Understanding seizures in children Seizures or convulsions in children are among the many different conditions that necessitate a visit to the hospital or the emergency room. This usually results from abnormal electrical activity in the brain and can occur at any age. It can comprise a very frightening experience for parents or other witnesses. Seizures can come in various forms: They could involve the entire body, or just one side or part of the body, like a limb or the face. They may present with jerky rhythmic movements or a stiffening of a limb, limbs or the whole body. These abnormal movements are not requisite, though; some children undergoing seizures could only have a vacant look on their faces and remain unresponsive, or may just become limp, losing their balance and falling down. Seizures could even manifest in some children in the form of abnormal cries or laughter. For children with recurrent convulsions, there might be certain triggers like sleep deprivation, flashing lights or emotional stress, all of which can bring on an episode. Some children may feel or complain of symptoms such as headache, blurry vision, discomfort in the stomach, and an unpleasant feeling or fear preceding a seizure. The most common cause of seizures in children is febrile convulsion, which can occur in kids between six months to six years of age who have fever. The seizure in these cases lasts between a few seconds to a couple of minutes and will usually occur within 24 hours of the onset of fever. Genetic factors do play a role in this type of seizure; it occurs more frequently in children if there is a family history of such seizures in the parents, siblings, or first-degree relatives. The seizures may recur with further febrile illnesses, but it is still a benign condition that does not have serious consequences such as brain damage or intellectual impairment as parents tend to fear. Of course, not all seizures that accompany fever in childhood are febrile seizures. They can also be a presentation of more serious diseases like meningitis (infection of the covering layer of the brain), encephalitis (infection of the brain), or cerebral malaria (infection of brain due to malaria). These are very grave conditions that call for immediate treatment and could very well be fatal. These children will require long-term anti-convulsant treatment, the duration of which could last two years or more. Some of these children miay have underlying genetic conditions as well. Seizures in children may occur without fever too and such seizures are usually due to disturbances in our body homeostasis like abnormality in blood sugar or electrolyte (sodium, calcium) levels, deranged liver or kidney function, sudden blood pressure changes or impairment in the supply of oxygen to the brain. Trauma to the head due to a fall, assault or accident, tumours in the brain, poisons, toxins and drug abuse can also cause seizures. In these situations, apart from the immediate management of seizures, the correction of the underlying conditions is equally important because it is the severity of these that determines the final outcome. As for those children who suffer repeated seizures, and to whom none of the above-mentioned factors apply, they can be diagnosed with ‘seizure disorder’ or epilepsy, in which seizures are triggered recurrently from within the brain. This disorder can also be linked to some genetic conditions, and young patients will need long-term medication. Seizure episodes that last a long while, or repeated episodes of the same, can have detrimental effects on the growing brain of a child, and intervention and treatment is therefore necessary. But before we seek the help of health facilities, there are some life-saving measures that can be taken at home, such as placing a seizing child in a left lateral position to prevent airway compromise due to the tongue falling back, or aspiration of oral secretions or vomited material. Though seizures are fairly common in the pediatric age group, only less than one third of these are caused by epilepsy, and the outlook for most children with seizures is therefore generally positive. But then again, seizures in children may sometimes signal a potentially serious underlying disease or condition that requires careful investigation and management. Dr Shrestha is the Chair of the Department of Paediatrics at Patan Hospital and Professor of Paediatrics at the Patan Academy of Health Sciences
Posted on: Wed, 02 Oct 2013 06:40:10 +0000
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