What if my child has seizures?
[mme_highlight] Febrile seizures represent the most common form of seizures in childhood, with a prevalence of 2 to 5 % of all children; generally these seizures are self-limited. A seizure refers to a single event; if it becomes recurrent it is called epilepsy. Any insult to the cerebral cortex can cause a seizure. [/mme_highlight]
Seizures account for 1 to 5% of all emergency department visits. Seizures can be classified as febrile and afebrile, being the former the most frequent. When a seizure becomes recurrent it is called epilepsy. Transient epileptic discharges may appear in an electroencephalogram in 3 to 5% of healthy children, particularly in those with a positive history of seizure activity in the family.
How common are seizures in childhood?
[mme_databox]
|
Prevalence – The total number of cases of a disease in a given population at a specific time.
[/mme_databox]
What are febrile seizures?
Febrile seizures represent the most common form of seizures in childhood, with a prevalence of 2 to 5 % of all children living in United States and Europe, a number that turns to 8% in Japan.
Febrile Seizures can be defined as a seizure accompanied by fever in a child from 6 months to 6 years of age, without evidence of central nervous system lesion or infection. Febrile seizures can cause your child to pass out and have jerking movements of limbs and face. They generally do not last more than 1 to 2 minutes. After the seizure, your child may feel confused or sleepy; this is normal.
There is an association between seizure and bacterial meningitis has been established by studies. There is a confounding element in this case – fever – and that is why it is imperative to rule out bacterial meningitis before making a diagnosis of febrile seizure.
Why do febrile seizures occur?
The exact process that leads to febrile seizures to occur remains unknown. However, several factors such as vitamin B6 deficiency, electrolyte disturbances (sodium, potassium, and chloride), reduction in serum and cerebrospinal fluid (CSF) zinc levels, as well as low gamma-aminobutyric acid (GABA) levels are thought to play a role.
The study shown below found that zinc levels in children with febrile seizures were significantly lower than those in children with afebrile seizures.
[mme_databox]
|
[/mme_databox]
How can I help my child if she/he is having a febrile seizure?
Keep calm, do not try to stop the movements and put your child on side. If the seizure lasts more than 5 minutes, call the emergency. Even if it recovers spontaneously and your child is with fever, take her/him to the doctor as soon as possible, to make sure it was a febrile seizure. Generally, these seizures are self-limited; doctor can prescribe medicines to lower fever or to treat a possible infection.
Keep also in mind that children with a first episode of febrile seizure have higher odds to have another one. It is important to emphasize that febrile seizures do not cause brain damage.
What is epilepsy?
A seizure refers to a single event; if it becomes recurrent it is called epilepsy. Epilepsy is not itself a disease, but rather a manifestation of a pathology involving the cerebral cortex, like in the case of a brain tumor. The epileptic crisis are classified as partial or generalized. The complex crisis occurs when a limited group of neurons from one of the hemispheres in the brain is activated. Partial crisis are subdivided in simple and complex, without or with loss of consciousness, respectively.
The generalized crisis involves the two hemispheres of brain and loss of consciousness may be the first manifestation. Seizures tend to be stereotyped (similar to previous seizures), random (in anytime of the day) and without being related to any precipitator like environment or psychological events.
Bear in mind that any insult to the cerebral cortex can cause a seizure, even if it is transient: trauma, infection, bleeding (subarachnoid hemorrhage) and low levels of calcium or sodium.
What is the medical approach to childhood epilepsy?
Your doctor will order some tests to investigate the cause of epilepsy in your child, like a blood sample, an electroencephalogram (EEG), computerized tomography (CT) or a magnetic resonance (MRI). Treatment usually involves medicines to prevent seizures. These can have interaction with other medicines and vice versa, thus it is important you tell your doctor about any medicine your child is taking. A special diet or a brain surgery may be necessary in a few cases.
Summary
- Seizures are common in children. Any insult to the cerebral cortex can cause a seizure.
- Seizures can be classified as febrile and afebrile, depending on the presence of fever. Febrile seizures are the most common, occurring in 2 to 5 % of all children.
- Epilepsy is diagnosed when seizures are recurrent. Your doctor will ask exam tests to try to find the cause of the epilepsy and possibly will prescribe a medicine to prevent seizures in your child.
- If your doctor has prescribed a therapeutic regimen to prevent seizures, follow it strictly.
- Call the emergency if a seizure lasts more than 5 minutes or if you notice repeated seizures overtime.
- Take your child to a doctor after a seizure. Alarm signs are an increase in the number or in the duration of seizures.
[mme_references]
References
- American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures (1996) Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 97: 769–772; discussion 773–765.
- Najaf-Zadeh A, Dubos F, Hue V, Pruvost I, Bennour A, Martinot A. Risk of bacterial meningitis in young children with a first seizure in the context of fever: a systematic review and meta-analysis. PLoS One. 2013;8(1):e55270.
- Lee JH, Kim JH. Comparison of serum zinc levels measured by inductively coupled plasma mass spectrometry in preschool children with febrile and afebrile seizures. Ann Lab Med. 2012 May;32(3):190-3.
- Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1981; 22:489.
- Hauser WA, Annegers JF, Kurland LT. Prevalence of epilepsy in Rochester, Minnesota: 1940-1980. Epilepsia 1991; 32:429.
- Oka E, Ohtsuka Y, Yoshinaga H, et al. Prevalence of childhood epilepsy and distribution of epileptic syndromes: a population-based survey in Okayama, Japan. Epilepsia 2006; 47:626.
- Murphy CC, Trevathan E, Yeargin-Allsopp M. Prevalence of epilepsy and epileptic seizures in 10-year-old children: results from the Metropolitan Atlanta Developmental Disabilities Study. Epilepsia 1995; 36:866.
[/mme_references]