Seizures Intro

INTRODUCTION
Seizures in Children
Seizures are generally described as the sudden and abnormal dysfunction of the brain that results in sudden changes in the behavior
as well as movements of various body parts.
A seizure occurs when the brain functions abnormally, resulting in a change in movement, attention, or level of awareness. Different types of
seizures may occur in different parts of the brain and may be localized (affect only a part of the body) or widespread (affect the whole body).
Seizures may occur for many reasons, especially in children. Seizures in newborns may be very different than seizures in toddlers, school-aged
children, and adolescents. Seizures, especially in a child who has never had one, can be frightening to the parent or caregiver.
Type of Seizures in Children

There are different types of seizures that can be categorized by their outer appearance and the reports of the electroencephalogram pattern
(EEG). Following are the main types of the seizures in children.
Febrile Seizures: A child's contraction to several illnesses like cold, chickenpox, ear infection etc. might result into this type of seizures, which is
accompanied by high fever. A child's whose older siblings have had several incidences of febrile seizures may suffer from similar episodic
seizures.
Neonatal Seizures: This type of seizure occurs within the first month of the child's birth. Most of the times it occurs as soon as the child is born.
The neonatal seizures are quite hard to recognize as the newborn doesn't have any convulsions but they show several symptoms like focal
misdirection (both eyes set in different directions). Lip smacking and breathless periods may also be observed.
Atonic Seizures: The atonic seizures actually make the children go off balance and fall suddenly to the ground with a sudden loss of muscle tone
in an unresponsive manner. The atonic seizures are also called as drop attacks.
GTC Seizures: The GTC (generalized tonic clonic seizures) are defined in five distinguishing stages, that are - contract (contraction of the legs,
arms and other body parts), straighten out (extended body parts), tremor (sudden shaking of the body), clonic period (sudden contraction-
relaxation of the body), and the postictal period (sleepiness, problems with speech, vision along with fatigue and body aches).
Infantile Seizures: This type of seizures are said to be the rarest that occur to the children of 3 months to a year of age. During this type of
seizure, the infant is most probably at the point of awakening with certain periodic movements of the neck, legs or the trunk that last for a few
seconds or more. They are also called as infantile spasms, which are quite dangerous with several long term complications.
Myoclonic Seizures: Myoclonic seizures, generally are characterized by quick movement of a large group of muscles in several parts of the body.
These seizures occur for several times during a day or also for several days in a row. There are many types of seizures in children that are
distinguished by their causes.
Causes of Seizures in Children

A child having tendency of seizures actually undergoes one to many seizures in the long period of time. Following are the causes of seizures in
children:
 Infections or high fever
 Chemical imbalance of the body that causes loss of metabolism
 Congenital conditions or trauma
 Genetic factors and family history
 Brain tumors and neurological problems
 Habits of the mother like smoking, alcohol consumption, drugs and certain medications
When the child goes through several seizures without any specific reason, it is called as epilepsy.
Symptoms of Seizures in Children

The intensity and the degree of seizures vary according to the type of seizure. Following are the probable symptoms that indicate that a child is
having seizures.
 Jerking movements of the body
 Staring, rapid eye blinking, loss of consciousness, confused appearance
 Breathing problem and incontinence
 Falling without any specific reason and unresponsiveness for several minutes
 Lips turning blue in color
The sudden movements of the body parts are most often followed by disorientation and a long period of deep sleep. Most symptoms of seizures in
children may also resemble other medical conditions, so it is best to consult the doctor and start the treatment of the same.
Diagnosis of Seizures in Children
There are various diagnosis methods of seizures in children that can diagnose the actual type of seizures, as well as make it easy to plan the
treatment for it. Along with outer appearance of the seizure and the EEG, following are the several other diagnostic methods of seizures in
children:
 Blood tests
 MRI scan (Magnetic Resonance Imaging)
 CT scan (Computerized Tomography scan)
 Lumber Puncture (removal of a small amount of the CSF (Cerebral Spinal Fluid) and performing tests on it.
Treatment of Seizures in Children

Treatment for seizure in children are recommended as per the condition of that particular child. These specifications will depend mainly on the
age, overall health and other medical history of the child. The type, degree and intensity of seizure will also determine the line of treatment for
seizures in children. The obvious goal behind the treatment of seizures is to stop or decease the frequency of seizures in children that too without
troubling the normal growth of the children. Medications as per the type of seizure, timely blood tests, urine tests and the EEGs to keep a check on
the progress of the child as per the medication that is being provided and a ketogenic diet are the three possible curative measures that are
observed by the health care providers with the help of the parents of the child.
Generalized seizures may be controlled using a variety of medications, including barbiturates, phenytoin, valproic acid, or Ethosuximide.
Phenobarbital may be effective in the treatment of both generalized and simple partial seizures, including status epilepticus. Pediatric
maintenance doses average 3 to 5 mg/kg/day. Common dose-related side effects include sedation and ataxia and hyperactivity is occasionally
evident. Risk for idiosyncratic hepatotoxicity and for rash is probably not dose related.
Phenytoin is also effective in the treatment of both generalized and partial seizures and may be administered intravenously as treatment for status
epilepticus. Pediatric maintenance doses average 4 to 7 mg/kg/day. Intravenous infusion of a loading dose (18 mg/kg) should be performed slowly
and cautiously due to risk of hypotension. Dose-related side effects may include sedation and ataxia. Long-term use may be complicated by
gingival hyperplasia, hirsutism, or lymphadenopathy. Potential idiosyncratic side effects include rash, hepatotoxicity, or a lupus-like syndrome.
Valproic acid is useful in treating a variety of generalized (tonic-clonic, absence) and partial seizure disorders as well as some myoclonic
epilepsies. It is particularly useful in treatment of mixed seizure disorders. Pediatric maintenance doses range from 30 to 60 mg/kg/day PO and no
intravenous form is available. Dose-related side effects may include sedation, GI upset, thrombocytopenia, and hyperammonemia. Fulminant
hepatotoxicity is the most feared idiosyncratic complication of therapy; children under 2 years of age and children receiving multiple
anticonvulsants appear to be at greatest risk.
Ethosuximide is used primarily in the treatment of absence (petit mal) epilepsy and occasionally as an adjunctive agent in other generalized
seizure disorders. Maintenance doses average 20 to 30 mg/kg/day. Common side effects include sedation, headache, and stomach upset.
Idiosyncratic reactions may include rash or blood dyscrasias.
Partial seizures often respond to many of the anticonvulsant medications used for generalized seizures, including phenytoinand valproic acid.
Another first-line agent used in the treatment of partial seizures is carbamazepine, which is effective against both partial and secondarily
generalized seizures. Maintenance doses average 10 to 20 mg/kg/day PO. Dose-related side effects may include stomach upset, sedation, and
ataxia. Potential idiosyncratic reactions include leukopenia ,aplastic anemia, rash and Stevens-Johnson syndrome

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INTRODUCTION

Type of Seizures in Children

Causes of Seizures in Children

Symptoms of Seizures in Children

Treatment of Seizures in Children

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