What are the common causes of seizures in children. How can different types of seizures be identified. What symptoms should parents watch for. Which treatment options are available for childhood seizures.

Understanding Seizures in Children: An Overview

Seizures in children are sudden, abnormal waves of electrical activity in the brain that can manifest in various ways. While often alarming for parents, it’s important to note that seizures are relatively common, with approximately 1 in 10 people experiencing a single seizure in their lifetime. However, when a child shows a tendency to have recurrent seizures, it may be diagnosed as epilepsy, which affects about 1 in 26 people who experience seizures.

Contrary to popular belief, not all seizures involve dramatic symptoms like loss of consciousness or convulsions. The signs and symptoms can vary greatly depending on the type of seizure and the area of the brain affected. Some seizures may be subtle, with the child experiencing an “odd feeling” or déjà vu rather than visible physical symptoms.

Causes of Seizures in Children: Provoked vs. Unprovoked

Seizures in children can be categorized into two main types: provoked and unprovoked. Understanding the distinction between these categories is crucial for proper diagnosis and treatment.

Provoked Seizures

Provoked seizures are triggered by specific conditions or factors. These may include:

• High or low blood sugar levels
• Head injuries
• Infections
• Very high blood pressure
• Stroke
• Kidney or liver failure
• High fever

It’s worth noting that provoked seizures are relatively rare compared to unprovoked seizures.

Unprovoked Seizures

Unprovoked seizures occur without an immediate, clear cause. After thorough evaluation, doctors may discover underlying factors such as:

• Genetic conditions
• Brain lesions

In some cases, even after extensive testing, the cause of a child’s seizures may remain unknown. However, it’s important to remember that treatment can still be effective in managing seizures, even when the underlying cause is not identified.

Types of Seizures in Children: From Focal to Generalized

Seizures in children can be classified into several categories, each with its own characteristics and symptoms. Understanding these types can help parents and caregivers better recognize and respond to seizure activity.

Focal Seizures

Focal seizures, one of the most common types in children, originate in one specific area of the brain. They can be further divided into two subcategories:

1. Focal aware seizures (previously known as simple partial seizures): During these episodes, the child remains fully conscious and can recall the seizure afterward. However, they may be unable to interact with others during the event.
2. Focal impaired awareness seizures (formerly called complex partial seizures): In these cases, the child becomes unaware of their surroundings and may not remember the seizure afterward.

Symptoms of focal seizures can include:

• Sensations of falling or spinning
• “Pins and needles” feelings
• Sudden emotions like anger or fear
• Involuntary gestures or movements
• Auditory or olfactory hallucinations
• Speech difficulties or memory problems
• Rhythmic twitching of limbs
• Blank stares or apparent daydreaming

Generalized Seizures

Generalized seizures affect both hemispheres of the brain simultaneously. They can be categorized into two main types:

1. Non-motor seizures: These include absence seizures, also known as “petit mal” seizures.
2. Motor seizures: These involve various types of muscle movements or loss of muscle tone.

Absence Seizures

Absence seizures are one of the most common types of generalized seizures in children. They typically present as brief episodes of “zoning out” or appearing to daydream. These seizures usually last less than 15 seconds but may occur multiple times throughout the day. Absence seizures often begin between the ages of 4 and adolescence, and some children may outgrow them.

Motor Seizures

There are four main types of generalized motor seizures:

• Atonic seizures: These involve a sudden loss of muscle tone, often resulting in falls or head drops.
• Myoclonic seizures: Characterized by sudden, shock-like muscle contractions affecting one or more limbs.
• Tonic seizures: Involve sudden stiffening of muscles.
• Tonic-clonic seizures: Previously known as “grand mal” seizures, these involve a combination of muscle stiffening and rhythmic jerking movements.

Recognizing Seizure Symptoms in Children: What to Watch For

Identifying seizure symptoms in children can be challenging, as they may vary greatly depending on the type of seizure. However, there are some common signs that parents and caregivers should be aware of:

• Sudden, uncontrolled body movements
• Loss of consciousness or awareness
• Staring spells or blank looks
• Sudden changes in behavior or emotion
• Unexplained falls or loss of muscle control
• Repetitive movements or actions
• Confusion or disorientation
• Unusual sensory experiences (e.g., strange tastes, smells, or visual disturbances)

If you suspect your child is experiencing seizures, it’s crucial to keep a detailed record of these episodes, including their frequency, duration, and any noticeable patterns. This information can be invaluable to healthcare providers in making an accurate diagnosis.

Diagnosing Seizures in Children: The Importance of Accurate Evaluation

Diagnosing seizures in children requires a comprehensive approach that may involve several steps and diagnostic tools. The process typically begins with a thorough medical history and physical examination, followed by various tests to confirm the diagnosis and identify any underlying causes.

Medical History and Physical Examination

During the initial evaluation, the healthcare provider will gather detailed information about the child’s symptoms, medical history, and family history of seizures or neurological disorders. A comprehensive physical examination, including a neurological assessment, will also be performed.

Diagnostic Tests

Several diagnostic tests may be used to evaluate seizures in children:

• Electroencephalogram (EEG): This non-invasive test records the brain’s electrical activity and can help identify abnormal patterns associated with seizures.
• Neuroimaging: MRI or CT scans may be used to visualize the brain’s structure and identify any abnormalities that could be causing seizures.
• Blood tests: These can help rule out metabolic or genetic conditions that may be contributing to seizures.
• Lumbar puncture: In some cases, a spinal tap may be performed to check for infections or other abnormalities in the cerebrospinal fluid.

Accurate diagnosis is crucial for developing an effective treatment plan and determining the long-term prognosis for children with seizures.

Treatment Options for Childhood Seizures: A Multifaceted Approach

The treatment of seizures in children aims to control seizure activity, minimize side effects, and improve overall quality of life. The approach to treatment may vary depending on the type and frequency of seizures, as well as any underlying causes.

Anti-Epileptic Medications

Anti-epileptic drugs (AEDs) are often the first-line treatment for seizures in children. These medications work by altering brain chemistry to reduce the likelihood of seizures. Some common AEDs used in pediatric patients include:

• Valproic acid
• Carbamazepine
• Levetiracetam
• Oxcarbazepine
• Lamotrigine

The choice of medication depends on various factors, including the type of seizure, the child’s age, and potential side effects. It’s important to note that finding the right medication and dosage may take time and require close monitoring by a healthcare provider.

Dietary Therapies

In some cases, dietary modifications may be recommended to help control seizures. The ketogenic diet, a high-fat, low-carbohydrate diet, has shown effectiveness in reducing seizure frequency in some children, particularly those with drug-resistant epilepsy.

Surgical Interventions

For children with severe, drug-resistant epilepsy, surgical options may be considered. These can include:

• Resective surgery: Removal of the area of the brain responsible for seizures
• Corpus callosotomy: Severing the connection between the brain’s hemispheres to prevent seizure spread
• Vagus nerve stimulation: Implantation of a device that sends electrical impulses to the vagus nerve to reduce seizure activity

Alternative Therapies

Some families explore complementary and alternative therapies to manage seizures in children. These may include:

• Herbal supplements
• Acupuncture
• Biofeedback
• Mindfulness and relaxation techniques

It’s important to discuss any alternative treatments with a healthcare provider before incorporating them into a child’s seizure management plan.

Living with Seizures: Supporting Children and Families

Managing seizures in children extends beyond medical treatment. It involves creating a supportive environment and addressing the emotional and social aspects of living with a chronic condition.

Safety Measures

Implementing safety measures at home and in school can help prevent injuries during seizures. These may include:

• Padding sharp corners on furniture
• Using protective headgear during certain activities
• Avoiding unsupervised swimming or bathing
• Educating family members and caregivers on proper seizure first aid

Educational Support

Children with seizures may require additional support in school. This can include:

• Individualized Education Programs (IEPs)
• Accommodations for medication administration
• Training for school staff on seizure recognition and management

Emotional and Social Support

Living with seizures can be challenging for children and their families. Providing emotional support and access to resources is crucial. This may involve:

• Connecting with support groups for families affected by epilepsy
• Counseling or therapy to address anxiety or depression related to seizures
• Encouraging open communication about seizures with peers and teachers

The Future of Seizure Management in Children: Emerging Treatments and Research

The field of pediatric seizure management is continually evolving, with ongoing research into new treatments and interventions. Some promising areas of development include:

Gene Therapy

Researchers are exploring gene therapy as a potential treatment for certain types of genetic epilepsy. This approach aims to correct or replace faulty genes responsible for seizure activity.

Precision Medicine

Advances in genetic testing and neuroimaging are paving the way for more personalized treatment approaches. This may allow healthcare providers to tailor interventions based on a child’s specific genetic profile and seizure characteristics.

Neuromodulation Techniques

New neuromodulation devices and techniques are being developed to provide targeted seizure control with fewer side effects. These may include advanced brain stimulation technologies and minimally invasive surgical options.

Improved Anti-Epileptic Medications

Ongoing research is focused on developing new anti-epileptic drugs with improved efficacy and fewer side effects. This includes exploring novel mechanisms of action and drug delivery methods.

As research in these areas progresses, it offers hope for improved seizure management and better outcomes for children living with epilepsy.

Seizures in Children | Causes, Types, Symptoms & Treatment

A seizure is a sudden, abnormal wave of electrical activity in the brain. Seizures begin suddenly. Most often stop on their own within a few minutes.

Seizures are common. About one in 10 people will have a single seizure in their lifetime.

People often associate seizures with dramatic symptoms, such as loss of consciousness or convulsions (uncontrolled shaking). Signs and symptoms vary depending on the type of seizure a person has and what part of the brain is involved. Some seizures are not obvious to others. Rather than physical symptoms, the child has an “odd feeling,” such as déjà vu (a sense of having experienced the present situation before). These odd feelings come “out of the blue.” They usually get worse as the person continues to have seizures.

Seizures are treatable. Many children outgrow their tendency to have them. An accurate diagnosis can help doctors find the most effective treatment.

When a child has shown a tendency to have seizures, it is called epilepsy. About one in 26 people who have seizures will develop epilepsy.

What Causes Seizures in Children?

Seizures can be divided into two general categories, provoked and unprovoked. Provoked seizures can be caused by many different conditions, such as high or low blood sugar, a head injury, infection or very high blood pressure. A stroke, kidney or liver failure, and high fever may also provoke a seizure. These types of seizures are extremely rare.

Unprovoked seizures do not have an immediate, clear cause. After further evaluation, doctors may find a cause, such as a genetic condition or lesion in the brain.

Finding the cause of seizures can be challenging for doctors and frustrating for families. Sometimes even after extensive evaluation, the cause of a child’s seizure is unknown. Even if the doctor doesn’t discover the cause of a child’s seizures, treatment may help bring the seizures under control.

Types of Seizures in Children

There are many different types of seizures in children. They fall into a few categories:

• Focal, meaning the seizure activity begins in one part of the brain and may spread from there.
• Generalized, meaning the seizure affects all parts of the brain at once.
• Infantile spasms, a type of seizure that begins during the first year of life.
• Status epilepticus, which involve convulsions of more than five minutes.
• Febrile seizures, which occur within 24 hours of a fever for children between six months and five years of age.

Focal Seizures

Focal seizures are a common type of seizure in children. Symptoms include:

• A feeling of falling or spinning
• A feeling of “pins and needles”
• A sense that familiar things are suddenly unfamiliar, or vice versa
• A sudden feeling of anger or fear
• “Automatisms” (involuntary gestures), such as removing or fiddling with clothing, grunting, lip-smacking and clumsy movements
• Buzzing noises
• Garbled speech or problems with memory
• Repeating words or phrases, laughing or crying
• Rhythmic twitching of a limb or part of a limb (twitching may spread to other parts of the body)
• The appearance of daydreaming, including blank stares
• Smelling or tasting things that aren’t there
• Vivid hallucinations
• Wandering

Children can experience two types of focal seizures:

• “Focal aware seizures” (previously called “simple partial seizures”)—The child remains fully alert and awake. They remember having the seizure. But they may not be able to interact with others while the seizure is happening.
• “Focal impaired awareness seizures” (previously called “complex partial seizures”)—The child is unaware of their surroundings. They may not remember the seizure.

Generalized Seizures

There are two categories of generalized seizures. They include non-motor such as absence (pronounced “ab-SONCE”) seizures and motor seizures.

Non-motor, Absence Seizures

Sometimes called “petit mal seizures,” absence seizures are one of the most common seizures in children. A child having this type of seizure may look like they are daydreaming or zoning out. The seizures last 15 seconds or less. They may occur many times a day. They may begin at age four through adolescence. Some children outgrow them.

Motor Seizures

The four types of generalized motor seizures include:

• Atonic seizures
• Myoclonic seizures
• Tonic seizures
• Tonic-clonic seizures

Atonic seizures
Atonic seizures involve a sudden loss of muscle tone. Sometimes called a “drop attack,” these can cause symptoms such as:

• Brief loss of consciousness
• Falling to the ground
• Head dropping down

Myoclonic seizures
Myoclonic seizures involve sudden, shock-like muscle contractions affecting one or more limbs. These seizures may happen once or in clusters, with more than one occurring in a short period of time.

Tonic seizures
These seizures involve stiffening of the body and/or arms and legs. They may occur when the person is awake or asleep. If they happen while standing or sitting, the person may fall to the ground.

Tonic-Clonic seizures
When a person has a tonic-clonic seizure (sometimes called a “grand mal seizure”), they lose consciousness, their muscles stiffen, and their arms and legs jerk uncontrollably. A tonic-clonic seizure usually begins on both sides of the brain. It can also start on one side and spread to the whole brain. There are two phases:

• Tonic phase: The person’s muscles stiffen. They may fall to the floor. Breathing is affected. The person may turn a bit blue in the face and cry out. The person may bite their tongue or cheek, causing bleeding from the mouth.
• Clonic phase: This follows the tonic phase. It involves convulsions—the person’s arms and usually legs begin to jerk. Sometimes the person loses control of their bladder or bowel.

These seizures usually last a few minutes. A tonic-clonic seizure of five minutes or more is a medical emergency.

Infantile Spasms (West Syndrome)

Sometimes called “epileptic spasms,” these seizures are diagnosed in a baby’s first year of life. They may start with a quick spasm involving a downward head jerk. Over time, these may develop into clusters of spasms in which the child’s arms or legs arms rise and/or straighten suddenly.

Seizures most often occur when the child is waking up or falling asleep. At first, these symptoms may be subtle. Over time, they become more noticeable.

Infantile spasms are a medical emergency. They do not pose an immediate danger, but children with infantile spasms are at high risk for developmental delays. The child may lose skills, such as crawling and walking, if left untreated. They need immediate treatment for the seizures to minimize their risk for long-term problems.

Cincinnati Children’s offers a specialized neurometabolic program to help infants or children experiencing infantile spasms. It is available through our Infant Seizure Program.

Status Epilepticus

Status epilepticus is a medical emergency. It involves convulsive seizures lasting more than five minutes. If the seizures last longer than 30 minutes, serious problems could occur, including permanent brain damage. Children diagnosed with status epilepticus need to have “rescue medication” nearby at all times. An adult can give this medication to stop the convulsions quickly.

Febrile Seizures (seizures in toddlers)

These seizures occur in children ages six months to five years old. They happen within 24 hours before or after the child has a fever. These motor seizures involve convulsions. Children typically outgrow these seizures.

Febrile seizures can be simple or complex. To be considered complex, febrile seizures must last longer than 15 minutes or occur more than once in 24 hours or affect one part of the body. The shaking may affect one or both sides of the body. A small percentage of children who have complex febrile seizures develop epilepsy.

Signs and Symptoms of Seizures

When you hear the word seizure, you may picture someone lying on the ground and shaking violently. This is how seizures are shown on television and in the movies. However, many types of seizures are subtle. They can be hard to recognize, especially in infants.

The most common symptoms include:

Non-motor Symptoms

• A color change of the lips or face
• A funny feeling the child can’t describe
• Lack of awareness and/or decreased responsiveness, plus staring
• Eyes or head turned into one direction
• Staring with eye fluttering
• Seeing stars or shapes
• Excessive drooling
• Loss of bowel or bladder control

Motor Symptoms

• “Automatisms,” or repetitive activities, such as fiddling with clothing, grunting, lip-smacking and clumsy movements
• Convulsions (uncontrolled shaking of the body)
• Drooping facial features
• Jerking movements or stiffening of one or more arms and legs
• Sudden loss of muscle control
• Twitching or jerking of the face, arm or leg

When the seizure is over, the child may be tired and need to rest.

Auras

Some people experience an “aura” (warning). This is part of the seizure. Auras usually last seconds to minutes. They occur before the person has visible signs of a seizure. Some common auras can include:

• A physical sensation (numbness or tingling, racing heartbeat, dizziness, headache)
• An emotion (suddenly feeling sad or anxious)
• A change in senses (unusual smells or taste)

People who experience an aura can take safety precautions, such as sitting down, telling someone they are about to have a seizure, or taking medication as prescribed.

What Do You Do if a Child is Having a Seizure?

• Stay calm and stay with your child.
• Protect your child from getting hurt. Move objects away that may harm them.
• Place a soft object under your child’s head.
• Roll your child onto their side.
• Loosen tight clothes.
• Time the seizure when it starts.
• Be prepared to give seizure rescue medication based on your child’s individual seizure plan.
• Call 911 if seizure lasts five minutes or longer and you do not have a seizure rescue medication.
• Do not put anything in the child’s mouth. Your child cannot swallow their tongue.
• Do not try to keep your child from moving. This may cause you or your child to get hurt.
• Do not give liquids or medicine by mouth until your child is fully awake and alert.

Most seizures will stop within minutes on their own. If your doctor has prescribed “rescue medication” for seizures lasting five minutes or longer, be prepared. Know where the medication is and how to give it to your child. Store the medications securely at room temperature. Avoid storing it in places such as a car’s glove compartment or a tote bag that will be out in the sun.

After a seizure:

• Your child may be confused and sleepy. It is OK to let them sleep.
• Your child may have pee or poop in their pants.
• Any bleeding from the mouth may mean that your child bit their tongue or the inside of their cheek. Check the mouth only after the seizure is over. Put a clean cloth on the area and use gentle pressure to stop the bleeding.

Most seizures are not emergencies. But you should call 911 if your child:

• Has a seizure that lasts longer than usual
• Has a cluster of seizures (more than one seizure in a short period of time)
• Does not return to “normal” after the seizure within their usual timeframe (being sleepy is OK)
• Is not breathing normally after the seizure ends
• Has a seizure while in the water
• Is injured during a seizure

Diagnosing Seizures in Children

If your child experiences a seizure, they should be seen by a pediatric neurologist or pediatric epileptologist (a pediatric neurologist specializing in epilepsy).

During your child’s first appointment, the doctor will ask questions about your child’s seizure history and health history and whether other people in your family have had seizures. The doctor will also do a thorough exam and may order tests, such as:

• Electroencephalogram (EEG)
• Magnetic resonance imaging (MRI) of the brain
• Genetic testing

The goal is to discover the underlying cause of the seizure(s) and provide treatment. Sometimes it is not possible to find the underlying cause.

Treatment for Seizures

If your child is diagnosed with epilepsy, the doctor may prescribe anti-seizure medication. This medicine helps control seizures. The doctor will choose the medicine based on your child’s age, weight, seizure type and physical condition.

The goal of treatment is to achieve the best quality of life with no seizures and no side effects from the medicine. Sometimes the medicine will need to be changed if there are side effects that are too much to handle or if it doesn’t control the seizures. If a child is seizure-free after two years of being on medicine, the doctor may try to take them off their seizure medicine.

If a child still has seizures after taking two different epilepsy medications, their epilepsy is called intractable. This is the case for about 30% of children with epilepsy.

Learn about intractable epilepsy and how it’s treated.

Preventing Seizures

Your child’s provider may prescribe anti-seizure medication. It is also important for you to be aware of situations that seem to lead to your child’s seizures. These are called seizure triggers. Some common seizure triggers include:

• Fatigue – it is important to keep a good sleep schedule.
• Excessive stress – mental health professionals can help children and families learn to manage stress in healthy ways.
• Fever or other symptoms of illness – it is important to have good hand washing. Stay up to date on immunizations.
• Visual stimuli, such as flashing bright lights or computer games (please note that this type of seizure trigger is rare.)
• Using certain medications or not taking anti-seizure medication as prescribed.
• Hormonal changes, such as those with the menstrual cycle

Knowing your child’s seizure triggers can help your child avoid situations that could lead to a seizure. This will help you be more aware during “high risk” times (such as when your child is sick).

To identify seizure triggers, keep a seizure log. For each seizure, write down what time it is, what was happening and how your child felt before the seizure started. Look for patterns and connections. Talk to your child’s provider about what you learn.

What Is the Outlook for Children with Seizures?

Seizures are not necessarily a lifelong condition. Many children outgrow their tendency to have seizures. And for those who do not, treatment is often effective.

In recent years, science has come a long way to develop new treatments for people with seizures, especially those who have intractable epilepsy. Most children who have seizures can go to school, play sports and live full lives.

Seizures and Epilepsy in Children

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Health Issues

​​Seizures are sudden events that cause temporary changes in physical movement, sensation, behavior or consciousness. They are caused by abnormal electrical and chemical changes in the brain. Here’s what parents should know about seizures, how to help someone who is having one and when a child may be diagnosed with epilepsy.

Are there different types of seizures?

There are many different types of seizures. Some last for only a few seconds, while others may last a few minutes. The specific type of seizure a person has depends on where in the brain the seizure starts, how the seizure spreads and how much (and what part) of the brain is involved.

Common seizure types

Doctors divide seizures into two basic
types based on how much of the brain is involved. These include:

1. 
   Generalized seizures that involve the whole brain.

2. 
   Focal seizures that start in one specific part of the brain.

Symptoms of seizures might include:

• Loss of consciousness

• Convulsions (whole body shaking)

• Confusion

• Brief periods of staring

• A sudden feeling of fear or panic

• Uncontrolled shaking of an arm or leg

• Flexing, stiffening, jerking or twitching of the upper body

• Nodding of the head

What is epilepsy?

The term
epilepsy is used to describe seizures that occur repeatedly over time without an acute illness (like fever) or an acute
brain injury. Sometimes, the cause of the recurring seizures is known
(symptomatic epilepsy), and sometimes it is not
(idiopathic epilepsy).

A doctor would likely diagnose a child with epilepsy if the following were true:

• The child has had one or more unprovoked seizures.

• The doctor thinks the child is likely to have a seizure again

• The child’s seizures are not directly caused by another medical condition, like diabetes, a severe infection or an acute brain injury

Common generalized seizures

Common focal seizures

• Focal seizures (previously called complex partial seizures) involve abnormal electrical activity in one part of the brain. During these seizures a person can be confused and consciousness is impaired. They often engage in random, repetitive and purposeless activities like wringing the hands or walking slowly in circles. The person is unaware of what is going on around them and may be unable to talk normally. This type of seizure typically lasts 1 to 2 minutes.
• Focal seizures can involve jerking of one or more parts of the body, or sensory changes like smells or tingling feelings that may not be obvious to onlookers. During the seizure the person is fully aware of what is going on. These seizures where consciousness is not impaired have been called
  simple partial seizures.
• Focal seizures can start in one area of the brain and spread to involve both sides of the brain. In some instances, a focal seizure can progress to a convulsive seizure.

Other disorders that can look like seizures:

Some children experience sudden episodes that might resemble seizures, but are really not.

Examples include:

• Breath holding

• 
  Fainting (syncope)

• Facial or body twitching (myoclonus)

• Sleep disorders (night terrors, sleepwalking, and cataplexy)

They may occur just once or may recur over a limited time period. Again, although these episodes may resemble epilepsy, they are not, and they require quite different diagnostic tests and treatment.

What to do if your child is having a convulsion

Most seizures will stop on their own and do not require
immediate medical treatment. If your child is having a convulsion, protect them from injuring themselves. You can do this by laying them on their side with their hips higher than their head, so they will not
choke if they
vomits. Do not put anything in the mouth.

• 
  If the convulsion does not stop within five minutes or is unusually severe ​(difficulty breathing, choking, blueness of the skin, having several in a row),
  call 911 for emergency medical help. Do not leave your child unattended, however. After the seizure stops, call the pediatrician immediately and arrange to meet in the doctor’s office or the nearest emergency department. Also call your doctor if your child is on an
  anticonvulsant medication, since this may mean that the dosage must be adjusted.

• 
  If your child has diabetes, is injured or has a seizure in the
  
  water, this is always an emergency and 911 should be called immediately.

• 
  If your child has a fever, the pediatrician will check to see if there is an infection. If there is no fever and this was your child’s first convulsion, the doctor will try to determine other possible causes by asking if there is a
  family history of seizures or if your child has had any recent
  head injury. They will examine your child and also may order blood tests, pictures of the brain using
  computed tomography (CAT scan) or
  magnetic resonance imaging (MRI), or testing with an electroencephalogram (EEG), which measures the electrical activity of the brain. Sometimes a spinal tap will be performed. This involves examining a specimen of spinal fluid for some causes of convulsions such as meningitis, an infection of the lining of the brain. If no explanation or cause can be found for the seizures, the doctor may consult a
  pediatric neurologist, a pediatrician who specializes in disorders of the nervous system.

• 
  If your child has had a febrile convulsion, some parents may try controlling the fever using
  acetaminophen. However, these approaches do not prevent future febrile seizures, but only make the child more comfortable. If a bacterial infection is present. Your doctor will probably prescribe an
  antibiotic. If a serious infection such as
  meningitis is responsible for the seizure, your child will have to be
  hospitalized for further treatment. When seizures are caused by abnormal amounts of sugar, sodium or calcium in the blood, hospitalization also may be required so that the cause can be found, and the imbalances corrected.

• 
  If epilepsy is diagnosed, your child usually will be placed on an anticonvulsant medication. When the proper dosage is maintained, the seizures can almost always be completely controlled. Your child may need to have their blood checked periodically after starting some medications. They also may need periodic EEGs. Medication usually is continued until there have been no seizures for a year or two.

Remember

As frightening as seizures can be, it’s encouraging to know that the likelihood that your child will have another one drops greatly as they gets older.
(About 1 in 100 adults 18 and older have active epilepsy). Unfortunately, a great deal of misunderstanding and confusion about seizures still exists. That’s why it is important that your child’s friends and teachers become educated about their condition.

If you need additional support or information, consult with your pediatrician or contact your local or state branch of the
Epilepsy Foundation of America.

More information:

• 
  Epilepsy in Children: Diagnosis & Treatment
• 
  How to Support a Child with Epilepsy: Information for Parents
• 
  Febrile Seizures in Children
• 
  Ask the Pediatrician: Do you have resources to help explain seizures and epilepsy to my child’s teacher and classmates?
• 
  Helpful Resources for Patients and Families (AAP. org)
  ​

Last Updated

2/27/2023

Source

Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under grant U23MC08582 for Project Access. (Copyright © 2010 Epilepsy Foundation of America, Inc)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Fever – Humanitas

Fever is usually a signal that something is wrong in the body. In an adult, fever is accompanied by malaise, however, as a rule, a temperature increase of no more than 103 F (39.4 C) is considered harmless. In children of the first days of life and infants, even a slight increase in temperature may indicate the presence of a serious infection.

However, the severity of the fever does not always indicate the severity of the underlying condition. Mild illness may cause fever with significant fever, and severe illness may cause mild fever.

The fever usually resolves within a few days. A number of over-the-counter drugs can lower a fever, but in some cases it is better not to lower it. An increase in body temperature greatly contributes to the body’s fight against a number of infectious diseases.

Symptoms

Fever is an increase in temperature above normal values. The temperature normal for an individual may be slightly above or below the average normal temperature 98.6 F (37 C).

Fever, depending on the cause, may be accompanied by signs and symptoms such as:

• Sweating
• Trembling
• Headache
• Muscle pain
• Loss of appetite
• Dehydration
• General weakness

Fever 103 F (39. 4 C) to 106 F (41.1 C) may cause:

• Hallucinations
• Confusion
• Irritability
• Convulsions
• Dehydration

Conditions requiring medical attention

Fever in itself is not a cause for concern and a reason to seek medical attention. However, there are times when, if you have a fever, you need to see a doctor yourself or take your child to the doctor.

Temperature measurement

Several types of thermometers are suitable for taking your own and your baby’s temperature, including oral, rectal, and ear (tympanic) thermometers.

Although not the most accurate method, an oral thermometer can be used to measure armpit temperature (axillary temperature).

• Place the thermometer in the armpit and cross your arms over your chest.
• Wait four or five minutes. Axillary temperature is slightly lower than oral.
• The doctor who came on call must be informed of the actual readings of the thermometer and name the place where the temperature was taken.

A rectal thermometer is suitable for measuring temperature in young children:

• To do this, grease the bulb of the thermometer with petroleum jelly.
• Place the baby on the stomach.
• Carefully insert the bulb of the thermometer half a centimeter into the child’s rectum.
• Hold the thermometer and child still for three minutes.
• Never let go of the thermometer while it is in the child’s body. If the child wriggles, the thermometer may go deeper and cause damage.

Infants

Unlike adults, unexplained fever in children is a serious cause for concern. If your child’s temperature rises to 101 F (38.3 C) or more, contact your pediatrician. You should also call a doctor in the following cases:

• Fever in a child under 3 months old.
• Refusal of the child to eat and drink.
• Fever and unexplained irritability: the child cries a lot, for example when changing a diaper or at the slightest movement.
• Lethargy and lack of reaction in a child with fever. In infants and children under 2 years of age, these signs may be signs of meningitis, an infection and inflammation of the membranes and fluid surrounding the brain and spinal cord. If meningitis is suspected, the child should be seen by a doctor immediately.
• The body temperature of the newborn is below normal – below 97 F (36.1 C). In the youngest children, during illness, body temperature is difficult to regulate: it may fall rather than rise.

Children

If a child has a fever, but still reacts to others: makes eye contact, responds to facial expressions and voice, then there is probably nothing to worry about.

In the following cases, the child should be taken to the doctor:

• Lethargy or irritability, frequent vomiting, severe headaches or abdominal pain, or any other symptoms that cause severe discomfort.
• Fever after being in a hot car. Seek immediate medical attention if:
• Fever persists for more than one day (in children under 2 years of age) or more than three days (in children 2 years of age and older)

In special cases, for example, if the child has diseases associated with disorders of the immune system or any pre-existing diseases. Doctors also advise caution if a child has recently been prescribed a new drug.

Adults

Seek medical attention if:

• Temperature rises above 103 F (39.4 C)
• Persistence of fever for more than three days

In addition, seek immediate medical attention if any of the following signs or symptoms accompany a fever:

• Severe headache
• Severe swelling of the throat
• Unusual skin rash, especially if it progresses rapidly
• Unusual sensitivity to bright light
• Stiff neck and pain when bending head forward
• Confusion
• Prolonged vomiting
• Labored breathing or chest pain
• Extreme lethargy or excitability
• Abdominal pain or pain when urinating
• Other unexplained signs and symptoms

Complications

Fever may be accompanied by the following complications:

• Severe dehydration
• Hallucinations
• Fever-induced convulsions (febrile convulsions) in a small number of children aged 6 months to 5 years
• Febrile convulsions

Febrile seizures are usually accompanied by loss of consciousness and convulsions of the limbs, involving muscle groups on both sides of the body. Although febrile seizures are a cause of concern for parents, in most cases they do not have any long-term consequences.

If ​​a febrile seizure occurs:

• Place the child on its side or stomach on the floor or other flat surface
• Remove all sharp objects within reach of the child
• Rid the child of tight clothing
• Hold the child to avoid injury.

Do not put anything in the child’s mouth or try to stop seizures
In most cases, seizures go away on their own. After the seizures stop, it is necessary to show the child to the doctor as soon as possible to determine the cause of the fever.

If convulsions persist for more than 10 minutes, seek emergency medical attention.

Health clinic. Medical center in Kaliningrad.

Description

Cramps are paroxysmal, involuntary contraction of muscles as a result of their overstrain. Convulsions occur suddenly and do not last long, but after a certain interval of time they can be repeated. They usually cause severe pain. Young people complain of painful cramps much less often than the elderly and children. Such muscle contractions occur predominantly at night when the body is warm and asleep, or during muscle activity.

The calf muscles are most susceptible to cramps, less so are the hips, back, neck and abdomen. Cramps can be both in one muscle and cover a group of muscles.

Causes

Cramps appear due to insufficient blood circulation in the muscles, especially during physical exertion. For some, convulsions appear and intensify when exposed to external stimuli – pricking the body with a needle, sudden loud sounds, alcohol abuse.

A factor in the development of seizures in athletes is a lack of salt in the body, caused by increased sweating.

Even monotonous repetitive movements, such as typing on a keyboard or moving a computer mouse, can cause seizures.

Night cramps are the result of a complex of psychophysiological disorders (low blood circulation and stress).

If the same muscle groups are under load, then when tired, they can also be subject to convulsive contractions. This is especially true for people who work standing up.

Sometimes convulsions are a consequence of diseases of the nervous system (epilepsy, tetanus, neurosis), poisoning, metabolic disorders or the activity of the endocrine glands.

Spasms of the calf muscles are also an independent disease, and may be accompanied by any disease (for example, varicose veins). They occur during a long walk, swimming.

Convulsive contractions of the muscles of the glottis can be caused by irritating odors or gases. Often they lead to malnutrition and changes in the functions of the brain and heart, respiratory arrest.

Seizure symptoms

Symptoms of seizures range from mild to very severe. With a mild form, confusion, darkening of the eyes, snorting, convulsive twitching and tingling in a certain part of the body are possible. Moderate severity – when urinary and fecal incontinence is added to the previous symptoms, short-term fainting.

The most dangerous form of seizures is an epileptic seizure. In this case, there is an inexplicable feeling of fear and numbness, nausea, dizziness, salivation, foam from the mouth, deviation of the direction of the eyes and head. Convulsions last more than two minutes, after which there is a loss of consciousness.

Seizure treatment

Treatment of seizures is carried out depending on the underlying disease. Applicable anticonvulsants: phenobarbital, hexamidine, benzonal, diphenin. Thermal procedures, local massage, a clear mode of work and rest have a positive effect. With convulsive status or recurrent convulsions, emergency medical care is necessary, otherwise there is a risk of developing cerebral edema, respiratory depression and other vital functions.

In order to prevent dehydration in hot weather, the patient is advised to drink cold water with table salt dissolved in it (1 teaspoon of salt per liter of water).

Another way to improve local circulation with recurring cramps is to apply alternately hot and cold compresses to the affected area.

If the cramp has already begun, the attack cannot be stopped. Those around are able to call for medical help as soon as possible, as well as protect the patient from injuries and bodily harm that he can inflict on himself.

Self-help in the event of a cramp is stretching the affected muscle. For example, to get rid of a spasm in the calf muscle, you need to overcome the pain and push the heel down to lengthen the muscle.

General convulsions and loss of consciousness are symptoms of epilepsy. Before the doctor arrives, you need to create a calm environment for the patient, lay him down in such a way as to help the muscles relax.