First Aid: Seizures (for Parents)

en español: Primeros auxilios: Convulsiones

Reviewed by: Kate M. Cronan, MD

Seizures are almost never life-threatening. Many last only a few minutes and stop on their own. Still, it can be alarming to see a child having a seizure, and it helps to know what to do.

Signs and Symptoms

Seizures can take many forms, from staring spells to involuntary movements of the arms and legs. Some signs a child might be having a seizure are:

• unusual sensations or twitching before the seizure
• staring, not responding to anyone
• uncontrollable muscle spasms
• loss of consciousness (passes out)
• uncontrolled peeing or pooping

What to Do if Your Child Has a Seizure:

If someone is nearby, ask them to call your child’s doctor. If no one is with you, follow the steps below and then call the doctor:

1. Gently place your child on the floor or ground, and remove any nearby objects.
2. Lay your child on his or her side to prevent choking on saliva (spit).
3. If your child vomits, clear out the mouth gently with your finger.
4. Loosen any clothing around the head or neck.
5. Make sure your child is breathing OK.
6. Don’t try to prevent your child from shaking — this will not stop the seizure and may make your child more uncomfortable.
7. Don’t put anything in your child’s mouth. Your child will not swallow his or her tongue, and forcing teeth apart could cause injuries or block the airway.
8. Don’t give your child anything to eat or drink, and don’t give any medicine pills or liquid by mouth until your child is completely awake and alert.
9. Try to keep track of how long the seizure lasts.
10. Your child may be sleepy or may take a while to get back to normal after the seizure. Stay with your child until he or she is awake and aware, and let your child rest after the seizure.

Get Emergency Medical Care or Call 911 if Your Child:

• has a seizure lasting more than 5 minutes or is having repeated seizures
• has trouble breathing
• has a bluish color on the lips, tongue, or face
• remains unconscious for more than a few minutes after a seizure
• falls or hits his or her head before or during a seizure
• seems to be sick
• has a seizure while in water
• has any symptom that concerns you

Think Prevention!

If your child has a known seizure condition, be sure that he or she gets plenty of rest and takes any prescribed seizure medicine on time.

Reviewed by: Kate M. Cronan, MD

Date reviewed: July 2018

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Juvenile Myoclonic Epilepsy (for Parents)

en español: Epilepsia mioclónica juvenil

Reviewed by: Lily Tran, MD

and
Andrew I. Mower, MD

Neurology at Nemours Children’s Health

What Is Juvenile Myoclonic Epilepsy?

Kids with juvenile myoclonic epilepsy have myoclonic seizures that usually begin during the teen years. They may also have absence seizures and generalized tonic-clonic seizures.

Seizures may happen less often in adulthood, but medicine will likely be needed for life.

What Are the Signs & Symptoms of a Juvenile Myoclonic Seizure?

Different types of seizures can happen in juvenile myoclonic (my-uh-KLON-ik) epilepsy. The types and their symptoms are:

Myoclonic Seizures

This kind of seizure is the most common type in juvenile myoclonic epilepsy, and is the hallmark of this condition. In a myoclonic seizure, a child:

• has brief muscle twitches or jerks in the upper arms, shoulders, or neck
• has movements on one or both sides of the body at the same time
• usually is awake and can think clearly during and right after the seizure

Absence Seizures

An absence seizure starts suddenly in the middle of activity and ends abruptly. During the seizure, a child:

• blanks out or has staring spells that last 5–20 seconds
• may flutter their eyes or look upward
• is unaware of what is going on during the seizure
• returns to normal activity and won’t remember having the seizure after it’s over
• has lip-smacking, chewing movements, or fumbling movements in their hand(s)

Tonic-Clonic Seizures

In this type of seizure, a child:

• has convulsions, or rigid muscles and rhythmic body jerks
• rolls the eyes back
• cries out
• may pee or poop
• can’t respond during seizure
• is confused and sleepy after the seizure

Seizures in juvenile myoclonic epilepsy typically happen within 30 minutes of waking up in the morning or after a nap. They’re more likely to happen when someone is tired, stressed, or didn’t get enough sleep.

What Causes Juvenile Myoclonic Epilepsy?

The cause of juvenile myoclonic epilepsy isn’t known, but it tends to run in families. Genetic changes (mutations) have been associated with the condition.

How Is Juvenile Myoclonic Epilepsy Diagnosed?

If your child had a seizure, the doctor probably will want you to see a pediatric neurologist (a doctor who treats brain, spine, and nervous system problems). The neurologist will ask questions about what happened during the seizure, do an exam, and order an EEG to measure brain wave activity.

How Is Juvenile Myoclonic Epilepsy Treated?

Seizures are usually well-controlled with medicine, which many people will need to take for life. If they’re not, doctors have other treatments to try.

How Can Parents Help?

To help your child live better with epilepsy, be sure they follow the neurologist’s recommendations about:

• taking any medicines
• avoiding triggers (such as excessive stress, lack of sleep, blinking lights, drinking alcohol, some types of medicines)
• taking precautions while swimming or bathing
• whether it’s OK for your teen to drive
• whether your child should wear a medical ID bracelet

To keep your child safe during a seizure, make sure that other adults and caregivers (family members, babysitters, teachers, coaches, etc. ) know what to do.

Juvenile myoclonic epilepsy is a lifelong condition. But many kids go on to live a normal life with a few extra steps taken to keep them safe. When it’s time, help your child successfully move to adult health care.

What Else Should I Know?

If your child has epilepsy, reassure them that they’re not alone. Your doctor and the care team can answer questions and offer support. They also might be able to recommend a local support group. Online organizations can help too, such as:

• Epilepsy Foundation
• CDC – Managing Epilepsy

Reviewed by: Lily Tran, MD

and
Andrew I. Mower, MD

Date reviewed: February 2022

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Febrile seizures in children aged 3 months.

– 5 y. – 5 years,
associated with fever.

At this age, the child’s brain is still insufficiently mature and more
sensitive to internal and external factors. To a greater extent
predisposed to febrile seizures are children with similar manifestations in
parents, as well as in the presence of a pathology of pregnancy and childbirth in the mother.

Febrile seizures appear in diseases that occur with high
temperature (above 38 ° C) – acute viral infection, influenza, tonsillitis, Tite,
bronchitis, pneumonia, etc. An increase in temperature, causing metabolic changes and
violations of the blood supply to the brain, increases the readiness for convulsions.

Not included in this group convulsions due to infectious diseases
nervous system (meningitis, encephalitis), as well as when the occurrence of febrile
seizures are preceded by afebrile paroxysms.

Convulsions usually occur on the first day of the rise in temperature and are manifested in
in the form of loss of consciousness with general tension of the body and twitching of the limbs.
Sometimes convulsions can be erased or predominate on one side.
body. Some children may foam at the mouth and involuntarily
urination.

Convulsions usually last 3-5 minutes. Repeated cramps throughout the day
are rare. Sometimes hours or minutes before seizures occur
the child becomes restless, clings to the mother, screams. And then general
excitation is replaced by convulsions.

Febrile convulsions are classified into simple and complex.

Simple febrile seizures account for 80-90% of all febrile seizures. Characteristic features of simple febrile seizures
are:

• single episodes,
• short duration (no more than 15 min.),
• generalized tonic-clonic, clonic or tonic
  attacks.
• As a rule, simple febrile seizures occur in normal
  developing children without focal neurological disorders.
• Simple febrile seizures are usually not complicated by transient and
  permanent neurological disorders.

Complex febrile convulsions are characterized by the following
signs:

• duration more than 15 min.,
• repeatability within 24 hours,
• focal character (convulsions predominate on one side of the body).
• Complicated febrile seizures are often followed by transient
  neurological disorders.

It is also possible to develop febrile status epilepticus – arising on
background of fever, recurrent generalized tonic-clonic seizures
lasting more than 30 min. Death from febrile status epilepticus
observed extremely rarely.

Neuropsychic development of children with febrile convulsions, as a rule,
age appropriate.

Prevention and treatment of febrile seizures. Significant
difficulties arise when deciding on the treatment of children with febrile
convulsions. In the absence of risk factors, even with repeated simple febrile
convulsions, there is no reason to prescribe antiepileptic therapy, since
the likelihood of developing epilepsy in such children is negligible.

If there are risk factors or complex febrile seizures, ask about
the appointment of antiepileptic therapy is decided individually. In this case
there is a risk of transition of febrile convulsions into epilepsy.

To prevent febrile seizures in a child with a high fever,
apply paracetamol (daily dose of 20-30 mg per kg) every 4-5 hours and
wet rubdowns with cold water or vodka. No increase allowed
body temperature above 38°C! It is necessary to measure the child’s body temperature
every hour, and if its increase is noted despite all the measures, it is necessary
call an ambulance.

If febrile convulsions develop, they usually last 2-3 minutes and
bought on their own. If they last more than 10 minutes or are repeated, then
it is necessary to enter diazepam (seduxen). This therapy is carried out by emergency physicians
care or hospital.

Parents of children with febrile seizures should:

1. Prevent seizures: measure body temperature every hour
   with illness; give drugs that reduce the temperature; conduct a physical
   cooling the child (rubbing, enemas with boiled water at room
   temperature).
2. Be able to properly provide first aid to a child in the event of
   fit:

• open the collar and remove tight clothing;
• remove foreign objects (prostheses) from the oral cavity;
• put the child on his back and turn his head to the side;
• do not try to open the jaws with any object;
• do not give any drugs or liquids by mouth;
• measure temperature;
• carefully observe the course of the attack;
• to be near the child until the attack stops completely.

Dynamic monitoring of patients who have had single febrile
convulsions have shown that the risk of recurrent febrile seizures
is 30%, and epileptic seizures not associated with an increase
temperature, – 2-3%. The negative impact of febrile seizures on neurological
the status and mental development of the child has not been proven.

Thus, in most cases, the prognosis for febrile convulsions
favorable, the likelihood of developing epilepsy in such children is low, therefore
febrile seizures are called benign epileptic syndrome of childhood
age.

Expert told why febrile convulsions are dangerous in children – Moscow 24, 07/14/2022

July 14, 2022, 08:32

Society

Any illness of a child and an increase in his temperature is already a big stress for the whole family. But when the baby also starts having seizures, it’s easy to panic. We tell you what is important for parents to know about febrile convulsions and how to behave correctly during an attack in a child.

Typical and atypical

Photo: depositphotos/belchonock

Febrile seizures occur due to a specific reaction of a child’s immature brain to a sharp rise in body temperature – from 38 degrees and above, Olga Keln, a pediatric neurologist, told Moscow 24. Babies usually suffer from seizures between the ages of six months and five years. But sometimes convulsions occur in children from 3 months to 8 years.

Most common are typical febrile seizures that last from a few seconds to 10-15 minutes. The child’s muscles begin to contract convulsively symmetrically, for a while he may even lose consciousness.

Olga Cologne

pediatric neurologist

But such attacks usually do not recur during the day. What can not be said about atypical convulsions that can return several times a day. They can last more than a quarter of an hour. These attacks are often characterized by asymmetry, when convulsions and contractions occur only in the muscles of one half of the body or limb.

Febrile seizures in children can occur not only against the background of a temperature caused by an infectious disease. The reason may be the heat of a different nature. For example, due to teething, heatstroke or sunburn, trauma, or a severe allergic reaction.

Is epilepsy possible?

Photo: depositphotos/danr13

Febrile convulsions do not affect the behavior, development and academic performance of the child. In addition, seizures at a high temperature are not symptoms of epilepsy, the doctor reassures. However, there is still a small risk of transformation of convulsions.

Particular care must be taken if the child often has atypical seizures and if he has neurological diseases. It is also better to be on the lookout when one of the immediate family suffers from epilepsy. If any of these factors are present, the baby needs to be examined.

If epilepsy has been ruled out, prophylactic treatment is usually not required. The use of nootropics “to restore the brain” after an attack is not justified.

Olga Keln

pediatric neurologist

It is also important to remember that convulsions are a symptom of meningitis and encephalitis, so a doctor should examine a child in any such conditions. If he suspects the presence of dangerous diseases, he may prescribe a lumbar puncture – a lumbar puncture.

Febrile seizures are associated in some studies with iron deficiency in the child’s body and with the herpes virus type VI. Therefore, if the child has had several episodes, the doctor may recommend testing for herpes and ferritin.

Algorithm of actions

Photo: depositphotos/Ondrooo

In most cases, febrile convulsions do not pose any threat to the child. The main thing is that parents should not panic, but should be able to properly take care of the baby during an attack, the doctor reminds.

The child should be laid on his side and make sure that there is nothing in his mouth, otherwise he may choke. For the same reason, during an attack, you should not give the baby any drugs through the mouth, and also try to give him water.

In addition, you need to call an ambulance and record the start and end times of febrile seizures. Thus, it will be easier for doctors to differentiate an attack.