• Seizure Disorder—Child

    (Disorder, Seizure—Child; Epilepsy—Child)

    Definition

    A seizure happens when there are certain types of abnormal electrical activity in the brain. When two or more seizures occur, it is considered a seizure disorder (epilepsy). While there are many different types of seizures, the main categories are:
    • Generalized seizure—onset is throughout the brain (both hemispheres)
    • Partial seizure (focal seizure)—begins within certain areas of the brain
    Generalized Seizure
    Generalized seizure
    Abnormal and excessive electrical activity in the brain.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Seizure disorder is caused by abnormal brain function. While it is often difficult to identify the exact cause, factors include:
    • Genetic disorder
    • Brain infection, trauma , tumor ; bleeding into the brain; or other brain damage

    Risk Factors

    Risk factors for developing seizure disorder include:
    • Premature birth or low birth weight
    • Damage to brain during birth
    • Abnormal brain structure
    • Traumatic brain injury
    • Brain infection
    • Brain tumor
    • Seizure soon after birth (in first month)
    • Family history of seizure disorder
    • Cysticercosis (an infection caused by a pork tapeworm )
    If your child already has a seizure disorder, these factors can increase the chance of having a seizure:
    • Sleep deprivation
    • Stress
    • Hormonal changes (eg, during the menstrual cycle)
    • Flashing lights (eg, strobe lights)
    • Use of certain medicines or drugs
    • Missing doses of anti-seizure medicines

    Symptoms

    There are many kinds of seizure disorders with a variety of symptoms like:
    • Aura—a sensation at the start of a seizure (eg, perception of an odd smell or sound, spots appearing in front of the eyes, or stomach sensations)
    • Staring, eye blinking, or eye rolling
    • Loss of consciousness
    • Repeated jerking of a single limb
    • Uncontrollable jerking of muscles
    • Hand rubbing, lip smacking, or picking at clothing
    • Loss of bladder or bowel control
    • Drowsiness or confusion after a seizure

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history and do a physical exam. Tests may include:
    • Blood tests
    • Electroencephalogram (EEG)—uses sensors to evaluate electrical brain activity
    • MRI scan —uses magnetic waves to make pictures of structures inside the brain
    • CT scan —type of x-ray that uses a computer to make pictures of structures inside the head
    • Lumbar puncture —test of the cerebrospinal fluid from the lower back
    • Magnetoencephalography (MEG)—imaging device that measures the brain's magnetic fields

    Treatment

    You will work with the doctor to choose a treatment plan that is right for your child. Options include:

    Medication

    There are many different kinds of medicines to treat seizure disorder. Common examples include:
    • For generalized seizure disorder: valproic acid (Depakote), phenytoin (Dilantin)
    • For partial seizure disorder: carbamazepine (Tegretol, Carbatrol, Tegretol XR), phenytoin (Dilantin), lamotrigine (Lamictal), oxcarbazepine (Trileptal)

    Surgery

    If medicine does not work or the side effects are too severe, your child may need surgery. Surgery involves the removal of the seizure focus. This is the area of the brain that starts the seizure. Surgery is only an option if your child has very localized areas of the brain involved.

    Vagus Nerve Stimulation (VNS)

    With VNS, a device is implanted in the chest. It provides electrical stimulation to the vagus nerve, a long nerve that runs from the brain to beyond the stomach. VNS can prevent or decrease the frequency of seizures. If this is an option for your child, he may still need to take medicine.

    Ketogenic Diet

    This is a very strict diet . It is high in fat and low in carbohydrates and proteins. It keeps the body’s chemical balance in a state of ketosis. Ketosis decreases the frequency of seizures. If you would like your child to start this diet, talk to the doctor. Since it is a strict diet and your child needs proper nutrients, you will need to work with a dietician.

    Other Lifestyle Changes

    You can help your child to decrease his chance of a seizure by:
    • Making sure he takes his anti-seizure medicine as prescribed
    • Having your child get enough sleep
    • Finding ways to help him avoid hyperventilating (eg, by doing deep breathing exercises, meditation)
    • Having your child avoid strobe lights
    Other things to consider:
    • Have your child wear a medical alert bracelet. That way, if your child has a seizure, people around him will understand what is happening. They will be able to get help.
    • Keep a seizure log for your child. Record things that were happening around the time of a seizure. This will help to identify a seizure trigger.
    • If your child’s condition is severe, take these steps to prevent serious injuries:
      • Do not allow your child to swim or bathe alone.
      • Do not have your child climb or play in areas where he could fall.
      • Talk to the doctor to find out which activities are safe for your child. He may have to avoid certain sports.

    Prevention

    There are no known ways to prevent every type of seizure disorder. You can take steps to prevent your child from brain injuries or conditions that could lead to seizures:
    • Get prenatal care.
    • Be sure that your child always wears a helmet when doing certain activities (eg, bike riding, skateboarding, playing contact sports).
    • Have your child wear seat belts or sit in a car seat when riding in a car.
    • Teach your child never to dive into water. To be safe, he should always go into the water feet first.

    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

    American Association of Neurological Surgeons. Epilepsy. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Epilepsy.aspx . Accessed July 1, 2010.

    Carson-DeWitt R. Seizure disorder. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated October 2009. Accessed July 1, 2010.

    Children’s Hospital Boston. Seizures and epilepsy. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1967/mainpageS1967P0.html . Accessed July 1, 2010.

    Cincinnati Children’s. Epilepsy and seizures. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/info/neurology/diagnose/epilepsy-seizures.htm . Updated October 2009. Accessed July 1, 2010.

    DynaMed Editorial Team. Epilepsy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 28, 2010. Accessed July 1, 2010.

    Massachusetts General Hospital. Activities, safety, and first aid. Massachusetts General Hospital website. Available at: http://www2.massgeneral.org/childhoodepilepsy/child/activities.htm . Accessed July 1, 2010.

    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.

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