Epilepsy & Seizures

What is a seizure?

A seizure can be caused when a group of neurons repeatedly misfires all at once. Seizures involve different involuntarily actions in the body such as:

• Muscle spasms
• Jerking limbs
• Facial twitching
• Sensations
• Emotions
• Behaviors
• Loss of awareness
• Loss of consciousness

What is epilepsy?

Epilepsy is a common condition with the highest incidence of diagnosis occurring in early childhood. More than 450,000 children and adolescents in the United States are living with epilepsy.

In nearly half of all people with epilepsy and seizures, the cause is unknown (idiopathic). In other cases, epilepsy and seizures can be linked to specific causes or other conditions, including:

• Genetic factors
• Brain tumors
• Neurofibromatosis
• Tuberous sclerosis
• Developmental brain abnormalities
• Chromosomal abnormalities
• Arteriovenous malformations
• Infections such as meningitis or encephalitis
• Stroke
• Traumatic head injury
• Developmental neurological conditions
• Autism spectrum disorder

While many children may experience one seizure during childhood, an epilepsy diagnosis requires two or more unprovoked seizures that occur at least 24 hours apart.

There are different types of seizures, which can be mild to severe and can happen frequently or infrequently.

Types of seizures

Focal or partial seizures

This type of seizure starts in a specific part of the brain. Children with focal seizures may experience sudden feelings of sadness or joy, or they may hear, taste, smell and see things that are not there. They may feel like they are in a dreamlike state and show repeated facial movements such as blinking. Focal seizures usually only affect one part of the brain, but they can become generalized, involving the entire brain.

Generalized seizures

These seizures impact the whole brain all at once. The abnormal nerve activity happens quickly, causing a variety of symptoms, from loss of consciousness to major muscle contractions. There are different kinds of generalized seizures:

• Absence seizures. A child having an absence seizure seems to be staring into space and may show slight muscle twitching. These seizures are more common in girls and tend to last less than a minute.
• Tonic seizures. A child having a tonic seizure will show muscle stiffening in the back, legs and arms.
• Clonic seizures. A child having a clonic seizure will experience repeated jerking movements on both sides of the body.
• Myoclonic seizures. Myoclonic seizures cause the upper body, arms and legs to jerk and twitch.
• Atonic seizures. A child having an atonic seizure will lose normal muscle tone and may fall down.
• Tonic-clonic seizures. A child having a tonic-clonic seizure shows a combination of symptoms, including stiff and jerking limbs and loss of consciousness.

Seizures can happen at any time, day or night. They can last for a few seconds or a few minutes. A child may recover quickly after a seizure, or it may take several hours for him or her to recover. Children may experience certain symptoms after a seizure, including:

• Headache
• Pain in the muscles that contracted during the seizure
• Loss of function related to a focal seizure (such as weakness on one side of the body or language recovery)
• Sleepiness
• Confusion

Many forms of epilepsy require lifelong treatment to control the seizures, but some children do outgrow the seizures. For most children diagnosed with epilepsy, medicines and surgery control and reduce seizures.

Most children with epilepsy lead normal and productive lives. They can participate in the same activities as other children but may need closer supervision, such as not riding a bicycle or swimming without an adult nearby.

Key Points to Remember

• Epilepsy is a condition in which nerve cells in the brain send abnormal electrical signals to other parts of the brain and body.
• The abnormal electrical signals cause seizures that may cause a patient to convulse, lose consciousness or fall down.
• There are different types of seizures, which can affect one part of the brain or all of the brain.
• Medicine, surgery and implanted devices can help control seizures in children with epilepsy.
• Some children stop having seizures as they get older while others may need lifelong treatment.
• Riley Hospital for Children has the only Level 4 Epilepsy Program in Indiana as defined by the National Association of Epilepsy Centers (NAEC).