changes in excitability in neurons. Seizures occur when brain cells, which communicate through electrical signals, send out abnormal signals. A seizure is not a disease but a symptom of central nervous system dysfunction, which can be the result of illness, tumor, infections, drug abuse, vascular lesions, brain injury and congenital deformities.

Seizures are either Unprovoked Seizures (Primary Seizures or Idiopathic Seizures with no determined cause) or Provoked Seizures (Secondary Seizures caused by an insult to the Central Nervous System). The most common of these in children are due to a high temperature of over 104 degrees, called a Febrile Seizure. Also included are metabolic conditions (hypoglycemia, hypoxia, toxemia of pregnancy) and those that involve CNS insult (brain injury). Seizures come in many forms. Some seizures involve convulsive activity such as jerking movements or stiffening of the body. Other seizures are exhibited by simply staring off into space. Seizures are divided into two major categories, Generalized seizures affecting the whole brain (both hemispheres of the brain), and Partial seizures, or focal seizures, affecting only one part or side of the brain.

 

Generalized seizures are either convulsive or nonconvulsive.

  • Convulsive involves muscle movement such as stiffening (tonic) or jerking (clonic) activity. When these movements are combined it may be called “grand mal.” Other types of convulsive seizure activity include myoclonic characterized by sudden, single jerks and atonic, typically characterized by dropping quickly to the floor as if suddenly asleep or paralyzed. In infants these seizures may be called infantile spasms.
  • Nonconvulsive involves alteration of consciousness without muscle movement. This form of seizure activity was formerly called “petit mal,” and is now commonly referred to as “absence” and are typically characterized by an abrupt onset of staring, ending just as abruptly with no confused state following the events.

 

Partial seizures can be simple or complex.

  • Simple partial seizures are focal seizures that involve movement or sensation on one side of the body without altered consciousness. Simple partial seizures are commonly localized to areas in the brain called the motor or sensory strip. Partial seizures may be with or without aura, which involves associated states such as fear, or changes in heart rate, flushing, or abdominal discomfort. During these seizures, the child is aware of what is happening but can’t control it. The seizure can cause uncontrolled movement of part of the body, things to smell or taste strange to the child, stomach pain, or sudden fear or anger.
  • Complex partial seizures commonly originate from the frontal and temporal lobes of the brain where there are many complex interconnections, resulting in alteration of conscious. Typical complex partial seizures manifest as sudden change in level of alertness with or without aura, blank stare, confusion state, or aimless movements such as wandering around or repetitive behavior. These seizures vary, depending upon where in the brain they occur. The child may stare, chew, make odd movements, mumble, run, scream or even see things.