• Seizure—Child
• Seizure Disorder—Child

Definition

• Lose consciousness
• Stare into space
• Have convulsions (abnormal jerking of the muscles)
• Experience abnormalities of sensation or emotion

• Generalized seizure disorder—onset is throughout the brain, not from a single focal location
• Partial seizure disorder (focal seizure)—begins within certain areas of the brain

Brain Cells (Neurons)

Copyright © Nucleus Medical Media, Inc.

Causes

• In newborns:
  • Congenital brain abnormalities (present at birth)
  • Birth injuries that deprive the brain of oxygen
  • Metabolic disorders
  • Maternal drug use
  • Infection
• In infants and children:
  • Febrile seizure—caused by spike in fever in a baby or very young child
  • Brain tumor
  • Infections (encephalitis, cerebritis, brain abscess)
• In children and adults:
  • Congenital conditions
  • Genetic
  • Head trauma—common cause (eg, concussion, skull fracture, bleeding inside of the skull, oxygen deprivation due to near-drowning)
  • Infections (eg, encephalitis, cerebritis, brain abscess)
  • Stroke
  • Brain tumor
• In elderly:
  • Stroke
  • Trauma
  • Brain tumor
  • Degenerative diseases (eg, Alzheimer’s disease)

Risk Factors

• Previous brain injury—seizure disorder usually develops within one year of injury
• Previous brain infection
• Abnormal blood vessel that has formed in the brain
• Brain tumor
• History of stroke
• History of complex febrile seizures
• Use of certain medicines or recreational drugs
• Stopping the use of medicines, recreational drugs, or alcohol
• Drug overdose
• Exposure to toxins (eg, arsenic, lead, or carbon monoxide)
• Family history of seizure disorders
• Alzheimer’s disease
• Toxemia during pregnancy
• Chemical abnormalities (decreased or excess blood sodium or glucose, low blood calcium)
• Liver or kidney failure
• Severe, untreated high blood pressure
• Chronic diseases (eg, lupus, polyarteritis nodosa, porphyria, sickle cell disease, Whipple’s disease)
• Syphilis
• Cysticercosis (an infection caused by a pork tapeworm)

• Sleep deprivation
• Alcohol
• Hormonal changes (such as those that occur at points during the menstrual cycle)
• Stress
• Flashing lights, especially strobe lights
• Use of certain medicines
• Missing doses of anti-epileptic medicines

Symptoms

• Aura—a sensation at the start of a seizure, may involve the perception of an odd smell or sound, visual symptoms, or unusual stomach sensations
• Staring
• Loss of consciousness
• Repeated jerking of a single limb
• Generalized convulsion with uncontrollable jerking of muscles throughout the body
• Hand rubbing
• Lip smacking
• Picking at clothing
• Perception of an odor, sound, or taste
• Loss of bladder or bowel control
• Postictal state—a state of drowsiness, alteration in responsiveness, and/or confusion that commonly occurs after a generalized tonic-clonic seizure; may last minutes, hours, or days

• Generalized tonic-clonic seizures—loss of consciousness, stiffening, uncontrollable jerking of muscles throughout the body
• Absence seizures—staring, eye blinking, or eye rolling

• Complex partial or temporal lobe seizures:
  • May lose contact with reality, stop purposeful activity, and begin a series of automatic gestures (eg, lip smacking, hand-wringing, or picking at clothing)
  • May appear as a brief moment of confusion or loss of attentiveness
  • May have a perception of unusual sights, sounds, or smells
• Simple partial seizures:
  • Does not involve a loss of contact with reality or a loss of consciousness
  • Single area of the body may move uncontrollably (eg, leg or arm shaking)
  • May include the perception of an odor, sound, or taste, or an unrelated emotion

Diagnosis

• Blood tests—to look for abnormal levels of different substances in the blood
• Electroencephalogram (EEG)—a test that uses sensors to evaluate electrical brain activity
• Magnetic resonance imaging (MRI) scan—a test that uses magnetic waves to make pictures of structures inside the brain
• Computed tomography (CT) scan—a type of x-ray that uses a computer to make pictures of structures inside the head (used in some cases)
• Lumbar puncture—a test of the cerebrospinal fluid (CSF) from the lower back; may be done to look for infection or bleeding
• Magnetoencephalography (MEG)—an imaging device that measures the brain's magnetic fields
• Positron emission tomography (PET)—an imaging test that shows activity in the brain
• Single photon emission computed tomography (SPECT)—an imaging test that shows blood flow in the brain

Treatment

• Treat the underlying cause (if known)
• Prevent seizures—may be done through medicine, surgery, or special therapies
• Avoid factors that stimulate seizure activity

Prevention

• Always wear a helmet when using bikes, rollerblades, skateboards, or scooters.
• Wear protective headgear when playing contact sports.
• Dive in safe depths of water.
• Always wear a seatbelt.
• Avoid using street drugs.
• If your baby or child has a high fever, get treatment right away.
• Get prenatal care. If you have high blood pressure during pregnancy, get proper treatment.
• If you have a chronic condition, get proper care.

• Depending on your condition, avoid driving.
• Do not swim or bathe alone.
• Do not work on ladders or ledges.
• Avoid or modify athletic activities.

RESOURCES

Epilepsy Foundation http://www.efa.org/

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

CANADIAN RESOURCES

Center for Epilepsy and Seizure Education http://epilepsy.cc/

Epilepsy Ontario http://www.epilepsyontario.org/

References

Antiepileptic drugs (AEDs) for seizure disorders. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/http://www.ebscohost.com/dynamed/what.php . Updated August 29, 2012. Accessed August 31, 2012.

Cecil RL, Goldman L, Ausiello DA. Cecil Textbook of Medicine. 22nd ed. Philadelphia, PA: WB Saunders Company; 2004.

Epilepsy in Adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 9, 2012. Accessed August 31, 2012.

FDA approves new drug to treat severe form of epilepsy. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116980.htm . Accessed August 31, 2012.

FDA approves Potiga to treat seizures in adults. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm258834.htm . Accessed August 31, 2012.

Fisher RS, Van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: Definition proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46:470–472.

12/20/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine .

5/14/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Neal EG, Chaffe H, Schwartz RH, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008 May 2. [Epub ahead of print]

11/10/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Sabril approved by FDA to treat spasms in infants and epileptic seizures. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm179855.htm . Updated August 21, 2009. Accessed October 8, 2009.

5/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Quet F, Guerchet M, Pion SD, Ngoungou EB, Nicoletti A, Preux PM. Meta-analysis of the association between cysticercosis and epilepsy in Africa. Epilepsia. 2010 ;51(5):830-837.

Revision Information

• Reviewer: Rimas Lukas, MD
• Review Date: 09/2012 -
• Update Date: 00/93/2012 -