Infant Toddler Development Training
Module 6, Lesson 4
Overview of Seizures
A seizure is an involuntary spasm of a muscle or muscles. A seizure can be as mild as a tic or an eye blink to tonic and clonic jerking of muscles and a loss of consciousness. Seizures can be an isolated neurological condition or seizures can be an associated symptom of another neurological condition.
Please refer to NICHCY Epilepsy for a required reading before going further in this section.
One seizure does not equate to a seizure disorder. A single seizure may be the result of a high fever, an acute central nervous system infection, or a traumatic injury including a concussion. However, all seizures need to be evaluated for cause.
If a child has repetitive seizures, it is called epilepsy. Epilepsy is a chronic neurological condition characterized by recurrent seizures that may occur with or without other brain abnormalities. Several factors may influence seizure activity including changes in growth, metabolism, and sleep. Seizures may be brief or continuous and require emergency intervention if they do not stop.
Causes of Seizures
Seizures are a sign of brain dysfunction and have a variety of causes including hypoglycemia (low blood sugar), hyponatremia (low sodium), hypocalcemia (low calcium), infections, trauma, and malformations of the structures of the brain. Seizures originate with abnormal hyper-synchronous electrical discharges from the cortical neuronal network in the brain. These electrical discharges lead to an interruption in the usual brain generated electrical signals that result in an abrupt change in a person's behavior.
Seizures that are due to perinatal asphyxia/hypoxia do not usually begin right at birth but, often are manifest within 24 to 48 hours following the birth. Seizures in newborns are often not full-blown and the symptoms can be very subtle. These seizures in newborns tend to be generalized but, may be partially complex or focal in distribution.
Classifications of Seizures
Classifications of seizures are usually based on the clinical symptomatology and on electro-encephalogram (EEG) reports. Manifestations of seizures include altered consciousness, and prominent motor manifestations. Seizures with primarily altered consciousness include generalized seizures, absence seizures, and simple and partial complex seizures. Seizures with prominent motor manifestations include myoclonic and atonic seizures, tonic – clonic seizures, status seizures, and febrile seizures.
Risks and Diagnosis
Seizure disorders tend to be highest in children who have a positive family history of seizures. For infants and young children, a common trigger is an illness often accompanied by fever. Trauma can also precipitate a seizure.
Seizures are diagnosed by measuring brain wave patterns using an EEG. The best time to confirm a diagnosis is to run an EEG when the child is having the seizure. Brain imaging can also assist in the diagnosis of pathology such as brain malformations, but are not used to diagnose a seizure.
Mimics of Seizures
There are conditions that mimic seizures. These include sleep disorders such as parasomnias , sleep myoclonus (irregular and involuntary contractures of the muscles that occur while sleeping), and dystonias (abnormal muscle tone) that may be hypertonia, hypotonia, or mixed tone.
A syncope syndrome may also mimic a seizure. Syncope is a brief loss of consciousness that is caused by a sudden drop in blood pressure or a failure of the regular rhythm of the heart that results in a lack of oxygen to the cerebrum.
A migraine headache may also mimic a seizure. Sometimes young children will hold their breath and may even pass out. This may also include a seizure.
Information about the basic first aid for Seizures was referenced in lesson 2 of this module.
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