Because seizures are accompanied by violent symptoms, they often seem extremely threatening. Yet they are not at all rare in children: About four percent experience such a seizure once during their childhood. And you don’t have to think of epilepsy right away. Most often, it is a so-called occasional seizure such as febrile convulsion and it remains with a one-time occurrence.
Not necessarily epilepsy
In epilepsy disorder, the seizures occur repeatedly; however, it is rarer overall: affected are approximately 0.8 percent of the population. Often, no direct cause is found; in some cases, a hereditary predisposition is the trigger. In these cases, epilepsy often occurs in childhood and adolescence. In addition, brain damage of various origins can be the reason for the disease, for example birth defects, infections of the central nervous system, craniocerebral injuries, metabolic disorders, circulatory disorders of the brain or brain tumors.
What is a seizure?
Seizures occur when additional (but abnormal) activity builds up in addition to the normal electrical activity of the brain. This usually happens suddenly and without warning. Sometimes a seizure can be triggered by external stimuli, such as the flickering of a television or computer. The sudden electrical discharge from nerve cells in the brain triggers muscle spasms, resulting in the typical image of a seizure.
What does a typical seizure look like?
- Sudden loss of consciousness, the body becomes stiff, arms and legs are stretched, possibly the back muscles are also hyperextended (tonic phase).
- Rhythmic muscular discharges in arms and legs, for example, twitching, flaccidity of the extremities (clonic phase).
- Eye-rolling, pupil dilation, foaming at the mouth.
- Wetting or defecation
- Changes in breathing (pauses in breathing, raspy breathing, bluish discoloration of the skin, due to a lack of oxygen)
- “After sleep” or “exhaustion sleep.” Afterwards, there is usually no memory of the seizure; the child is drowsy and dazed.
- In infants and young children, seizures may be atypical. Then the seizure is manifested by a sudden slackening of the muscles and eye-rolling. The child has a fixed gaze and there may be pauses in breathing (the lack of oxygen causes the skin to turn a grayish-bluish color). Or short-term behavioral abnormalities may be seen, and the child may appear absent and unresponsive.
First aid measures
- Calm the child
- Protect it from injuries it may suffer from the uncontrolled movements, remove tight clothing.
- Do not try to restrict the twitching movements or hold the child. In doing so, you may injure it.
- There is a risk that the child bites his tongue. Nevertheless, do not push objects between the teeth, as this can lead to tooth fractures.
- If convulsions no longer occur: Put the child in the stable side position (children under two years in the prone position).
- Notify an emergency physician
- Continue to monitor breathing to possibly begin a rescue breath.
Important: After a seizure, be sure to thoroughly examine the child to rule out brain disease as the cause. By describing the duration and nature of the seizure in detail to the doctor, you can help him in the diagnosis and treatment.
What to do about febrile seizures?
Febrile convulsions are almost always harmless. They are triggered by a sudden and rapid rise in fever, are accompanied by twitching and usually last only a few minutes. Infants and toddlers (up to about age four) are affected. In about 35 percent of children who have had a febrile convulsion once, it recurs with another febrile infection. For this reason, fever-reducing drugs are given to such children at an early stage.
In the case of recurrence, seizure-interrupting medications should also be in the house. At the latest on the third occasion, the physician will clarify whether the seizure should be considered the first sign of epilepsy.