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Pediatric Seizures
Reet Sidhu, Kohilavani Velayudam and Geogory Barnes,
Pediatrics in Review 2013;34;333 DOI: 10.1542/pir.34-8-333

Pediatric Seizures MacKoul PediatricsSeizures are abnormal electrical activity of brain cells causing abnormal stereotypical movements that usually resolve on its own. Signs and symptoms include but not limited to abnormal body movements, jerking, eye rolling, staring, confusion, loss of bowel/bladder function, tongue biting, etc. Most common causes of seizures include fevers, infection and head injury. Most patients with seizures are unaware it is occurring.

The most common type of seizure in children is febrile seizures. It is caused by a rapid spike in body temperature usually from a viral or bacterial infection. Febrile seizures occur after 1 month of age to 5 years of age peaking around 18 months. At the onset of illness, febrile seizures in 6 months and older can be prevented by alternating Tylenol and Motrin to reduce to risk of rapid spike in body temperature.

Seizures are not always easy to distinguish in young children as behavior may mimic a seizure. Often young children daydream/mind wander with vacant stares or sometimes have repetitive movements. The difference can be distinguished if the daydreaming, starting and/or repetition movement stop once the child is touched. Twitching, lip smacking, rapid eye movements, stiffening of an arm/leg or one side of the body is usually associated with a seizure. Any abnormal movements in children should be evaluated.

Most children (>60%) with an unprovoked seizure will likely never have another seizure. If 2 more seizures occur, further evaluation is completed with brain wave tracings (EEG) and often brain imaging (MRI). The choice of beginning anti-seizure medication is highly variable and multifactorial.

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January 24, 2014