Causes of pediatric seizures: Seizures and Epilepsy in Children
Seizures and Epilepsy in Children
What is epilepsy in children?
Epilepsy is a brain condition that causes a child to have seizures. It
is one of the most common disorders of the nervous system. It affects
children and adults of all races and ethnic backgrounds.
The brain consists of nerve cells that communicate with each other
through electrical activity. A seizure occurs when one or more parts of
the brain has a burst of abnormal electrical signals that interrupt
normal brain signals. Anything that interrupts the normal connections
between nerve cells in the brain can cause a seizure. This includes a
high fever, high or low blood sugar, alcohol or drug withdrawal, or a
brain concussion. But when a child has 2 or more seizures with no known
cause, this is diagnosed as epilepsy.
There are different types of seizures. The type of seizure depends on
which part and how much of the brain is affected and what happens
during the seizure. The 2 main categories of epileptic seizures are
focal (partial) seizure and generalized seizure.
Focal (partial) seizures
Focal seizures take place when abnormal electrical brain function
occurs in one or more areas of one side of the brain. Before a focal
seizure, your child may have an aura, or signs that a seizure is about
to occur. This is more common with a complex focal seizure. The most
common aura involves feelings, such as deja vu, impending doom, fear,
or euphoria. Or your child may have visual changes, hearing
abnormalities, or changes in sense of smell. The 2 types of focal
Simple focal seizure.
The symptoms depend on which area of the brain is affected. If
the abnormal electrical brain function is in the part of the
brain involved with vision (occipital lobe), your child’s sight
may be altered. More often, muscles are affected. The seizure
activity is limited to an isolated muscle group. For example,
it may only include the fingers, or larger muscles in the arms
and legs. Your child may also have sweating, nausea, or become
pale. Your child won’t lose consciousness in this type of
Complex focal seizure.
This type of seizure often occurs in the area of the brain that
controls emotion and memory function (temporal lobe). Your
child will likely lose consciousness. This may not mean he or
she will pass out. Your child may just stop being aware of
what’s going on around him or her. Your child may look awake,
but have a variety of unusual behaviors. These may range from
gagging, lip smacking, running, screaming, crying, or laughing.
Your child may be tired or sleepy after the seizure. This is
called the postictal period.
A generalized seizure occurs in both sides of the brain. Your child
will lose consciousness and be tired after the seizure (postictal
state). Types of generalized seizures include:
This is also called petit mal seizure. This seizure causes a
brief changed state of consciousness and staring. Your child
will likely maintain posture. His or her mouth or face may
twitch or eyes may blink rapidly. The seizure usually lasts no
longer than 30 seconds. When the seizure is over, your child
may not recall what just occurred. He or she may go on with
activities as though nothing happened. These seizures may occur
several times a day. This type of seizure is sometimes mistaken
for a learning or behavioral problem. Absence seizures almost
always start between ages 4 to 12.
This is also called a drop attack. With an atonic seizure, your
child has a sudden loss of muscle tone and may fall from a
standing position or suddenly drop his or her head. During the
seizure, your child will be limp and unresponsive.
Generalized tonic-clonic seizure (GTC).
This is also called grand mal seizure. The classic form of this
kind of seizure has 5 distinct phases. Your child’s body, arms,
and legs will flex (contract), extend (straighten out), and
tremor (shake). This is followed by contraction and relaxation
of the muscles (clonic period) and the postictal period. During
the postictal period, your child may be sleepy. He or she may
have problems with vision or speech, and may have a bad
headache, fatigue, or body aches. Not all of these phases occur
in everyone with this type of seizure.
This type of seizure causes quick movements or sudden jerking
of a group of muscles. These seizures tend to occur in
clusters. This means that they may occur several times a day,
or for several days in a row.
What causes a seizure in a child?
A seizure can be caused by many things. These can include:
A seizure may be caused by a combination of these. In most cases, the
cause of a seizure can’t be found.
What are the symptoms of a seizure in a child?
Your child’s symptoms depend on the type of seizure. General symptoms
or warning signs of a seizure can include:
Jerking movements of the arms and legs
Stiffening of the body
Loss of consciousness
Breathing problems or stopping breathing
Loss of bowel or bladder control
Falling suddenly for no apparent reason, especially when
associated with loss of consciousness
Not responding to noise or words for brief periods
Appearing confused or in a haze
Nodding head rhythmically, when associated with loss of
awareness or consciousness
Periods of rapid eye blinking and staring
During the seizure, your child’s lips may become tinted blue and his or
her breathing may not be normal. After the seizure, your child may be
sleepy or confused.
The symptoms of a seizure may be like those of other health conditions.
Make sure your child sees his or her healthcare provider for a
How are seizures diagnosed in a child?
The healthcare provider will ask about your child’s symptoms and health
history. You’ll be asked about other factors that may have caused your
child’s seizure, such as:
Your child may also have:
A neurological exam
Blood tests to check for problems in blood sugar and other
Imaging tests of the brain, such as an
, to test the electrical activity in your child’s brain
Lumbar puncture (spinal tap)
, to measure the pressure in the brain and spinal canal and
test the cerebral spinal fluid for infection or other problems
How are seizures treated in a child?
The goal of treatment is to control, stop, or reduce how often seizures
occur. Treatment is most often done with medicine. Many types of
medicines used to treat seizures and epilepsy. Your child’s healthcare
provider will need to identify the type of seizure your child is
having. Medicines are selected based on the type of seizure, age of the
child, side effects, cost, and ease of use. Medicines used at home are
usually taken by mouth as capsules, tablets, sprinkles, or syrup. Some
medicines can be given into the rectum or in the nose. If your child is
in the hospital with seizures, medicine may be given by injection or
intravenously by vein (IV).
It is important to give your child medicine on time and as prescribed.
The dose may need to be adjusted for the best seizure control. All
medicines can have side effects. Talk with your child’s healthcare
provider about possible side effects. If your child has side effects,
talk to the healthcare provider. Do not stop giving medicine to your
child. This can cause more or worse seizures.
While your child is taking medicine, he or she may need tests to see
how well the medicine is working. You may have:
Your child may need blood tests often to check the level of
medicine in his or her body. Based on this level, the
healthcare provider may change the dose of medicine. Your child
may also have blood tests to check the effects of the medicine
on his or her other organs.
Your child’s urine may be tested to see how his or her body is
reacting to the medicine.
An EEG is a procedure that records the brain’s electrical
activity. This is done by attaching electrodes to the scalp.
This test is done to see how medicine is helping the electrical
problems in your child’s brain.
Your child may not need medicine for life. Some children are taken off
medicine if they have had no seizures for 1 to 2 years. This will be
determined by your child’s healthcare provider.
If medicine doesn’t work well enough for your child to control seizures
or your child has problems with side effects, the healthcare provider
may advise other types of treatment. Your child may be treated with any
of the below:
A ketogenic diet is a type of diet is very high in fat, and very low in
carbohydrates. Enough protein is included to help promote growth. The
diet causes the body to make ketones. These are chemicals made from the
breakdown of body fat. The brain and heart work normally with ketones
as an energy source. This special diet must be strictly followed. Too
many carbohydrates can stop ketosis. Researchers aren’t sure why the
diet works. But some children become seizure-free when put on the diet.
The diet doesn’t work for every child.
Vagus nerve stimulation (VNS)
This treatment sends small pulses of energy to the brain from one of
the vagus nerves. This is a pair of large nerves in the neck. If your
child is age 12 or older and has partial seizures that are not
controlled well with medicine, VNS may be an option. VNS is done by
surgically placing a small battery into the chest wall. Small wires are
then attached to the battery and placed under the skin and around one
of the vagus nerves. The battery is then programmed to send energy
impulses every few minutes to the brain. When your child feels a
seizure coming on, he or she may activate the impulses by holding a
small magnet over the battery. In many cases, this will help to stop
the seizure. VNS can have side effects such as hoarse voice, pain in
the throat, or change in voice.
Surgery may be done to remove the part of the brain where the seizures
are occurring. Or the surgery helps to stop the spread of the bad
electrical currents through the brain. Surgery may be an option if your
child’s seizures are hard to control and always start in one part of
the brain that doesn’t affect speech, memory, or vision. Surgery for
epilepsy seizures is very complex. It is done by a specialized surgical
team. Your child may be awake during the surgery. The brain itself does
not feel pain. If your child is awake and able to follow commands, the
surgeons are better able to check areas of his or her brain during the
procedure. Surgery is not an option for everyone with seizures.
How can I help my child live with epilepsy?
You can help your child with epilepsy manage his or her health. Make
If age-appropriate, make sure your child understands the type
of seizure he or she has, and the type of medicine that is
Know the dose, time, and side effects of all medicines. Give
your child medicine exactly as directed.
Talk with your child’s healthcare provider before giving your
child other medicines. Medicines for seizures can interact with
many other medicines. This can cause the medicines to not work
well, or cause side effects.
Help your child avoid anything that may trigger a seizure. Make
sure your child gets enough sleep, as lack of sleep can trigger
Make sure your child visits his or her healthcare provider
regularly. Have your child tested as often as needed.
Keep in mind that your child may not need medicine for life. Talk with
the healthcare provider if your child has had no seizures for 1 to 2
If your child’s seizures are controlled well, you may not need many
restrictions on activities. Make sure your child wears a helmet for
sports such as skating, hockey, and bike riding. Make sure your child
has adult supervision while swimming.
When should I call my child’s healthcare provider?
Call the healthcare provider if:
Key points about epilepsy and seizures in children
A seizure occurs when one or more parts of the brain has a
burst of abnormal electrical signals that interrupt normal
There are many types of seizures. Each can cause different
kinds of symptoms. These range from slight body movements to
loss of consciousness and convulsions.
Epilepsy is when a person has 2 or more seizures with no known
Epilepsy is treated with medicine. In some cases, it may be
treated with VNS or surgery.
It’s important to avoid anything that triggers seizures. This
includes lack of sleep.
Seizures and Epilepsy in Children
Treatment of a Seizure
Specific treatment for a seizure will be determined by your child’s doctor based on:
Your child’s age, overall health, and medical history
Extent of the condition
Type of seizure
Your child’s tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
The goal of seizure management is to control, stop, or decrease the frequency of the seizures without interfering with the child’s normal growth and development. The major goals of seizure management include the following:
Proper identification of the type of seizure
Using medication specific to the type of seizure
Using the least amount of medication to achieve adequate control
Maintaining good medicating levels
Treatment may include:
There are many types of medications used to treat seizures and epilepsy. Medications are selected based on the type of seizure, age of the child, side effects, the cost of the medication, and the adherence with the use of the medication.
Medications used at home are usually taken by mouth (as capsules, tablets, sprinkles, or syrup), but some can be given rectally (into the child’s rectum). If the child is in the hospital with seizures, medication by injection or intravenous (IV) may be used.
It is important to give your child his/her medication on time and as prescribed by your child’s physician. Different people use up the medication in their body differently, so adjustments (schedule and dosage) may need to be made for good control of seizures.
All medications can have side effects, although some children may not experience side effects. Discuss your child’s medication side effects with his/her physician.
While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:
Blood work – frequent blood draws testing is usually required to check the level of the medication in the body. Based on this level, the physician may increase or decrease the dose of the medication to achieve the desired level. This level is called the “therapeutic level” and is where the medication works most efficiently. Blood work may also be done to monitor the affects of medications on body organs.
Urine tests – these tests are performed to see how the child’s body is responding to the medication.
Electroencephalogram (EEG) – a procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp. This test is done to monitor how the medication is helping the electrical problems in the brain.
Ketogenic diet – Certain children who are having problems with medications, or whose seizures are not being well controlled, may be placed on a special diet called the ketogenic diet. This type of diet is low in carbohydrates and high in protein and fat.
What is a Ketogenic Diet?
The ketogenic diet is sometimes offered to those children who continue to have seizures while on seizure medication. When the medications do not work, a ketogenic diet may be considered. No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. However, the diet does not work for everyone.
What does the Diet Consist of?
The ketogenic diet is very high in fat (about 90 percent of the calories come from fat). Protein is given in amounts to help promote growth. A very small amount of carbohydrate is included in the diet. This very high- fat, low- carbohydrate diet causes the body to make ketones. Ketones are made by the body from the breakdown of fat. They are made for energy when the body does not get enough carbohydrates for energy. If your child eats too many carbohydrates, then his/her body may not make ketones. The presence of ketones is important to the success of the diet.
Fruit and fruit juice
Breads and cereals
Vegetables (corn, peas, and potatoes)
Snack foods (chips, snack cakes, crackers)
Your child’s doctor will determine if this diet is right for your child. When the ketogenic diet is started, your child will be admitted to the hospital. It may take four to five days in the hospital to get the diet started and for you to learn how to plan the diet.
While in the hospital, your child may not be able to eat for one to two days until ketones are measured in the urine. Once ketones are present in the urine, special high-fat, low-carbohydrate shakes may be started. These are sometimes called “keto shakes.” After several meals of keto shakes, your child will be started on solid foods.
You may also be taught how to check your child’s urine for ketones. The dietitian will help determine how much fat, protein, and carbohydrate your child is allowed to have, usually divided into three meals a day. The ketogenic diet can by very challenging to prepare and requires that all foods be weighed using a food scale. The ketogenic diet is not nutritionally balanced, therefore, vitamin and mineral supplements are needed.
Some medications and other products, such as toothpaste and mouthwash, contain carbohydrates. It is important to avoid these products if your child is on the ketogenic diet. Your child may not make ketones in their urine if too many carbohydrates are included in the diet. Your child’s doctor and dietitian can give you a list of medications, and other products, that are free of carbohydrates.
How Long is the Diet Used?
Children usually stay on the diet about two years. The diet is then slowly changed back to a regular diet.
Sample ketogenic meal
Sample ketogenic shake
60 g heavy cream
500 g Ross Carbohydrate-free Formula (concentrate)
21 g strawberries
270 g heavy cream
53 g eggs
13 g Egg Beaters
10 g cheddar cheese
10 g bacon
21 g butter
Additional Treatment Options:
Vagus nerve stimulation (VNS)
Some children, whose seizures are not being well-controlled with seizure medications, may benefit from a procedure called vagus nerve stimulation (VNS). VNS is currently most commonly used for children over the age of 12 who have partial seizures that are not controlled by other methods.
VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck. This is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is then programmed to send energy impulses every few minutes to the brain. When the child feels a seizure coming on, he/she may activate the impulses by holding a small magnet over the battery. In many people, this will help to stop the seizure.
There are some side of the effects that may occur with the use of VNS. These may include, but are not limited to, the following:
Another treatment option for seizures is surgery. Surgery may be considered in a child who:
Has seizures that are unable to be controlled with medications.
Has seizures that always start in one area of the brain.
Has a seizure in a part of the brain that can be removed without disrupting important behaviors such as speech, memory, or vision.
Surgery for epilepsy and seizures is a very complicated surgery performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain.
A child may be awake during the surgery. The brain itself does not feel pain. With the child awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged.
Surgery is not an option for everyone with seizures. Discuss this with your child’s doctor for more information.
Febrile seizure – Symptoms and causes
A febrile seizure is a convulsion in a child that’s caused by a fever. The fever is often from an infection. Febrile seizures occur in young, healthy children who have normal development and haven’t had any neurological symptoms before.
It can be frightening when your child has a febrile seizure. Fortunately, febrile seizures are usually harmless, only last a few minutes, and typically don’t indicate a serious health problem.
You can help by keeping your child safe during a febrile seizure and by offering comfort afterward. Call your doctor to have your child evaluated as soon as possible after a febrile seizure.
Usually, a child having a febrile seizure shakes all over and loses consciousness. Sometimes, the child may get very stiff or twitch in just one area of the body.
A child having a febrile seizure may:
- Have a fever higher than 100.4 F (38.0 C)
- Lose consciousness
- Shake or jerk the arms and legs
Febrile seizures are classified as simple or complex:
- Simple febrile seizures. This most common type lasts from a few seconds to 15 minutes. Simple febrile seizures do not recur within a 24-hour period and are not specific to one part of the body.
- Complex febrile seizures. This type lasts longer than 15 minutes, occurs more than once within 24 hours or is confined to one side of your child’s body.
Febrile seizures most often occur within 24 hours of the onset of a fever and can be the first sign that a child is ill.
When to see a doctor
See your child’s doctor as soon as possible after your child’s first febrile seizure, even if it lasts only a few seconds. Call an ambulance to take your child to the emergency room if the seizure lasts longer than five minutes or is accompanied by:
- A stiff neck
- Breathing problems
- Extreme sleepiness
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Usually, a higher than normal body temperature causes febrile seizures. Even a low-grade fever can trigger a febrile seizure.
The fevers that trigger febrile seizures are usually caused by a viral infection, and less commonly by a bacterial infection. The flu (influenza) virus and the virus that causes roseola, which often are accompanied by high fevers, appear to be most frequently associated with febrile seizures.
The risk of febrile seizures may increase after some childhood vaccinations. These include the diphtheria, tetanus and pertussis vaccine and the measles-mumps-rubella vaccine. A child can develop a low-grade fever after a vaccination. The fever, not the vaccine, causes the seizure.
Factors that increase the risk of having a febrile seizure include:
- Young age. Most febrile seizures occur in children between 6 months and 5 years of age, with the greatest risk between 12 and 18 months of age.
- Family history. Some children inherit a family’s tendency to have seizures with a fever. Additionally, researchers have linked several genes to a susceptibility to febrile seizures.
Most febrile seizures produce no lasting effects. Simple febrile seizures don’t cause brain damage, intellectual disability or learning disabilities, and they don’t mean your child has a more serious underlying disorder.
Febrile seizures are provoked seizures and don’t indicate epilepsy. Epilepsy is a condition characterized by recurrent unprovoked seizures caused by abnormal electrical signals in the brain.
Recurrent febrile seizures
The most common complication is the possibility of more febrile seizures. The risk of recurrence is higher if:
- Your child’s first seizure resulted from a low-grade fever.
- The febrile seizure was the first sign of illness.
- An immediate family member has a history of febrile seizures.
- Your child was younger than 18 months at the time of the first febrile seizure.
Most febrile seizures occur in the first few hours of a fever, during the initial rise in body temperature.
Giving your child medications
Giving your child infants’ or children’s acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) at the beginning of a fever may make your child more comfortable, but it won’t prevent a seizure.
Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.
Prescription prevention medications
Rarely, prescription anticonvulsant medications are used to try to prevent febrile seizures. However, these medications can have serious side effects that may outweigh any possible benefit.
Rectal diazepam (Diastat) or nasal midazolam might be prescribed to be used as needed for children who are prone to long febrile seizures. These medications are typically used to treat seizures that last longer than five minutes or if the child has more than one seizure within 24 hours. They are not typically used to prevent febrile seizures.
Feb. 24, 2021
What Are They, Symptoms, Treatment & Prevention
What is a febrile seizure?
Infants and small children can often experience a fever when they’re sick. This rising of the child’s body temperature is typically just a sign of the body working against the illness. In many cases, it’s something to watch and carefully monitor, but not panic about. However, a fever can sometimes bring on a seizure in childhood. A febrile seizure is usually a convulsion (irregular or uncontrollable movement in the body) that’s caused by abnormal electrical activity in the brain. This unusual activity is sometimes sparked by a childhood fever.
Febrile seizures usually happen when a child is between the ages of 6 months and 5 years. The seizures typically happen during the first day of the fever and last for about three to five minutes. For most children, febrile seizures only happen one or two times during childhood.
Unless they last for a prolonged period of time, febrile seizures generally don’t cause brain damage. If the seizure lasts longer than a few minutes, there’s a chance that the child’s brain won’t get enough oxygen. A lack of oxygen can harm the brain.
What parts of the body are impacted by febrile seizures?
A febrile seizure might involve only one arm or one side of the child’s body. You might hear this called focal febrile seizure because it’s located on one side of the body — usually face, arm, leg or all of them on one side of the body. The seizure can progress to whole body convulsions — called a generalized seizure. For some people, a febrile seizure can affect both sides of the body right from the start.
What temperature does a child usually have during a febrile seizure?
One of the most accurate ways to measure a small child’s temperature is rectally. Children who have febrile seizures tend to have a rectal temperature that’s higher than 102 degrees Fahrenheit.
Are febrile seizures hereditary?
Febrile seizures could run in your family. If you know of someone in your family who experienced this condition in childhood, talk to your healthcare provider about it when discussing any possible hereditary (passed down through a family) conditions.
Are febrile seizures related to epilepsy?
Epilepsy is a medical condition where one can experience repeated seizures without any triggers (the seizures are unprovoked). These seizures happen without fever. This is the big difference between epilepsy and febrile seizures — when a child has febrile seizures, there’s a fever. Even if your child had recurrent febrile seizures, this doesn’t mean that the child has epilepsy.
Symptoms and Causes
What causes a febrile seizure?
The exact reason febrile seizures happen isn’t clear. These seizures might happen when a child’s temperature rises rapidly. In many cases, there’s no way to predict or prevent a febrile seizure.
What are the symptoms of a febrile seizure?
There are several different symptoms of a febrile seizure, however, not every child will experience all of these symptoms. One child might only have a few of these symptoms, while another child may have many of the symptoms on the list.
Possible symptoms of a febrile seizure can include:
- A fever that’s high or a rapid rise in body temperature.
- Loss of consciousness or fainting like episode that lasts 30 seconds to five minutes.
- General muscle contraction and rigidity that usually lasts 15 to 20 seconds.
- Violent rhythmic muscle contractions and relaxations that commonly lasts for one to two minutes.
- Biting of the cheek or tongue.
- Clenching of the teeth or jaw.
- Rolling of the eyes back in the head or persistent eye deviation to one side.
- Losing control of urine or stool.
- Absence of breathing or difficulty breathing during a seizure. The skin may also be a blue color. After the seizure ends, the child might take deep, spontaneous breaths.
Management and Treatment
What do I do if my child has a febrile seizure?
If you’re child has a febrile seizure there are several things you should do. During a febrile seizure, try to:
- Stay calm.
- Protect your child from injury.
- Do not attempt to restrain or hold the child down during the seizure.
- Turn your child onto his or her side if vomiting occurs.
- Do not put anything in your child’s mouth.
- Loosen clothing.
- Support your child’s head with a pillow or soft object.
- Try to note how long the seizure lasts, what types of movements are happening and which parts of the child’s body it’s affecting.
- If the seizure continues for greater than two minutes, call 911.
- Call your doctor and have your child examined urgently for infection and seizure. Consider referral to a seizure specialist as appropriate.
After the seizure ends, your child will be disoriented for a few minutes while the brain rests and recharges. This is normal.
When should I call for help if my child has a febrile seizure?
There are several things to watch for during a febrile seizure that would mean calling for emergency help. Call 911 if your child:
- Is having a seizure for the first time or experiencing a new type of seizure.
- Is experiencing a seizure that lasts longer than 2-3 minutes.
- Is having repeated seizures.
- Has difficulty breathing.
- Has a blue skin color.
How can I help to prevent a fever?
Even though you can’t prevent a febrile seizure, there are a few things you can do to reduce your child’s chance of developing a fever.
Some daily tips for preventing a fever in your child can include:
- Giving fever medicine as prescribed by your child’s doctor.
- Not bundling up or overdressing your child. The body loses heat through the skin. If you bundle up your child, the excess heat cannot escape.
- Sponging your child with lukewarm water or putting him or her in a shallow bathtub containing 2 to 3 inches of water and dripping water over the child’s body. If your child starts shivering or shaking in the bathtub, stop sponging and remove him or her from the bath water. Also, don’t use alcohol or cold water to bring down your child’s fever.
- Giving your child plenty of fluids to prevent dehydration during a fever.
- Promptly treating any infection that may be producing the fever.
A note from Cleveland Clinic
Seizures can be scary. Febrile seizures are unpredictable and, in most cases, not something you can prevent from happening. If your child experiences febrile seizures, make sure you have a plan ready for each seizure. Talk to your healthcare provider about ways to care for your child both during and after seizures. Remember, febrile seizures are usually a condition of early childhood and don’t last for the child’s entire life.
What Causes Epilepsy in Children?
Seizures are caused by uncontrollable, spontaneous activity, and can be a debilitating condition for many people. This image shows the abnormally high activity of the right part of the brain during an epileptic seizure.
Courtesy, with permission: RME Sabbatini.
When the cells in the brain fire normally, it is like a harmonious symphony. But when someone has epilepsy, the brain experiences uncontrollable, spontaneous activity — like a trumpet playing during a violin solo. Epilepsy affects an estimated 10.5 million children worldwide, and the types and severity of the disorder can vary significantly. So what causes pediatric epilepsy, and what can be done to treat it?
Epilepsy is characterized by recurrent, spontaneous seizures, and the seizures can manifest in different ways depending on which part of the brain is involved. In general, a seizure is defined as a period of abnormal, synchronous excitement of a group of brain cells. During a seizure, brain cells go into a spasm of activity, usually starting with a small group of cells and spreading to a larger area of the brain.
Some seizures, called absence seizures, cause the person to be unresponsive for a few seconds or minutes, while others, such as generalized seizures, can involve falling and convulsions.
Tallie Baram, who studies pediatric epilepsy at the University of California, Irvine, says seizures can interfere with a child’s life in many ways. “Some epilepsies can interfere with the ability of a child to pay attention in school, or they can involve brain structures that are involved in learning and memory, and these parts may not work very well,” she says. “It can also be dangerous if a child is crossing a street and suddenly loses the ability to interact with the environment or falls down to the ground.”
Causes and Prognosis
There are numerous types of epilepsy that can be due to several different causes. For example, sometimes brain damage due to trauma, such as lack of oxygen to the brain at birth or a severe brain infection, can lead to epilepsy.
“Children that are born prematurely or have very difficult births can have brain injuries that cause seizures during the first weeks of life,” says Paul Carney, a pediatric neurologist at the University of Florida. “The good news is that a lot of these children that have mild brain injury will outgrow their seizures in the first month. However, a small percentage will unfortunately go on to develop difficult-to-treat seizures that can be lifelong.”
Another cause of pediatric epilepsy is abnormal development of the brain, possibly due to maternal exposure to toxins, trauma, or an underlying genetic condition. When a genetic problem affects how the brain is formed or functions, seizures may be a visible indicator of other problems. “Seizures can be the tip of the iceberg of a serious brain disorder,” Baram says.
However, sometimes the cause of pediatric seizures is unknown. Because there is no one cause of pediatric epilepsy, there is no single prognosis. In general, 50 to 75 percent of children with epilepsy will eventually have complete seizure remission. Remission is more likely if there are no underlying neurological deficits present, seizure frequency is low, and response to anti-seizure medication is good.
About 20 percent of children with epilepsy have intellectual disabilities. Their epilepsy tends to persist throughout their lives with a low rate of remission.
Behavioral and psychiatric problems, such as attention deficit-hyperactivity disorder, autism, depression, and anxiety, are also common in children with epilepsy.
Some current research is focused on whether seizures themselves contribute to the cognitive deficits sometimes seen in children with epilepsy. John Swann, who studies pediatric epilepsy at the Baylor College of Medicine, believes that seizures contribute to learning and memory problems.
Swann’s laboratory induced seizures in infant mice who were otherwise neurologically normal and then tested their learning and memory skills as adults. He found that mice that experienced recurrent seizures as infants demonstrated spatial learning and memory deficits as adults. Further studies using brain slices showed changes in the microanatomy of cells in the hippocampus, a brain region involved in learning and memory.
“We saw that these cells had fewer branches and fewer synapses, or connections between cells,” Swann says. “Seizures are actually preventing the normal growth of these nerve cell branches.”
Swann says there is still a lot to sort out regarding the mechanism behind this growth suppression. “It may be a protective mechanism that the brain is using to try to stop the seizures,” he says. “If you decrease the number of excitatory synapses on a nerve cell branch, then the cell will be less excitable and you might have fewer seizures.”
The majority of children with epilepsy can control their seizures with anti-epileptic drugs, which act on the brain cells to make them less likely to fire.
“Medication is usually the first choice of treatment,” Carney says. “Eighty percent of children respond well to some form of medication, and the trend over the last 10 years has been to develop medications that are better tolerated and have fewer side effects.”
If seizures don’t respond to drugs, surgery to remove a small portion of the brain where the seizures originate can be considered. Seizure remission after surgery ranges from 60 to70 percent. While most children make remarkable recoveries after such surgeries, they sometimes suffer weakness on the opposite sides of their bodies from the surgery site.
Another option for medication-resistant epilepsy is vagus nerve stimulation. The vagus nerve controls body functions that are not under voluntary control, such as heart rate. In vagus nerve stimulation, a device like a pacemaker is implanted just under the left collarbone with a wire that delivers regular, mild electrical current to the vagus nerve and stimulates the brain. It is thought that this stimulation helps calm down the irregular brain activity that leads to seizures. This treatment has been shown to decrease seizure frequency by half in at least one-quarter of children.
Finally, a special diet can be considered for children who do not respond to anti-epileptic medication and who are not good candidates for surgery. The ketogenic diet is a high-fat, low-carbohydrate diet that mimics a fasting state and forces the body to use fat rather than carbohydrates as an energy source. While scientists don’t understand how it works, the ketogenic diet has been used for nearly 100 years to control epileptic seizures.
What makes some pediatric epilepsies resistant to medication remains mysterious. However, new animal models and advances in neuroimaging and genetics offer new hope for treatment. Improvements in magnetic resonance imaging (MRI) have helped doctors detect structural brain malformations in children with drug-resistant epilepsy, making successful surgical intervention more likely.
In addition, scientists have identified many genes that contribute to different pediatric epilepsy syndromes, and they believe that medications tailored for specific genetic mutations are on the horizon.
“There are many pediatric epilepsies with which a gene hasn’t been associated yet, but it’s just a matter of time,” Swann says. “There’s reason to be hopeful. Things are changing rapidly. We’re beginning to understand in some detail what is causing epilepsy and how it’s generated, and with that we are pursuing new ways to treat it.”
While experiencing uncontrollable seizures can be catastrophic for the developing brain, both human and animal research is moving at a rapid rate to help children live seizure-free lives.
About the Author
Mary Bates is a freelance science writer interested in the brains and behavior of humans and other animals. For her graduate degree in psychology, she studied the echolocation abilities of big brown bats. She has written for Psychology Today, Scientific American’s Mind Matters blog, the Howard Hughes Medical Institute, and other print and online publications.
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Common Causes of Seizures: THINK Neurology for Kids: Pediatric Neurology
Seizures occur when there’s a sudden surge of abnormal electrical activity in your child’s brain. While seizures usually don’t last long, they’re frightening for parents and children because of the changes they cause, from uncontrollable shaking to losing consciousness.
THINK Neurology for Kids specializes in treating children with seizure disorders. We understand that one of the first things parents want to know is what caused their child’s seizure, so we wrote this blog to give you the information you need.
We also want to let parents know that in this time of social isolation to stop the spread of COVID-19, they can still get medical care and support for their child through telemedicine.
Top three causes of seizures
The cause of a seizure can’t always be determined, but when there is an identifiable reason, it’s often due to one of three health conditions:
1. High fever
Seizures caused by a fever, called febrile seizures, affect 3-4% of all children between the ages of 6 months and 5 years. However, they most often occur in infants aged 12-18 months.
Febrile seizures typically occur in the first few hours after your child develops a fever and last less than a minute.
Parents should be prepared for the possibility of a second febrile seizure. Children who are younger than 1 year old when they have their first febrile seizure have a 50% chance of having a second occurrence. The risk drops to 30% for those who are older than 1 year at their first febrile seizure.
2. Traumatic brain injury
Children who suffer a moderate to severe traumatic brain injury (TBI) may have a seizure within minutes of the injury or the seizure may be delayed, occurring after a week. The chances of having a seizure depend on the child’s age, the type of trauma, and if the injury caused bleeding in the brain.
Post-traumatic seizures are diagnosed in about 37% of children aged 2 years and younger who suffer an accidental TBI without bleeding. That number drops to 16% in children aged 14-17 years old. The incidence of post-traumatic seizures can rise to a little more than half in young children with bleeding.
Central nervous system infections such as meningitis and encephalitis can cause acute seizures. Children who have encephalitis may have a seizure while they’re ill, but they’re also at risk for seizures after the acute infection heals because their brain cells are more likely to produce bursts of abnormal activity.
Other causes of seizures
Though they’re less common causes, there’s a very long list of health problems that can result in seizures in children and teens, including:
- Congenital brain malformations
- Neurological problems
- Blood infection
- Lack of oxygen during birth
- Maternal drug use
- Imbalanced brain chemicals
- Metabolic abnormalities
- Mitochondrial diseases
- Pediatric brain tumors (rare)
- Stroke (in newborns and infants)
Disorders that interfere with the metabolism of amino acids, fats, and carbohydrates often trigger a seizure. Additionally, seizures may develop in children who have low levels of blood sugar and imbalances of electrolytes such as calcium, sodium, and magnesium. Anything that disrupts the normal connections between nerve cells can result in a seizure.
Epilepsy versus seizures
Epilepsy and seizures are often confused for the same condition, but there are differences between them. Your child is diagnosed with epilepsy when they have two or more recurrent seizures that aren’t caused by a known medical condition.
However, many of the same health conditions that cause seizures are risk factors for epilepsy. For example, when a child’s first seizure occurs due to a traumatic brain injury or infection, they’re more likely to develop epilepsy.
Epilepsy also encompasses more than seizures. This complex disease is closely connect with comorbidities such as:
The Epilepsy Foundation estimates that one-third of children with autism spectrum disorder may have seizures.
Help for seizures is available via telemedicine
As we post this blog, we’re still practicing social isolation to stop the spread of COVID-19, so it’s important to know that you can still get help without coming into the office. If your child has suffered a condition that increases their risk for seizures, had a seizure, or is diagnosed with epilepsy, call THINK Neurology for Kids and we’ll tell you how you can schedule a telemedicine appointment with one of our physicians.
Epilepsy in young children: What is the treatment?
It is important to treat epilepsy for several reasons. Untreated epilepsy places children at increased risk of accidents, such as drowning, head injury from a fall, or choking. Frequent seizures may create both social and academic disadvantages for children.
Most seizures do not cause brain damage. Sometimes, however, it can be difficult to control generalized seizures. Sometimes a child having this kind of seizure will need intensive care to prevent brain damage or death.
About 75 percent of young children with epilepsy can control their seizures by using one or more anticonvulsant medications. Unfortunately, however, a significant number of children will continue to have several seizures per day, even when they are using medication. As a result, researchers are actively investigating new medications and non-drug treatments for epilepsy.
The most commonly prescribed medications for epilepsy in young children are listed below. Potential side effects, particularly those that affect development and behavior, are reviewed. A neurologist usually helps the family choose the best medication for a child’s epilepsy.
With some medications, a child will need to have regular blood tests to ensure that the blood level of the anticonvulsant drug is within a therapeutic range. The level may be affected by recent illness, other medications, and the child’s nutritional status.
Phenobarbital is one of the oldest and safest anticonvulsants for children. It is most commonly used for infants and toddlers. Initially, phenobarbital may cause drowsiness, but the child usually develops tolerance to this side effect.
Side effects: After several weeks or months of treatment, some children may develop hyperactivity, aggression, and insomnia. These side effects may respond to a decrease in dosage. However, some children may need to stop taking this medication.
Valproic Acid (Depakene, Depakote)
Valproic acid (Depakene or Depakote) is effective in treating many childhood seizure disorders.
Side effects: Children taking valproic acid may exhibit appetite increase and weight gain. Nausea and vomiting also have been reported. The most serious adverse effect of valproic acid, however, is liver failure.
At highest risk for liver damage are children:
- With mental retardation
- Younger than 2 years of age
- Who are taking several medications in addition to valproic acid
In general, sedation and other symptoms of central nervous system depression are not common as side effects.
In addition to its use as a daily anticonvulsant, phenytoin (Dylantin) is often given intravenously in the emergency room to stop an ongoing seizure.
Side effects: Potential side effects include involuntary eye movements, rashes, balance difficulties, weakened bones, nausea, and drowsiness. Attention and memory problems can occur, but are generally less severe than those associated with phenobarbital.
Overgrowth of the gums (gingival hyperplasia) can also be associated with phenytoin use. Careful oral hygiene is necessary to avoid infection, bleeding, and decay.
Phenytoin may also affect a child’s appearance. Effects that concern families include:
- Growth of dark hair on the child’s face and body (hirsutism)
- Coarsening of the child’s facial features
Carbamazepine (Tegretol) is most often used for the treatment of partial seizure disorders. It is a useful medication for students because it seldom causes sedation or learning problems.
Side effects: The most serious potential side effect of carbamazepine is neutropenia, which means that the body’s white blood cell count is very low. Children with neutropenia are at risk for overwhelming infection. For this reason, children on carbamazepine therapy should have periodic blood tests.
Approved by the FDA in 1993, Felbamate is effective against many types of seizures. It is most often used in patients with Lennox-Gastaut syndrome. These children are typically boys with autistic symptoms and seizures resistant to drug therapy.
Side effects: Common side effects include nausea, poor appetite, and constipation. Central nervous system problems can include insomnia, fatigue, balance problems, and aggression. As with valproic acid, rare cases of liver failure have been reported with the use of this drug. Bone marrow failure associated with felbamate also has been reported. However, none of these cases occurred in a child under 13 years of age.
Lamotrigine was approved by the FDA in 1994. Like Felbamate, it is used with other medications, particularly in the treatment of Lennox-Gastaut syndrome.
Side effects: The side effects of this medication are generally mild. The most common reason for stopping the medication is a rash, which develops in about 3% of people who use Lamotrigine. Other, less frequent side effects include headache, drowsiness, abnormal eye movements, and balance problems.
Topiramate was approved early in 2000 for use with other medications as an adjunct treatment for seizures in children.
Side effects: Potential side effects include loss of appetite, fatigue, dizziness, and tingling in the hands and feet. Cognitive effects may include problems with concentration and word finding. Because there is a moderately increased risk of kidney stones for children who use topiramate, they should be encouraged to drink fluids.
An older epileptic treatment, the ketogenic diet is effective for some individuals with epilepsy. It is based on the observation that depriving the body of carbohydrates promotes the release of a class of blood chemicals, called ketones. Ketones can help prevent some seizures.
Children must consume a diet composed largely of fat–the ratio of fat to carbohydrates and protein is typically 4 to 1. Much of the fat must be taken as heavy cream, mayonnaise, or butter. The diet requires that the child’s foods be weighed. The proportion of nutrients must be calculated for each meal. Even the carbohydrate content of the child’s medications are taken into account. Strict compliance is necessary for the diet to be effective.
Challenges related to the diet stem from its highly restrictive nature. Many children don’t like the foods, and as a result may eat foods that they shouldn’t. Families may also find food preparation and monitoring to be a burden. Because the diet has a low fiber content, constipation is common. Children on the diet also have an increased (3 percent) risk of kidney stones.
Occasionally, young children with intractable epilepsy are candidates for surgery. The very young surgical candidate has seizures of a frequency and severity to interfere with quality of life and development. Seizures that respond well to surgery include those that originate from a specific zone of the brain, rather than from multiple areas.
Available surgical procedures range from removal of a circumscribed portion of temporal lobe to hemispherectomy–removal of virtually half the brain. The long-term risks of surgical removal of major brain structures need to be weighed against the actual risks of ongoing intractable epilepsy. Infants seem to have a better developmental outcome after surgery. They also, however, have a higher mortality rate during and after the procedure than older children.
Vagal nerve stimulator
The vagal nerve stimulator is a small, battery-powered electrical device. It is implanted below the collarbone. In a cyclical fashion, it delivers intermittent electrical signals to the vagus nerve. These signals are then transmitted to the brain. Through a poorly understood process, the signals inhibit seizures.
An attractive feature of the stimulator is that users can “pulse” themselves by swiping a magnet across the implant site if they sense the onset of a seizure. The resulting signal may abort or shorten the episode.
The stimulator has been shown to reduce seizure frequency substantially for some individuals with epilepsy. It is usually intended only as adjunct therapy, and not as a replacement for anticonvulsant medications.
Side effects: Some users have complained of coughing or shortness of breath.
Dianne McBrien, MD
Peer Review Status: Internally Peer Reviewed
90,000 signs, symptoms and treatment of epilepsy in a child
Epilepsy is a common neurological disease. To one degree or another, its symptoms are manifested in about 5% of people. At the same time, epilepsy occurs in children three times more often than in adults.
All parents, whose child suffers from epilepsy, wonder why their child suffered from this disease. Due to the onset of epilepsy, it is classified as symptomatic – in these cases, the condition is caused by a structural defect in the brain, such as a cyst, tumor or hemorrhage; idiopathic – when there are no changes in the brain, but there is a hereditary predisposition to epilepsy; cryptogenic – if the cause cannot be identified.Epilepsy is a chronic disease, but this does not mean that such a diagnosis is a lifelong sentence. Today, the manifestations of epilepsy can be stopped, and with adequate treatment and adherence to the correct lifestyle, in 75% of cases, epilepsy can be eliminated forever.
Symptoms and early signs of epilepsy in children
Epilepsy in children is significantly different from epilepsy in adults. Its manifestations in newborns can be difficult to distinguish from the normal motor activity of an infant.Therefore, the diagnosis of epilepsy in children is associated with some difficulties.
It is generally accepted that epilepsy is always accompanied by seizures. In fact, the signs of epilepsy are very diverse. Some patients do not have such seizures at all.
Note that under the name “epilepsy” hides a whole group of more than 60 diseases with various symptoms. The variety of clinical manifestations of epilepsy often complicates diagnosis. What are the symptoms and signs of epilepsy in children and what should make parents alert?
Generalized convulsive seizures
This is the name of the very seizures with which epilepsy is often associated.At the beginning of the attack, all muscles are tense and breathing stops for a short time. Then convulsions begin, which can last from 10-20 seconds to 10-20 minutes. Spontaneous emptying of the bladder is common during an attack. The seizures stop by themselves, after which the child falls asleep.
Non-convulsive generalized seizures
Or absences (from the French absence – ‘absence’), proceed less noticeably. During such attacks, the child suddenly freezes, the gaze becomes empty and absent.Sometimes a slight tremor of the eyelids is noticeable, the child may close his eyes or throw his head back. At this moment, the child ceases to react to others, it is impossible to attract his attention. After the seizure, the child returns to the interrupted activity. Such attacks do not last very long – only 5–20 seconds, and adults most often do not notice them or pay no attention to them, mistaking them for usual absent-mindedness.
Absolute epilepsy usually begins at the age of five to seven years, and girls suffer from this form of epilepsy about twice as often as boys.Absorption epilepsy can last for several years until puberty. Then the seizures either gradually subside, or the epilepsy changes into another form.
Atonic seizures in children are characterized by sudden loss of consciousness with relaxation of all muscle groups. This attack looks like a normal fainting spell. Therefore, if your child loses consciousness from time to time for no reason, this is a cause for serious concern.
This is an involuntary adduction of the arms to the chest, tilting the head or the whole body forward and straightening the legs. Most often, these attacks occur in the morning, immediately after waking up. They last a few seconds. Sometimes the attack only affects a small group of muscles in the neck – then the spasm is expressed in an involuntary nodding of the head. Usually children two or three years old suffer from it, by the age of five it passes completely or, as in the case of absences, turns into a different form of epilepsy.
Other signs of epilepsy in children
In addition to the more or less obvious signs described above, there may be other reasons to think about a visit to the doctor. Children prone to epilepsy often have nightmares and often wake up screaming and crying. They walk in a dream, but do not react to attempts to speak to them.
Headaches are another symptom that should alert parents. The pain occurs abruptly, may be accompanied by nausea and vomiting.Sometimes the only early sign of epilepsy is short-term speech disorders – the child is conscious, can move, but for a few seconds or minutes loses the ability to speak and cannot answer the question.
Such signs of epilepsy are very difficult to notice and associate with a serious illness. Of course, all children have terrible dreams and headaches and do not always signal the presence of epilepsy. But, if such phenomena are repeated too often, it is necessary to seek the advice of a neurologist who can make an accurate diagnosis.All the described manifestations are far from always associated with epilepsy; they may have other reasons. The main methods for diagnosing epilepsy include brain electroencephalography and computed tomography or magnetic resonance imaging.
Treatment of childhood epilepsy
Depending on the cause of the epilepsy, the doctor selects the appropriate treatment. It is important not only to stop seizures, but also, if possible, to eliminate the cause of the disease.
A large number of anticonvulsants are available today.Each of them is effective for a certain form of epilepsy: that is, a medicine that works for one patient may be completely useless for another. Anticonvulsants are usually prescribed if the child has had more than two seizures. Modern medicines are very effective. In about 30% of cases, drug treatment leads to a complete recovery of the child. In more difficult situations, epilepsy medications can significantly reduce the frequency and severity of seizures. Usually, a very small dose is prescribed, gradually increasing it until the effect is noticeable.Epilepsy treatment is a lengthy process that takes several months or even years.
Influence of trace elements on childhood epilepsy
One of the causes of epilepsy may be the lack of some trace elements. Zinc is one of two substances, the lack of which can trigger the onset of epilepsy. This opinion was expressed by Andre Barbois at the meeting of the American Society of Neurological Sciences in 1973 .
Dr. Barbois and his team treated patients with epilepsy at a clinic in Montreal and found a link between low zinc levels in patients and the risk of seizures.The likelihood of an attack also increases with magnesium deficiency. Even if, in general, its content in the body is close to normal, sometimes short-term deficiency of this trace element occurs during stress, heat or after physical exertion. Therefore, preparations containing magnesium are often included in the complex therapy of convulsive conditions.
What tests to pass for epilepsy
It is impossible to independently determine the presence of a deficiency of various elements that worsen the condition of patients with epilepsy, as well as to prescribe the necessary mineral and vitamin complexes.This can only be done after special tests have been carried out.
But it should be noted that the information received is intended solely for the attending physician and cannot be interpreted independently for diagnosis and self-treatment.
What if the treatment does not help and the child’s seizures continue?
In cases where parents have doubts about the effectiveness of the prescribed treatment or the correctness of the diagnosis of epilepsy, it is important to obtain the expert opinion of another specialist.There is a solution, the main thing is not to lose hope.
With an individual, correctly selected treatment protocol, it is possible to control seizures, minimize side effects or even achieve a complete cure for a small patient.
If a child needs the help of a pediatric epileptologist of the highest category, but cannot find the right specialist at the place of residence, telemedicine services can be used. Leading epileptic centers provide treatment over the Internet, providing an opportunity to contact some of the best pediatric epileptologists in the world.
Treatment of epilepsy in children and newborns
Cause of epilepsy in a newborn
Parents of sick children ask themselves why this happened to their child and what are the causes of this disease.
Consider the factors that cause the appearance of epilepsy:
- Perhaps during the period of intrauterine development there was a failure in the formation of the brain. The reasons for this failure can be the use of alcohol and drugs during pregnancy, as well as smoking.If, while carrying a child, the expectant mother has had viral diseases (flu, herpes, colds), then the risk of developing epilepsy increases.
- The older a woman is, the higher the risk of having a child with pathologies.
- An important role is played by the prenatal process. If a child in the womb is without amniotic fluid for a long time, is entwined with an umbilical cord, childbirth lasts a very long time, then the likelihood of having a child with developmental disabilities increases.
- Disorders of the nervous system, as well as bacterial and colds, accompanied by high fever and seizures, can cause epilepsy.
- Epileptic factors are also trauma, falls and concussions.
- Low levels of the hormone dopamine lead to inhibition of chemical processes in the brain.
- Deficiency of microelements and vitamins. In 1973, American scientists discovered that a lack of minerals in the body is associated with seizures. Parents should monitor the amount of zinc and magnesium in the body. When stressful situations arise, as well as an increase in body temperature and an increase in physical activity, there is a rapid decrease in the amount of magnesium in the body.
- A benign or malignant brain tumor can cause the development of pathology.
- Cryptogenic causes, in which it is impossible to establish the factor of occurrence of epilepsy.
Epileptic seizures in infants and their features
The manifestation of epilepsy in infants is significantly different from seizures in adults. The manifestation of epilepsy in infants can be easily confused with normal physical activity. This factor makes it difficult to diagnose.
Signs of epilepsy:
- Epilepsy is associated with seizures. During an attack, all the muscles in the body tense, and breathing stops for a short time. Then convulsions begin, which have different duration and intensity. The bladder empties spontaneously. After a while, the seizures end, the child calms down and falls asleep.
- Epilepsy may manifest without seizures. The child seems to freeze, his eyes are glassy. Twitching of the eyelids, closing of the eyes and tilting of the head back can be observed.Such an attack lasts about 20 seconds. After such a seizure, the baby continues with his usual actions. Parents may not notice such a seizure.
- Loss of consciousness and muscle relaxation are characteristic signs of an atonic seizure. Such an attack resembles a fainting spell. It is necessary to consult a doctor if the child frequently loses consciousness.
- Spasm occurs with involuntary pulling of the arms to the chest, tilting the head, and straightening the legs. Such actions can often be observed upon awakening.
There are other symptoms of epilepsy. The child may have disturbing dreams. He can move around the apartment without responding to the speech of an adult. Severe headache accompanied by vomiting is also present.
Difference between epilepsy in newborns and physiological changes
It is difficult to identify epilepsy in newborns on their own. You should pay attention to such points as:
- Twitching and contraction of all muscles;
- Sharp turn of the head or body, short fade;
- Skin redness or pallor;
- Shouts accompanied by shudders;
- Simultaneous twitching of the limbs;
- View away.
How is epilepsy diagnosed in a newborn?
By observing the symptoms and the general condition of the child, epilepsy can be recognized. The appearance of seizures for no reason can raise suspicion. It is worth calling an ambulance immediately if the child has a seizure. A neurologist is able to determine epilepsy.
Stages of epilepsy diagnosis:
- Data is collected for the purpose of compiling a medical history. This collection includes information about the course of pregnancy, the condition of the child after childbirth, trauma and illness, as well as the presence in the family of relatives with a similar pathology.
- It is necessary to tell in detail about the seizure of the child.
- A medical examination is carried out, which includes an assessment of the neurological, mental and cardiac status.
- To exclude other diseases, blood is donated for analysis.
- In order to determine the nature of the seizure, a CT scan of the brain is performed.
- EEG is mandatory.
- To assess the state of the brain and identify pathology, MRI is performed.
After the research and analysis of the results obtained, the neurologist gives a conclusion about the presence or absence of epilepsy.
Methods for treating epilepsy
After confirming the diagnosis, the doctor prescribes treatment that includes taking anticonvulsants. Therapy is prescribed taking into account the diagnostic results, age and individual characteristics of the child’s body. At first, the dosage of drugs is minimal, then it is increased. In some cases, hormonal treatment and immunotherapy are required.
Parents’ actions during an attack. First aid
If the attack was short, then there is no need for special measures.During an attack accompanied by severe seizures, parents should do everything so that the child does not injure himself.
First aid includes the following steps:
- Hold the child’s torso and head;
- Remove pressure clothing;
- Open the window, give access to oxygen;
- If breathing has stopped, perform mechanical ventilation.
- Do not leave the child, stay close.
- Medication can be given to a child only after he comes to his senses.
If such an attack happened for the first time, lasted more than 5 minutes, then you need to call an ambulance.
After the seizure, the child falls deeply asleep. It is important to follow the child after the seizure, as seizures can recur. If the child slept peacefully for two hours, this means that the attack is over.
Impact of epilepsy on child development
The diagnosis of epilepsy is frightening for most parents. It should be noted that this pathology is not genetically determined.It has no effect on the psyche. The child is not threatened with mental retardation and aggression.
Some parents believe that strong medications are harmful to their baby. But, in fact, the lack of therapy is more harmful.
Epilepsy is a well-studied disease. There are effective methods of dealing with this pathology. The disease is not an obstacle to normal life.
In the minds of most people, the term epilepsy is associated with the term convulsive (convulsive) seizure.This association, although not true, nevertheless reflects part of the truth: seizures are indeed one of the frequent manifestations of epilepsy, but not all seizures are caused by epilepsy.
Epilepsy (primary epilepsy) is a chronic brain disease in which spontaneous outbursts of disordered activity of brain cells are observed. In children with epilepsy, it is very often impossible to find any cause of seizures, which distinguishes epilepsy from epileptic or convulsive syndrome – in which the cause of seizures is often known and can be eliminated.
The variety of epilepsy manifestations creates significant difficulties in making the correct diagnosis. Often, the descriptions of a convulsive seizure given by parents are very similar to the description of epileptic seizures, however, a detailed examination of the child reveals facts that put the diagnosis of epilepsy in great doubt.
In the meantime, making a correct diagnosis is extremely important for a child:
- If a child has epilepsy, the cause of the disease will most likely never be identified, and the child will need long-term treatment
- If the child does not have epilepsy, but a convulsive syndrome, then it is likely that the cause of the convulsions will be identified and after its elimination the child will be completely healthy and will no longer need any treatment.
- If a child has febrile seizures, it is likely that they do not need any treatment at all
A striking example of non-epileptic seizure (seizures) is the phenomenon Febrile seizures . This disease, although it may look very similar to epilepsy, is still very different from it in terms of the causes, further development of the disease and treatment.
Due to the fact that parents of children suffering from one form or another of seizures are faced only with the external manifestations of this disease and cannot know its cause (that is, they cannot distinguish true epilepsy from epileptic syndrome), further, in order to simplify the material, we will only use the term “epilepsy” to refer to both epilepsy and all other cases of epileptic seizures.
The manifestations of epilepsy are always very frightening, especially for people who encounter them for the first time. The symptoms of epilepsy depend on the form of the disease.
The main symptoms and signs of convulsive epileptic seizures in children are as follows:
- Convulsions – rhythmic contractions of the muscles of the whole body
- Loss of consciousness
- Temporary cessation of breathing, involuntary loss of urine and feces
- Strong tension of the muscles of the whole body (flexion of the elbows, strong extension of the legs)
Irregular movements in one of the parts of the child’s body: twitching of the arms or legs, pinching or wrinkling of the lips, throwing the eyes back and forcing the head to one side.
In addition to the typical (convulsive) forms of epilepsy, there are some other forms of epilepsy, symptoms of which have some peculiarities and cannot always be recognized by the parents:
Absolute epilepsy in children
The term absence epilepsy comes from the French word “absence” which means “absence.” During absence seizures of epilepsy, the child does not fall down and does not begin to convulse – it only suddenly freezes and stops responding to events happening around him.The main signs of absence epilepsy are:
- Sudden interruption of the child’s activity (he freezes in mid-sentence or, without completing the started movement)
- Stare or absent gaze focused on one point
- Failure to attract the child’s attention
- After the seizure stops, the child continues the action he started and does not remember anything about the seizure.
Most often, absence epilepsy begins at the age of 6-7 years.Girls suffer from absence epilepsy about twice as often as boys. In about a third of cases, children with absence epilepsy have relatives with epilepsy.
The average duration of childhood absence epilepsy is six and a half years. As they get older, in some children absences become less frequent and gradually disappear, in other cases absences turn into another form of epilepsy.
Atonic seizures in children
Atonic seizures are completely different from epileptic seizures, but they are also a form of epilepsy.Atonic seizures are characterized by a sudden loss of consciousness and a strong relaxation of all the muscles of the child. Children with these seizures may suddenly fall, bump, and appear extremely lethargic and weak. Very often, atonic seizures are completely indistinguishable from fainting, so all children who have had several episodes of fainting should be shown to a doctor.
Infantile spasm is a special form of epilepsy in which there is an involuntary and sudden adduction of the arms to the chest, tilt of the head or the entire body forward, and extension of the legs.Infantile spasm attacks often occur in the morning, immediately after the child wakes up.
Infantile spasms may last only a few seconds and only involve a small portion of the neck muscles (causing the child to occasionally nod their head unconsciously). Most often, children from 2 to 3 years old suffer from childhood spasm. By the age of 5, the child’s spasm can disappear without a trace or turn into another form of epilepsy.
A child with suspected infantile spasm should be seen as soon as possible.Children’s spasm can be part of some serious diseases of the nervous system, which quickly lead to a decrease in intelligence and disability in the child.
Sodium valproate, clonazepam, topiramate, etc. are used in the treatment of childhood spasm.
The real danger for the child is not short epileptic seizures, but the loss of consciousness and the fall of the child during the seizure.
As a result, parents or people caring for children with epilepsy should be able to provide first aid during a seizure.
First aid during an epileptic seizure in a child is as follows:
- If you notice the child has cramps, place him on a wide bed or on the floor, away from sharp objects, furniture protrusions on which the child could hit
- Turn the baby over on its side to help protect against strangulation
- Do not put anything in the child’s mouth or try to hold his tongue with your finger
- In most cases, seizures last from a few seconds to 2-3 minutes.
After cessation of seizures:
- Check if the baby is breathing. If there is no breathing, start mouth-to-mouth artificial respiration. Do not administer artificial respiration during seizures.
- Stay with your child until he fully recovers.
- Do not give the child to drink, is there any medicine until he fully recovers
- If the child has a fever, give him a rectal suppository with paracetamol.
When to call an ambulance?
An ambulance should be called if:
- the child had convulsions for the first time
- convulsions lasted more than 5 minutes or recurred again within a short time
- Child injured during seizures
- after seizures, the child is breathing heavily and unevenly
All children who have had epileptic seizures (convulsions) for the first time should be urgently taken to the hospital for examination.If the seizures recur in a child who is already taking antiepileptic treatment, the child’s parents should show him again to a neurologist and consult a change in treatment.
Not all children who have had one or more episodes of seizures or epileptic seizures need treatment
In many cases, treatment can be stopped because the child is in good condition and the risk of new seizures has been eliminated
There are a large number of anticonvulsant drugs .In each case, the treatment of epilepsy is selected individually, depending on the type of epilepsy. Some antiepileptic drugs work well for one form of epilepsy and are completely useless for another.
- Most children with epilepsy need treatment with only one antiepileptic drug
- In more than 80% of cases, medication completely eliminates seizures
- Many antiepileptic drugs can cause drowsiness, decreased attention, and school performance
- In no case is it allowed to abruptly stop treatment or change the dosage of drugs without the knowledge of the doctor – this can lead to increased side effects of treatment or cause new convulsions
- It is very important to follow the treatment program set by the doctor.Parents need to know what to do if a child has not taken one dose of medication
- One should try to teach a child to take medication on his own, but it should never be left entirely under his responsibility.
Febrile seizures are spoken in case of convulsive (convulsive) seizures against the background of temperature above 38 C, in children under 6 years of age who have never had seizures before.Treatment of febrile seizures in children depends on their duration: if the seizures last less than 15 minutes, symptomatic treatment of the temperature with antipyretic drugs and observation of the child are sufficient. In case of febrile seizures lasting more than 15 minutes, treatment with special anticonvulsants is necessary. Febrile seizures are not epilepsy.
What is a febrile seizure in a child?
Febrile (temperature) seizures are convulsive seizures that occur in children under 6 years of age who have never had a seizure without a fever.Febrile seizures must be distinguished from childhood epilepsy, which can occur at any age and require much more complex treatment than febrile seizures. If seizures occur in children over 6 years old, then most likely the child has epilepsy.
Febrile seizures affect up to 5% of all children under 6 years of age. Most often, febrile seizures are seen in children between the ages of 6 months and 3 years.
Causes of febrile seizures in children
The causes of febrile seizures in a child are not completely known.It has been established that one of the factors contributing to the occurrence of febrile seizures in children is the immaturity of the nervous system and weakness of inhibitory processes in the brain, which creates conditions for the transfer of excitation between brain cells and the occurrence of seizures. It is for this reason that febrile seizures are only spoken of in children under 6 years of age. If seizures are observed in a child over 6 years of age or in a child who has previously had seizures without fever, then most likely he has epilepsy or another form of epileptic seizures.
Febrile convulsions always occur against a background of increased temperature (above 38 C). Febrile seizures can be triggered by a common cold, ARVI, and some vaccinations.
An important factor in the development of febrile seizures is a hereditary predisposition to seizures. For example, a child’s risk of developing febrile seizures is significantly higher if his parents or other blood relatives have epilepsy.
Symptoms and signs of febrile seizures
As mentioned above, febrile seizures are not a form of epilepsy, but they have some features in common with this disease.In particular, the external manifestations (symptoms) of febrile seizures and epileptic seizures in children are very similar.
Febrile seizures in children are manifested by the following types of seizures:
- Tonic convulsions: strong tension of all muscles of the child’s body (throwing the head and eyes back, bending the arms to the chest, straightening the legs), which is replaced by rhythmic twitching or jerking, which gradually become more rare and disappear.
- Atonic convulsions: sudden relaxation of all muscles in the child’s body, involuntary loss of urine and feces.
- Local convulsions: twitching of the arms or legs, throwing the eyes back.
In most cases, during seizures, the child completely loses contact with the outside world, does not respond to the words and actions of the parents, stops crying, can hold his breath and turn blue.
Febrile seizures rarely last more than 15 minutes. In some cases, they can occur in series.
In about one in three children, febrile seizures may recur during the following episodes of fever.
Diagnosis of febrile seizures
After an episode of seizures, the child should be seen by a pediatric neurologist. Diagnosis of febrile seizures is to exclude all other causes of seizures, in particular various forms of epilepsy.
A set of examinations for a child with febrile seizures includes:
- Lumbar puncture and analysis of cerebrospinal fluid to exclude meningitis or encephalitis
- General and biochemical analysis of blood and urine
- Nuclear magnetic resonance or computed tomography
- Electroencephalogram (EEG)
Treatment of febrile seizures in children
In the event of febrile seizures in a child, an ambulance should be called.Before the arrival of an ambulance, parents must provide the child with first aid:
- If you are alone with a child – call for help
- A child with convulsions is placed on a flat, hard surface and the head is turned to the side
- The baby’s breathing rhythm should be monitored. If the child is not breathing and is very tense, wait until the seizure ends and begin to do artificial respiration. Artificial respiration during an attack is useless.
- Do not try to open the child’s mouth or insert a finger, spoon or other objects into his mouth – this can only harm the child
- Undress the child and ventilate the room.The air temperature in the room should not exceed 20 C.
- Use physical methods to lower the temperature.
- Give your child an antipyretic.
- Until the febrile seizures stop, do not leave the child alone or try to give him water to drink or swallow the medicine
If seizures are rare and last less than 15 minutes, no other treatment is needed.
For more prolonged and more frequent febrile seizures, intravenous administration of special anticonvulsants may be required by an ambulance doctor.
Prophylactic treatment of febrile seizures is indicated only for very frequent and prolonged seizures. The decision on the need for preventive treatment is made by a neuropathologist.
Does a child with febrile seizures have epilepsy?
Not all children with febrile seizures grow up to have epilepsy. The risk of developing epilepsy in children with febrile seizures is about 2%.
90,000 Convulsions in a child | Convulsions at a child’s temperature
Febrile seizures in children: causes, complications, treatment methods
Convulsions in a child – causes of occurrence
High fever (over 38 ° C) in children under 5 years of age can lead to serious complications.One of them is febrile seizures – characterized by muscle spasms, can lead to temporary loss of consciousness.
Convulsive syndrome is an individual feature of the central nervous system with an increased threshold of sensitivity. It occurs between the ages of six months and five years, often associated with a hereditary predisposition. Convulsions are often manifested in a child at temperatures above 38 ° C. If predisposing factors are absent, a convulsive state is not observed with an increase in temperature.
Convulsions at a temperature in a child – main varieties
The causes of febrile seizures are not fully understood. They can be triggered by acute viral infections, colds, overheating, and teething. One of the key factors is the underdevelopment of the children’s nervous system.
Convulsions at a temperature in a child are as follows:
- Tonic – there is a prolonged contraction of large muscles.There is a throwing back of the head, cramps in the legs of the child, twitching and straightening of the limbs. Muscles are constantly contracting, there is no relaxation period.
- Clonic – short-term contraction, alternating with muscle relaxation. What cramps look like in children at high temperatures – arms, legs are bent, the body is arched.
- Tonic-clonic – both types appear.
It is worth paying special attention to the following symptoms: frothing at the mouth, profuse salivation, frequent uncontrolled urination and stool.
Sleep cramps in a child are especially dangerous. Blocked airways may stop breathing. Sometimes spasms are accompanied by vomiting, there is a threat that the baby may drown.
How to identify seizures in a child at a temperature and how to treat them
When a child has a seizure – without a fever or with a fever – it is important for parents to remain calm. The main thing is to call an ambulance, and before her arrival, provide first aid. Remember: a convulsive state, on average, lasts no longer than half an hour, it is impossible to stop a seizure.
Before the arrival of the doctor, you must do the following:
- take off tight clothing, unbutton collar;
- put the child on a flat surface with his left side, turn his head to the side, fix;
- provide fresh air, ventilate the room;
- in order to avoid biting the tongue, place a dense roller of a handkerchief between the teeth;
- watch your breathing – if the baby stops breathing, the muscles are tense, wait until the spasm stops and give artificial respiration;
- during a seizure, do not try to drink, give medications, after – antipyretic drugs are allowed;
- Do not leave the baby alone before the ambulance arrives.
What to do in case of seizures in a child – consult a neurologist MOC Fortis
To find out why your child has seizures, consult a neurologist. The febrile type may indicate disorders of the central nervous system, first of all, such serious diseases: tumors, epilepsy. For their timely detection, make an appointment with a pediatric neurologist at Fortis Medical Health Center. In order to make a diagnosis, the doctor will send you for examination, prescribe the optimal treatment.Make an appointment for a consultation by filling out the online appointment form or by calling the contact numbers. Check out the schedule of appointments with medical specialists in advance. It is convenient to clarify information on issues of interest by writing a message through the feedback form.
Our address: Kharkov, Nezalezhnosti Avenue, 10 (2nd floor), Universitet metro station. Come from Monday to Friday – 8.00-21.00, Saturday – 8.00-18.00. We will be happy to help!
90,000 Treatment of epilepsy in children in St. Petersburg
Epilepsy can occur even in a month-old baby.There are more than 30 million epilepsy patients in the world, and 2/3 of them are children. In children with RRD, ASD and other developmental disorders, the incidence of epilepsy reaches 45%. Timely diagnosis and well-chosen treatment started on time allow in most cases to compensate for these conditions and achieve complete recovery.
But the problem is that epilepsy is difficult to recognize without special equipment (EEG video monitoring). Unfortunately, often parents go to the doctor when the disease affects the development of the child’s brain for more than a year.Each episode of abnormal electrical activity in the brain worsens the condition of the child.
The diagnosis of epilepsy in a child is not always extensive seizures with convulsions and foaming at the mouth. There are various forms of epilepsy: absence, focal, benign epilepsy is rare.
Symptoms of epilepsy can manifest themselves in different ways, so it is very important to be examined by a competent doctor on time:
- nods and pecks (in infants)
- Unusual physical activity
- “epilepsy without seizures”, when the child does not have seizures, but there is a stable high index of epileptiform activity that disrupts the normal development of the child’s brain
- progressive mental retardation
- Lack of dynamics in the development of the child, despite regular classes with specialists
- nocturnal epilepsy – seizures appear only at night and therefore no one notices them.
An epileptologist is a pediatric neurologist who specializes in the diagnosis and treatment of childhood epilepsy and other paroxysmal conditions. Treatment of epilepsy in children is a lengthy process. Children with epilepsy should be monitored regularly by an epileptologist to organize the correct care, monitor the quality of therapy and its effect on the body.
If your child has a developmental disability and you are planning intensive rehabilitation, it is important to rule out epilepsy or paroxysmal activity before starting rehabilitation.These conditions are a contraindication for many procedures. Uncontrolled exposure to a child’s brain can impair its functioning.
WHY IS IT NECESSARY TO APPLY FOR TREATMENT OF EPILEPSY IN CHILDREN AT THE CLINIC “PROGNOZ”?
Our doctors have extensive experience in managing children with epilepsy – the clinic has been successfully treating such patients since 1988
To conduct night video EEG monitoring, we use the latest generation equipment from Nicolet Biomedical.This US company has been a leader among medical device manufacturers for over 40 years.
Doctors who conduct EEG will be able to find a common language with any child, regardless of his behavior
EEG video monitoring is carried out in a comfortable environment for the child and parents
If a child needs rehabilitation related to his general mental development, the epileptologist draws up a program that will minimize the risks associated with epilepsy.
The clinic has the ability to conduct an EEG directly during therapy using the Tomatis method. This makes it possible to objectively judge how this therapy affects the electrical activity of the child’s brain.
For some types of epilepsy, we use non-drug hardware methods to reduce epileptic activity – Rhythmic Transcranial Magnetic Stimulation (rTMS). This device has a special mode that suppresses pathological electrical activity of the brain.
Sign up for a consultation with an epileptologist through the registration form on the official website of the Prognoz clinic or by phone. The cost of consulting a pediatric epileptologist and accompanying a child by an epileptologist during the course of rehabilitation at the Prognoz clinic can be found in the price section
90,000 Convulsions in children – diagnosis and treatment in the medical center “St. Andrew’s hospitals
Convulsions – a sudden disorder of the brain, manifested by various disorders of the motor, psychoemotional, sensitive and autonomic spheres.Convulsions can occur with loss of consciousness, as well as against the background of preserved or partially preserved consciousness.
Seizures in children can occur at any age, but it is generally accepted that up to two thirds of seizures occur in the first 3 years of life. Being a typical manifestation of epilepsy, seizures do not always indicate the presence of this disease in a child. Seizures are recorded in 5-10% of children, epilepsy is diagnosed in 0.5-1% of the population.
The causes of seizures in children can be:
- Perinatal disorders – birth trauma, previous hypoxia / cerebral ischemia, intracranial hemorrhage, intrauterine infections (intrauterine infection of the fetus with rubella, cytomegalovirus (CMV) viruses or the causative agent of toxoplasmosis).
- Infections – meningitis, encephalitis, brain abscess.
- Brain trauma – brain contusion, less often cerebral concussion.
- Metabolic disorders – a decrease in the level of calcium, sodium, magnesium, blood sugar (respectively, hypocalcemia, hyponatremia, hypomagnesemia, hypoglycemia), an increase in the level of sodium in the blood (hypernatremia), renal failure.
- Increased body temperature (febrile convulsions)
- Neurological diseases – epilepsy, congenital malformations of the central nervous system, hereditary metabolic diseases (disorders of amino acid metabolism, mitochondrial diseases, glycogenosis, etc.)), phakomatosis (neurofibromatosis, tuberous sclerosis, etc.), brain tumors.
- Drug withdrawal syndrome – seizures in newborns born to mothers who use drugs.
The main clinical types of seizures in children:
- tonic (synchronous / asynchronous tension of the muscles of the trunk, limbs)
- clonic (synchronous / asynchronous rhythmic contractions of all muscles)
- tonic-clonic (combination of tonic and clonic seizures with a predominance of one component or another)
- myoclonic (repeated, often symmetrical contractions of individual muscles or muscle groups)
- atonic (sudden decrease in muscle tone)
- infantile spasms (short-term consecutive symmetrical flexion / extension contractions of the muscles of the neck, limbs and trunk)
- absences (sudden short-term cessation of motor and speech activity with “fading” of the gaze).
The volume of necessary examination of children with seizures is determined by the doctor individually, it depends on the nature, conditions of occurrence, frequency of seizures; general condition of the patient, features of his somatic and neurological status and may include EEG, if necessary, EEG video monitoring, CT or MRI of the brain, lumbar puncture, biochemical studies of blood, cerebrospinal fluid, urine, etc. establishing a diagnosis that allows you to form the correct approaches to the treatment of a child.
Convulsive episodes in newborns and young children are in most cases isolated and do not require further treatment. Recurrent seizures, most commonly associated with various types of epilepsy, require carefully selected and long-term anticonvulsant therapy under the supervision of a pediatric neurologist (epileptologist).
Epilepsy seizure treatment – causes of epilepsy in children, the price of epilepsy treatment in Ryazan
A serious disease of the human nervous system, which is expressed in the fact that the patient has sudden seizures from time to time, is epilepsy.In past centuries, patients suffering from this disease were often mistaken for crazy or possessed by the devil. Indeed, for an outside observer, the sight of an epileptic seizure can be very intimidating. Convulsions, foam at the mouth and subsequent unconsciousness or coma of the patient are not a sight for the faint of heart. Fortunately, the achievements of modern medicine are able to keep the patient’s condition under control and prevent the onset of epileptic seizures.
Causes of epilepsy
To this day, many researchers on this issue cannot agree on whether epilepsy is an inherited disease.Nevertheless, the fact remains – 4 out of 10 people suffering from this disease in the family had or have epileptics.
In addition, the following factors can be attributed to the causes of epilepsy:
- serious head injuries;
- Certain parasitoses and viral diseases – for example, meningitis;
- insufficient supply of oxygen to the brain, developed for various reasons;
- all kinds of neoplasms in the brain.
In addition, in more than half of the cases, the circumstances that led to the onset of epileptic seizures remain unclear to the end.
Symptoms of epilepsy in children and adults
The most striking sign of this disease is the presence of seizures in the patient that are not associated with any external factors. For those around them, these attacks can be sudden, but many patients feel them approaching a day or two before the onset of the attack.Headache and insomnia, impaired appetite, irascibility, depression, etc. may indicate his approach.
After a seizure, the patient may not remember what happened to him as recently as a couple of minutes ago. Immediately after an epileptic seizure in children and adults, the victim may feel sleepy and fatigued. In addition to pronounced seizures, in which the patient falls to the floor, he may have small ones from time to time: at the same time, loss of consciousness is not accompanied by a fall.