Seizure, Pediatric

A seizure is a sudden burst of abnormal electrical and chemical activity in the brain. Seizures usually last from 30 seconds to 2 minutes. This abnormal activity temporarily interrupts normal brain function.

Many types of seizures can affect children. A seizure can cause many different symptoms depending on where in the brain it starts.

What are the causes?

The most common cause of seizures in children is fever (febrile seizure). Other causes include:

Injury, or trauma, at birth or a lack of oxygen during delivery.
Congenital brain abnormality. This is an abnormality that is present at birth.
Infection or illness.
Brain injury, head trauma, bleeding in the brain, or tumor.
Low blood sugar levels, low salt (sodium) levels, kidney problems, or liver problems.
Certain health conditions such as:
- Metabolic disorders or other conditions that are passed from parent to child (inherited).
- Developmental disorders such as autism spectrum disorder or cerebral palsy.
Reaction to a substance, such as a drug or a medicine, or suddenly stopping the use of a substance (withdrawal).
A stroke.

In some cases, the cause of this condition may not be known. Some people who have a seizure never have another one. When a child has repeated seizures over time without a clear cause, he or she has a condition called epilepsy.

What increases the risk?

Your child is more likely to develop this condition if:

There is a family history of epilepsy.
Your child had a seizure before.
Your child has a history of head trauma or lack of oxygen at birth.

What are the signs or symptoms?

There are many different types of seizures. The symptoms vary depending on the type of seizure your child has. Symptoms occur during the seizure and may also occur before a seizure (aura) and after a seizure (postictal).

Symptoms during a seizure

Uncontrollable shaking (convulsions) with fast, jerky movements of the arms or legs.
Stiffening of the body.
Confusion, staring, or unresponsiveness.
Breathing problems.
Head nodding, eye blinking or fluttering, or rapid eye movements.
Drooling, grunting, or making clicking noises with the mouth.
Loss of bladder and bowel control.

Symptoms before a seizure

Fear or anxiety.
Nausea.
Vertigo. This is a feeling like:
- Your child is moving when he or she is not.
- Your child's surroundings are moving when they are not.
Changes in vision, such as seeing flashing lights or spots.
Odd tastes or smells.
Déjà vu. This is a feeling of having seen or heard something before.

Symptoms after a seizure

Confusion.
Sleepiness.
Headache.
Weakness on one side of the body.
Sore muscles.

How is this diagnosed?

This condition may be diagnosed based on:

Symptoms of the seizure. Watch your child very carefully as the seizure occurs so that you can describe what you saw and how long the seizure lasted. It can be helpful to take video of your child during the seizure and show it to the health care provider.
A physical exam.
Tests, which may include:
- Blood tests.
- CT scan.
- MRI.
- Electroencephalogram (EEG). This test measures electrical activity in the brain. An EEG can predict whether seizures will return.
- A spinal tap, or a lumbar puncture. This is the removal and testing of fluid that surrounds the brain and spinal cord.

How is this treated?

In many cases, no treatment is needed, and seizures stop on their own. However, in some cases, treating the underlying cause of the seizures may stop them. Depending on your child's condition, treatment may include:

Avoiding known triggers.
Medicines to prevent or control future seizures (antiepileptics).
Medical devices to prevent and control seizures.
Surgery to stop seizures or to reduce how often seizures happen, if your child has epilepsy that does not respond to medicines.
A diet low in carbohydrates and high in fat (ketogenic diet).

Follow these instructions at home:

During a seizure:

Help your child get down to the ground, to prevent a fall.
Put a cushion under your child's head and move items to protect his or her body.
Loosen any tight clothing around your child's neck.
Turn your child on his or her side.
Do not hold your child down. Holding your child tightly will not stop the seizure.
Do not put anything into your child's mouth.
Stay with your child until he or she recovers.

Medicines

Give over-the-counter and prescription medicines only as told by your child's health care provider.
Do not give your child aspirin because of the association with Reye's syndrome.
Have your child avoid any substances that may prevent his or her medicine from working properly, such as alcohol.

Activity

Have your child avoid activities as told. These include anything that could be dangerous to your child if he or she had another seizure. Wait until the health care provider says it is safe to do these activities.
If your child is old enough to drive, do not let him or her drive until the health care provider says that it is safe. If you live in the U.S., check with your local department of motor vehicles (DMV) to find out about local driving laws. Each state has specific rules about when your child can legally drive again.
Make sure that your child gets enough rest. Lack of sleep can make seizures more likely.

General instructions

Avoid anything that has ever triggered a seizure for your child.
Educate others, such as caregivers and teachers, about your child's seizures and how to care for your child if a seizure happens.
Keep a seizure diary. Record what you remember about each of your child's seizures, especially anything that might have triggered the seizure.
Keep all follow-up visits. This is important.

Contact a health care provider if:

Your child has any of these problems:
- Another seizure or seizures. Call each time your child has a seizure.
- A change in seizure pattern.
- Seizures that continue with treatment.
- Symptoms of infection or illness, which might increase the risk of having a seizure.
- Side effects from medicines.
Your child is unable to take his or her medicine.

Get help right away if:

Your child has any of these problems:
- A seizure for the first time.
- A seizure that does not stop after 5 minutes.
- Several seizures in a row without a complete recovery between seizures.
- A seizure that makes it harder to breathe.
- A seizure that leaves your child unable to speak or use a part of his or her body.
Your child does not wake up right away after a seizure.
Your child gets injured during a seizure.
Your child has confusion or pain right after a seizure.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

A seizure is caused by a sudden burst of abnormal electrical and chemical activity in the brain. This activity temporarily interrupts normal brain function.
There are many causes of seizures in children, and sometimes the cause is not known.
To keep your child safe during a seizure, lay your child down, cushion his or her head and body, loosen clothing, and turn your child on his or her side.
Get help right away if your child has a seizure for the first time or has a seizure that lasts longer than 5 minutes.