Seizures in Children

Seizures can take on many different forms, affecting different children in different ways. Anything the brain does typically can also occur during a seizure, when the brain is being stimulated by the electrical discharges that cause seizures. 

While a range of behaviors might occur along with different types of seizures, not all behavioral changes indicate signs of a seizure. Some symptoms of a seizure might be due to other medical problems, or even side effects of medicines. 

To figure out whether a symptom might be the result of a seizure, consider these four main characteristics. Seizures are usually:

  • Unpredictable. In general, you can’t determine when and where a seizure might happen.
  • Episodic. Seizures can come and go.
  • Brief. Seizures usually last only seconds to a few minutes.
  • Stereotypic. Symptoms tend to be similar each time. 

Seizures have a beginning, middle and end. Not all parts of a seizure will be visible or easy to separate from one another. And not every child who has seizures will experience all the seizure stages or seizure symptoms described. 

Beginning of a Seizure

Some children or adults experience feelings, sensations or changes in behavior hours or days before a seizure. This is called prodrome. These feelings are generally not part of the seizure, but might warn a person that a seizure might happen. Not everyone has these signs, but they can help a person change their activity; make sure to take their medicine, or take steps to prevent injury.

A warning (aura) is the first symptom of a seizure, and is considered part of the seizure. Often the aura is an indescribable feeling. Other times it might be a change in feeling, sensation, thought, or behavior that is similar each time a seizure occurs. The aura can occur alone, and might be called a “simple partial seizure” or “partial seizure without change in awareness.” Many kids and adults have no aura or warning. For them, the seizure starts with a loss of consciousness or awareness.

Common symptoms before a seizure include the following.

Awareness, Sensory, Emotional or Thought Changes

  • Déjà vu (a feeling of being there before but not having been).
  • Jamais vu (a feeling that something very familiar is new).
  • Smells.
  • Sounds.
  • Tastes.
  •  Visual loss or blurring.
  • “Strange” feelings.
  • Fear/panic (often negative or scary feelings).
  • Pleasant feelings.
  • Racing thoughts.

Physical Changes

  • Dizzy or lightheaded.
  • Headache.
  • Nausea or other stomach feelings (often a rising feeling from the stomach to the throat).
  • Numbness or tingling in part of the body.

Middle of a Seizure

The middle of a seizure is often called the ictal phase. It’s the period of time from the first symptoms (including an aura) to the end of the seizure activity. The ictal phase lines up with the electrical seizure activity in the brain. 

Sometimes the visible symptoms last longer than the seizure activity on an electroencephalogram (EEG). That’s because some of the visible symptoms might be aftereffects of a seizure, or not related to seizure activity at all.

Common symptoms during the middle/ictal phase of a seizure include the following.

Awareness, Sensory, Emotional or Thought Changes

  • Loss of awareness (“blackout”).
  • Confusion, or feeling spacey.
  • Periods of forgetfulness or memory lapses.
  • Distractedness, periods of daydreaming.
  • Loss of consciousness, or “passing out.”
  • Inability to hear.
  • Sounds that seem strange or different from normal.
  • Unusual smells (often bad smells, like burning rubber).
  • Unusual tastes in mouth.
  • Inability to see.
  • Blurry vision.
  • Flashing lights.
  • Seeing objects or things that aren’t really there.
  • Numbness, tingling, or electric shock sensation in body, arm or leg.
  • Out-of-body sensations.
  • Feeling detached, as though floating.
  • Feelings of being somewhere or experiencing something before, without having actually had the experience (déjà vu).
  • Feeling that something which is very familiar is new or unfamiliar (jamais vu).
  • The sense that body parts feel or look different.
  • Panic, fear, or an intense feeling that something bad is about to happen.
  • Pleasant feelings.

Physical Changes

  • Difficulty talking. (A child might stop talking altogether, make nonsense or garbled sounds, or speech might not make sense.)
  • Inability to swallow.
  • Drooling.
  • Repeated blinking of eyes. 
  • Eyes that move to one side or look upward. 
  • Fixed staring. 
  • Lack of movement or muscle tone, including an inability to move. 
  • Tremors, twitching or jerking movements.
  • Rigid or tense muscles.
  • Repeated non-purposeful movements (automatisms) involving the face, arms or legs, such as: lip smacking or chewing movements, wringing or waving hands, dressing or undressing and walking or running.
  • Repeated purposeful movements. (The child or adult might continue the activity they were performing before the seizure.)
  • Convulsions. (The child or adult loses consciousness, their body becomes rigid or tense, and then fast jerking movements occur.)
  • Sudden loss of bladder or bowel control. 
  • Sweating.
  • Change in skin color (looks pale or flushed).
  • Dilated or larger-than-normal pupils.
  • Biting of tongue (from teeth clenching when muscles tighten).
  • Difficulty breathing.
  • Heart racing.

Ending of Seizure

As the seizure ends, the postictal phase occurs. Some people recover immediately, while others might take minutes to hours to feel like their usual selves. The type of seizure, as well as what part of the brain the seizure impacts, affects the recovery period—how long it might last and what might occur during it.

Common symptoms after a seizure include the following. 

Awareness, Sensory, Emotional or Thought Changes

  • Slowness to respond or inability to respond right away.
  • Sleepiness.
  • Confusion.
  • Memory loss.
  • Difficulty talking or writing.
  • Feelings of fuzziness, lightheadedness, or dizziness.  
  • Feelings of depression, sadness, fear, anxiety, frustration, embarrassment, shame or irritation. 

Physical Changes

  • Injuries, such as bruising, cuts, broken bones or head injury (if a fall occurs during the seizure).
  • Feelings of tiredness or exhaustion. 
  • Sleeping for minutes or hours.
  • Headache or other pain.
  • Nausea or upset stomach.
  • Thirstiness.
  • General weakness or weakness in one part or side of the body.
  • Urge to go to the bathroom.
  • Sudden loss of bladder or bowel control. 

Seizures take many forms. The treatment plan for your child depends on which type of seizures he/she has and needs specialised doctor like Dr. Krupa Torne from ICPN Mumbai

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