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home  |  health information  |  ABC of health

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Childhood seizures

What are childhood seizures?

Childhood seizures can be caused by a variety of common childhood illnesses that result in abnormal electrical activity in the brain. Recurrent seizures (ie those that occur more than once) are known as epilepsy. Seizures are sometimes also called convulsions, fits or attacks.

Epilepsy can therefore only be diagnosed if more than one seizure has occurred. A child who has only ever had one seizure cannot be said to be epileptic because they may never have another. Epilepsy affects approximately eight out of 1000 children of school age. (See separate Factsheet.)

What causes childhood seizures and who is at risk?

In the majority of children no cause for the seizure is found. Occasionally, epilepsy may have a genetic basis and therefore run in families. More rarely, brain injury at or around the time of birth may result in epilepsy, and even more rarely in childhood, a brain tumour may be the cause.

What are the common symptoms and complications of childhood seizures?

There are many different types of childhood seizures.

Primary generalised epilepsy

Primary generalised epilepsy is also called ‘grand-mal’ or ‘tonic–clonic’ epilepsy, and is by far the most common type of childhood epilepsy. A loss of consciousness is followed by falling to the ground and the body, arms and legs become stiff. This phase usually lasts for only a few seconds and, as breathing stops, the child often turns blue in the face. A rhythmic jerking of the arms, legs and often the entire body follows, which may be violent and alarming to observers. These are known as ‘involuntary movements’. During this stage, breathing resumes and a normal colour returns to the child’s face. This stage normally lasts less than five minutes and may be associated with tongue biting and incontinence of urine. On coming around, the child is confused, drowsy and often tearful, but does not remember what happened.

Absence seizures

Absence seizures are also known as ‘petit mal’ attacks, which are episodes of loss of consciousness without falling or involuntary movements. The child stops whatever he or she is doing, looks vacant for five to 20 seconds and then continues what he or she was doing as if nothing had happened.

These attacks occur after the age of two years and are most common between five and nine years of age. Most children grow out of them by their teenage years. It is important that absence seizures are diagnosed and treated, because if they are frequent the child’s education may be seriously disrupted.

Juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy is a condition that has a genetic basis and therefore runs in families. There are episodes of jerking of the hands, arms or entire body without alteration of consciousness. The jerks occur most frequently in the early morning. It usually begins in late childhood and the affected child may also suffer from absence attacks or generalised seizures. It is important that this condition is correctly diagnosed as some anti-epileptic medications may actually make it worse.

Temporal lobe epilepsy

Temporal lobe epilepsy may be difficult to recognise and diagnose in childhood because the child finds it difficult to describe the often complex sensations experienced. Outward signs of a child who is experiencing this type of epilepsy include making strange faces, swallowing, lip-smacking, chewing and muttering while being apparently awake but not in touch with what is going on around him or her.

 

What to do if your child has a seizure

Febrile convulsions

Febrile convulsions are a very common problem that affect approximately three per cent of children aged from about three months to five years. The child will have had one or more generalised seizures during the course of an illness that causes a fever, usually a viral illness. Continued febrile convulsions occur in about one-third of children after the first episode, but only five per cent go on to develop non-febrile convulsions (ie epilepsy). Therefore, if a child suffers from febrile convulsions he or she is not likely to develop epilepsy in later life. The condition often runs in families.

How do doctors recognise childhood seizures?

The diagnosis is usually based on your description of your child’s attack. Sometimes, but not always, further tests are required, such as an electrical recording of the brain known as an EEG (electroencephalogram). A brain scan may also be required, depending on the type of seizure and how often it occurs.

What is the treatment for childhood seizures?
Self-care action plan

Children with epilepsy do not require much change in their activities. If seizures are frequent or difficult to control, which is unusual, your child should not ride a bicycle in traffic, should not swim unaccompanied, and should take showers instead of baths to prevent the risk of drowning should a seizure occur while bathing. To help prevent seizures it is important to ensure that your child does not become over-tired.

You should make sure that those who look after your child, including yourself, teachers and older brothers and sisters, know what to do if your child has a seizure or fit. This includes lying the child on his or her side to prevent the tongue from obstructing breathing. No objects must be placed in the mouth. Any tight clothing around the neck should be loosened. The child should be left undisturbed until the seizure has calmed down. Young children may be very frightened on coming around and require comforting. If a generalised seizure does not stop after five minutes, an ambulance must be called.

For children with febrile seizures, the use of paracetamol and tepid sponging whenever your child has a fever reduces the risk of a fit.

Medicines

For the vast majority of children with epilepsy, the condition can be easily controlled by one anti-epileptic medication (eg carbamazepine, ethosuximide) usually taken two or three times each day. Common side effects include drowsiness and rashes. If these occur, you should inform your doctor without delay. More than 60 per cent of children grow out of their epilepsy and medication can be stopped if the child has not had a fit for at least two years. You should discuss this with your doctor before stopping any medications.

Complementary therapy

No good evidence shows that homoeopathic or herbal remedies have any beneficial effect. Older children may derive benefit from the Alexander technique, reflexology, relaxation and visualisation, all of which reduce stress levels.

What is the outcome of childhood seizures?

Single seizures do not usually cause any long-term damage. The majority of children grow out of epilepsy, but some require long-term treatment.

 

    

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