Let's face it: watching a seizure is scary. If you made it to the Childhood Seizure e-Book, you have probably recently been through an experience where you thought your child was dying. That experience is finished now, but it is likely going to take months for you--the parent--to get over it. The good news is that for children with seizures, the vast majority of the time everything works out fine.
Knowledge is an antidote to fear. This e-book will give you the knowledge you need to approach your child's seizures from a position of strength. In this Childhood Seizure e-Book, you'll find accurate information on pediatric seizures and epilepsy. This includes febrile seizures, petit mal epilepsy, grand mal (or tonic clonic) epilepsy, Juvenile Myoclonic Epilepsy, and Benign Rolandic Seizures. We'll discuss causes, prognosis (usually good!), treatment (if needed), and social issues. We'll start by explaining what happens during a seizure.
The brain consists of billions of neurons, communicating with each other via electrical impulses. These neurons are all touching each other, and the only reason there is any order is that many of the neurons exert a brake-like effect on other neurons. On occasion, the brain cells essentially get themselves into a reverberating "short circuit." The brain cells fire--causing the muscles that they control to contract, which leads to the movements we witness during a typical seizure. Fortunately, the brakes usually regain control, causing the stiffening to revert to slower twitches and then stop. Each time such an event occurs, the person is said to have experienced a seizure.
Brain cells communicate with electrical impulses
A seizure
is a kind of electrical short circuit.
"Epilepsy" is an (unfortunately) still emotion-laden word. It simply refers to people who have had more than one seizure. Epilepsy has nothing to do with intelligence. It just means a seizure tendency. This can be due to many causes, including just a genetic predisposition to an imbalance of the chemical channels that are supposed to prevent seizures; or to a brain disorder such as trauma. Seizures occur over a lifetime of about 11% of all people, although only 0.5% to 3% of the population will have epilepsy.
The good news is that most children with seizures do NOT have a serious underlying problem such as a brain tumor or stroke. Other than possible markers of seizures on the EEG, tests in kids with seizures such as MRI's--while typically indicated--are usually normal.
This lack of identifiable cause for most kids is understandably frustrating to parents who want to know "WHY?" But normal MRI's sure beat abnormal MRI's. See chapter on Diagnosis.
Yes! About 1 out of 10 people will experience a seizure at some point during their life. About 1 out of 200 people have had more than one seizure, i.e., have "epilepsy." Since you probably have met many more than 200 people in your life, that probably means you know other people who have seizures also--just you didn't know it because they have normal lives.
So, you have plenty of company. If you go to a major league baseball stadium, there are probably 300 people in the stadium who have epilepsy. And you have plenty of good company, too. For example, Joan of Arc, Ludwig van Beethoven, Michelangelo and Julius Caesar all had seizures.
It is very unlikely that a seizure will cause serious injury! No one can ever guarantee you much in life; but fortunately, it turns out that it is very unlikely to be hurt by a seizure. We don’t expect it to cause any kind of brain damage. After all, your child has already had a seizure and is OK, right? What better proof could be offered?
Now, that’s not to say that a seizure is exactly good for you, either. Many kids find it embarrassing (not that they need to be embarrassed), and it’s occasionally possible to fall during a seizure and hurt oneself. So, it is important to take regularly any medication that you plan out with your doctor.
What is more likely to hurt your child (than the seizure itself) would be if the parents became overly protective--or made the seizures into the focus of their own or their child's life. Let's not saddle anyone with medieval concepts of being "an epileptic." This seizure tendency is a small part of your total child!
We expect only good things for your child. The children are not evil, crazy, or possessed. People with seizures usually live totally normal lives. They get married, have kids, have jobs, and even have dogs if they want. A few jobs—like being a jet pilot—are probably not good ideas.
About 3 out of 4 kids with seizures have them completely controlled. Most kids outgrow their seizures, and can stop taking any anti-seizure medication after a few years. Your doctor will discuss this with you. See chapter on Diagnosis and Treatment.
In order to help your doctors to decide if the event was a seizure at all--and if so, what type of seizure--it would be tremendously helpful to observe:
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Was there an aura? An aura is the prodrome or "warning" to the seizure. This could include an abdominal discomfort, a movement or sensation in one part of the body, a visual disturbance, an "odd feeling," or just about anything else. [Important because a well defined aura makes the seizure likely to have started in one specific part of the brain.] |
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How did the seizure start? Did the seizure start in just one part of the body and then spread, or did it involve the whole body from the onset? [Important because a localized onset to the seizure makes the seizure likely to have started in one specific part of the brain.] A pattern of prominent crying or fright before the spell in a young child makes "breath holding spells" a possible diagnosis. |
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Were there palpitations (feelings of a rapid heart beat) or a preceding feeling of light-headedness? [These symptoms might suggest a cardiac problem.] |
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Were there symptoms of a "partial complex
seizure" (also sometimes seen in an "absence seizure")? These include: |
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Was the person able to respond to any outside stimulus? [In a moment of simple inattention such as boredom, the person will respond to a stimulus such as being called loudly or having their should gently shaken. In an absence seizure, there will be no response at all to being called. In contrast, during a partial complex seizure, there may be a confused response.] |
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Were there stiffening ("tonic") and/or later harsh jerking ("clonic") movements? |
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Was the jaw clenched or was the tongue bitten? |
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Was there any color change or breathing problem? |
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How long did the actual seizure last? |
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Was there a "post-ictal" state of confusion? How long did it last? |
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Was there a headache after the episode? |
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Was there any incontinence (an accident with the urine or bowels?) This is more likely to occur with seizures than with fainting, but is a non-specific symptom. |
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Was there any identifiable trigger? What was happening at the time? |
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Have there been any previous quick startle-like movements of the hands ("myoclonus"), typically in the morning hours? |
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Have there been any symptoms of night-time seizures? These include waking up with a bitten tongue, incontinence, headache, or with blood or extra saliva on the pillow; or falling out of bed. |
As you read through the following chapters about the classification and treatment of the different seizure types, you will further understand why observation about the above symptoms are helpful.
since 6/02