The Enid News and Eagle, Enid, OK

March 21, 2014

Dealing with seizures in children: What to do?

By Judy Rupp, columnist
Enid News and Eagle

— Your 3-year-old son has become emotionally upset following a tussle with his older sister over a favorite toy. Suddenly, he starts holding his breath, turns very pale and goes into convulsions. Seizures can and do occur at any age, often in response to specific events such as a blow to the head, physical or emotional trauma or a fever. Family and friends are understandably frightened and worried about what they should do.

A seizure is basically a sudden malfunction in the brain that occurs when too many brain cells get excited at once. A seizure typically lasts only a few minutes, although the person may act confused or sleepy for an extended period. Depending on the circumstances, parents and friends should understand that the seizure is not causing any additional pain and may have no lasting effect on the child’s brain or body.

A one-time seizure is usually by itself no cause for concern, although it should prompt a visit to the doctor. Epilepsy, by definition, involves recurring seizures of a similar type and may require ongoing attention and treatment.

FEBRILE SEIZURE: The most common childhood seizure occurs as a result of a medium or high fever — usually over 102 degrees Fahrenheit. These should not cause alarm unless the seizure lasts more than a few minutes or the fever is caused by a serious infection such as meningitis.

ABSENCE: A type of seizure that could be more worrisome but often goes undetected is known as petit mal, or absence. Some children are frequently “absent” because they are daydreaming or not paying attention. Less commonly, a child staring blankly ahead without notice of events taking place in the vicinity is having a petit mal seizure. In such cases, the child is completely unconscious — although only for a few seconds.

GENERALIZED SEIZURES: Seizures are classified as either generalized or partial. Even though the symptoms are more subtle, absence is a generalized seizure because it affects the whole brain.

GRAND MAL SEIZURES (also known as tonic-clonic) are the best known type of generalized seizure. The person may cry out, lose consciousness and fall to the floor, moving his or her arms in jerky movements. Teeth are usually clenched tight; the skin may turn bluish and the child may lose control of bladder or bowels.

During the tonic phase, muscles stiffen and breathing may become shallow or even stop briefly. This quickly progresses to the clonic phase, with jerking movements and a return to breathing, although it may continue to be irregular. This pattern may vary.

The best course is to try to keep the child free from harm. Place something soft under the head and remove hard or sharp objects from the vicinity. Contrary to popular belief, nothing should be placed in the patient’s mouth. Rather, turn the person on his or her side to keep the airways free and allow draining of secretions. CPR is usually not necessary unless breathing does not re-start.

Don’t try to restrict movements unless they are placing the child in danger. Stay with the person and offer reassurance and comfort until full consciousness returns. The child may remain confused for awhile and then fall into a deep sleep. As long as breathing is normal and comfortable, you don’t need to try to keep the child awake.

ATONIC SEIZURES involve a sudden loss of muscle tone, usually resulting in what is known as a drop attack. In some cases, only the head drops; in others, the child loses posture and collapses. As with other types of seizures, consciousness returns rather quickly, but the abrupt fall often results in injury to the head and face.

MYOCLONIC SEIZURES are characterized by involuntary muscle jerks, often affecting the upper part of the body. These may be mild and brief enough that the jerking is attributed to clumsiness, but can be forceful enough to throw the child to the floor.

PARTIAL SEIZURES are those that affect only a part of the brain.  During a simple partial seizure, the child is aware and conscious but unable to control movements in one part of the body. The child may complain of stomach pain or be bothered by what he or she perceives as strange smells and tastes.

A complex partial seizure can take one of several forms depending on what part of the brain is affected. The child may stare, chew, make odd movements or mumble. Whether the seizure occurs during sleep or waking hours, the child is unconscious and won’t remember it.  

With an understanding of seizures, parents can avoid either over-reacting or under-reacting to what is a fairly common experience.

The Long Term Care Authority of Enid Caregiver program makes no distinctions on the grounds of race, color, sex, age, ancestry, nation origin, religion, or disability; and a portion of the project cost are met by state and federal Older American Act funds from the Long Term Care Authority of End and OKDHS Aging Services.

Rupp is care coordinator for Long Term Care Authority of Enid Aging Services. Contact her at 237-2236.