Seizures
Seizures are a sudden and transient neurological disorder caused by sudden changes in the brain’s electrical and chemical activity. A seizure generally involves rapid and involuntary muscle spasms that cause uncontrollable shaking and involuntary movement of the limbs.
For onlookers, any seizure can be stressful and worrying but you should know that most seizures are not life-threatening and disappear within a few minutes. It is important for every parent to become familiar with the phenomenon, the possible reasons for its appearance and most importantly - what should be done and what should not be done during a seizure.
Types of seizures
Seizures may occur in various forms. It is standard practice to divide seizures into several types:
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Generalized onset seizure: involves all parts of the brain
The seizure can occurin varying degrees of severity:
- Absence seizure: more common in children. The seizure causes a disconnection from the environment, eyes remain open and staring, but the child is unaware and does not remember what happened to them during the seizure. In most cases, the episode is not accompanied by involuntary movements of the body.
- Tonic-clonic seizure: includes a number of possible symptoms, such as sudden loss of consciousness, spasms of the four limbs, back and head, muscle spasms, cyanotic lips, foaming at the mouth, snoring and loss of control over the sphincters. Following the episode, there may be disorientation, fatigue, drowsiness and pain. This type of convulsion requires medical treatment, especially if it lasts more than 30 minutes, or includes recurring episodes with no regaining of consciousness between them.
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Focal seizure: focused in only one part of the brain
Focused in only one part of the brain, and generally only some of the organs in the body.
The seizure can occur in varying degrees of severity:
- Focal aware seizure (simple): generally, a brief episode, with no loss of consciousness, including events related to the part of the brain where the abnormal electrical activity occurs, such as: local anesthesia of any organ, muscle spasm in the organ, involuntary movement, flickering of vision.
- Focal impaired awareness seizures (complex aware): the seizure is accompanied by semi-consciousness but can also include visual disturbances (e.g, aura), behavioral changes (such as aggression and confusion), repetitive automatic movements, and lack of alertness.
Possible causes
One-time seizures can occur following head trauma, a drastic drop in blood sugar (hypoglycemia) or when a high fever occurs (more information below). In the case of recurring seizures, it may be epilepsy, which may occur following a neurological disease (such as inflammation, tumors), genetic diseases or for no known reason.
Tests and diagnosis
In the case of a single episode, a blood test will usually be sufficient to determine whether there is a treatable problem, such as hypoglycemia. If 2 or more seizures occur, you may receive a referral from your family physician for a neurologist. A request may be made to perform an EEG (testing of the electrical activity in the brain) to understand the type of seizure that occurred. When the seizure is suspected to be caused by an inflammation, tumor or bleeding, a request will be made to perform a brain CT or MRI.
First aid
As specified, a seizure can be a stressful experience but if you know what to expect you can control the situation, remain calm and function properly. It is also important to inform people in the child’s immediate environment of what to do in case a seizure occurs.
What to do and what not to do in case of a seizure?
Do:
- Try to keep dangerous objects out of the child’s reach.
- Try laying the child on his or her side. Place a pillow or item of clothing underneath the head to prevent injury.
- If the seizure occurs while driving in a car, leave the child belted in the car seat.
- If the child is supposed to receive medication to stop the seizure, it is important to remember to give it.
Don’t:
- Avoid opening the mouth of a child who is seizing.
- Make sure to not insert any objects into the mouth and do not pull the tongue.
- Do not pour water on the child or place the child in the bath.
- Do not try to waken the child or stop the seizure.
In any case, it is important to remember that most seizures will end on their own and do not require immediate medical attention.
If it is a first seizure, immediately seek medical attention in the emergency room. In addition, in the case of recurring seizures, there are several circumstances that require urgent medical care:
- If the seizure does not end within 5 minutes.
- If the seizure is particularly severe, e.g. involves respiratory difficulty, choking, cyanosis of the skin.
- If the child received medication to stop a seizure, and the seizure is continuing.
In these cases, the MDA should be immediately called.
Febrile seizures
When dealing with seizures, it is important to also address febrile seizures- a common event occurring in approximately 3% of children between the ages of six months and six years.
A febrile seizure can be extremely frightening, but it is important to know that it does not cause long-term injury to a child’s health. Similar to the treatment administered for a tonic-clonic seizure, when the child is having a seizure, do not touch them and note the duration of the seizure:
- If the seizure is one-time and lasts less than 5 minutes, you don’t need to do anything special, just monitor. You should call the HMO hotline to determine whether a medical examination is needed for the heat-related illness.
- If the seizure lasts for more than 5 minutes or if the child is confused and does not regain consciousness when the seizure ends - immediately call MDA.
- If the seizure repeats itself - you must seek medical attention at the urgent care center or emergency room.
Treatment and coping
In the case of recurring seizures and a diagnosis of epilepsy, you will receive a recommendation from the physician regarding appropriate treatment to prevent seizures. The treatment aims to reduce the seizures and restore daily function with as few side effects as possible. The initial treatment generally involves use of anticonvulsant medication but if it turns out to be ineffective, there are other treatment options, such as a ketogenic diet or the implant of a vagus nerve stimulator.
For some children with epilepsy, the disease will disappear after a certain period of time, and for others, the disease will continue throughout their life. In any case, it is important to know that the majority of children who are coping with epilepsy can achieve full control of the disease and live a normal life with almost no limitations.
For any questions and deliberations related to management of the disease, you should contact the treating physician. For more information or for support and consultation, contact the Israel Epilepsy Association.