Seizure Disorder -- Child

Definition

A seizure is abnormal electrical activity in the brain. When 2 or more seizures occur, it is considered a seizure disorder, also known as epilepsy. While there are many different types of seizures, the main categories are:

  • Generalized seizure—activity occurs throughout the brain
  • Partial seizure, also called a focal seizure—begins within certain areas of the brain
Generalized Seizure
Generalized seizure
Abnormal and excessive electrical activity in the brain.
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Causes

Seizure disorder is caused by abnormal brain function. It is often difficult to identify the exact cause, but some factors that may play a role include:

  • Genetic disorder
  • Brain abnormalities or damage such as infection, trauma, tumor, or bleeding into the brain

Risk Factors

Factors that may increase your child's chance of seizure disorder include:

  • Premature birth or low birth weight
  • Damage to brain during birth
  • Abnormal brain structure
  • Traumatic brain injury
  • Brain infection
  • Brain tumor
  • History of febrile seizures
  • Seizure within the first month after birth
  • Family history of seizure disorder
  • Cysticercosis—an infection caused by a pork tapeworm

Symptoms

Symptoms can vary depending on the type of seizure disorder. These may include:

  • Aura—a sensation at the start of a seizure such as perception of an odd smell or sound, spots appearing in front of the eyes, or stomach sensations
  • Staring, eye blinking, or eye rolling
  • Loss of consciousness
  • Repeated jerking of a single limb
  • Uncontrollable jerking of muscles
  • Hand rubbing, lip smacking, or picking at clothing
  • Loss of bladder or bowel control
  • Drowsiness or confusion after a seizure

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done.

Tests may include:

  • Blood tests
  • Lumbar puncture—to evaluate the cerebrospinal fluid that protects the brain and spinal cord

Imaging tests evaluate the brain and surrounding structures. These may include:

Your brain may be tested. This can be done with:

Treatment

You will work with the doctor to choose a treatment plan that is right for your child. Treatments options include:

Medication

There are many different kinds of medications to treat seizure disorder. The exact medication will be based on the specific type of seizures and symptoms your child has. Anti-epileptic medications are a common option. In some cases, anti-epileptic medications may be used in combination.

Surgery

If medication does not work or the side effects are too severe, your child may need surgery. Surgery involves the removal of the area of the brain that starts the seizure. Surgery is only an option if your child has localized areas of the brain involved.

Vagus Nerve Stimulation (VNS)

With VNS, a device is implanted in the chest to give electrical stimulation to the vagus nerve. This nerve runs from the brain to beyond the stomach. Stimulation can prevent or decrease the frequency of seizures. Medication may still be needed.

Ketogenic Diet

A ketogenic diet is a strict diet. It is high in fat and low in carbohydrates and proteins. It keeps the body’s chemical balance in a state of ketosis. Ketosis decreases the frequency of seizures. If you would like your child to start this diet, talk to the doctor. Since your child needs proper nutrients, you will need to work with a dietician.

Other Lifestyle Changes

Your child's doctor may ask you to keep note of what was happening when your child had a seizure. This may help identify and make plans to avoid seizure triggers. These triggers can vary from child to child but some examples include:

  • Sleep deprivation
  • Stress
  • Hormonal changes common during the menstrual cycle
  • Flashing lights, such as strobe lights
  • Use of certain medications or drugs
  • Missing doses of anti-seizure medications

Help your child to decrease the chance of a seizure by:

  • Avoiding triggers
  • Making sure anti-seizure medication is taken as prescribed
  • Having your child get enough sleep
  • Finding ways to help your child avoid hyperventilating, such as by doing deep breathing exercises and meditation

Other things to consider:

  • Encourage your child to wear a medical alert bracelet. This will help people around your child understand what is happening if there is a seizure.
  • If your child’s condition is severe, take these steps to prevent serious injuries:
    • Do not allow your child to swim or bathe alone.
    • Do not have your child climb or play in areas where a serious fall could happen.
    • Talk to the doctor to find out which activities are safe for your child. Certain sports may need to be avoided.

Prevention

There are no known ways to prevent every type of seizure disorder. You can take steps to prevent your child from brain injuries or conditions that could lead to seizures:

  • Get prenatal care.
  • Be sure that your child always wears a helmet when doing certain activities such as bike riding, skateboarding, and playing contact sports.
  • Have your child wear seat belts or sit in a car seat when riding in a car.
  • Teach your child never to dive into water. To be safe, your child should always go into the water feet first.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 08/2014 -
  • Update Date: 09/30/2013 -
  • Epilepsy Foundation

    http://www.epilepsy.com/\

  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov

  • Center for Epilepsy and Seizure Education

    http://epilepsy.cc

  • Epilepsy Ontario

    http://www.epilepsyontario.org

  • Epilepsy. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Epilepsy.aspx. Updated May 2012. Accessed September 28, 2014.

  • Growing up with epilepsy: activities, safety, and first aid. Massachusetts General Hospital website. Available at: http://www2.massgeneral.org/childhoodepilepsy/overview/index.htm. Accessed September 28, 2014.

  • Living with epilepsy. Patient UK website. Available at: http://www.patient.co.uk/showdoc/23068986. Updated March 15, 2012. Accessed September 28, 2014.

  • Neal EG, Chaffe H, Schwartz RH, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008 May 2. [Epub ahead of print]

  • Seizure in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 26, 2014. Accessed September 28, 2014.

  • Seizures. Boston Children's Hospital. Available at: http://www.childrenshospital.org/health-topics/conditions/seizures. Updated 2010. Accessed September 28, 2014.

  • 5/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Quet F, Guerchet M, Pion SD, Ngoungou EB, Nicoletti A, Preux PM. Meta-analysis of the association between cysticercosis and epilepsy in Africa. Epilepsia. 2010 ;51(5):830-837.

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