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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
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 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.
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
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
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.
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
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.