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Seizures in Children

What happens inside your child's brain during a seizure? Here is a simplified explanation: Your brain is made up of millions of nerve cells called neurons, and these cells communicate with one another through tiny electrical impulses. A seizure occurs when a large number of the cells send out an electrical charge at the same time. This abnormal and intense wave of electricity overwhelms the brain and results in a seizure, which can cause muscle spasms, a loss of consciousness, strange behavior, or other symptoms.

Anyone can have a seizure under certain circumstances. For instance, a fever, lack of oxygen, head trauma, or illness could bring on a seizure. People are diagnosed with epilepsy when they have seizures that occur more than once without such a specific cause. In most cases -- about seven out of 10 -- the cause of the seizures can't be identified. This type of seizure is called "idiopathic" or "cryptogenic," meaning that we don't know what causes them. The problem may be with an uncontrolled firing of neurons in the brain that trigger a seizure.

Genetic research is teaching doctors more and more about what causes different types of seizures. Traditionally, seizures have been categorized according to how they look from the outside and what the EEG (electroencephalogram) pattern looks like. The research into the genetics of seizures is helping experts discover the particular ways different types of seizures occur. Eventually, this may lead to tailored treatments for each type of seizure that causes epilepsy.

Diagnosing a Seizure in a Child

Diagnosing a seizure can be tricky. Seizures are over so quickly that your doctor probably will never see your child having one. The first thing a doctor needs to do is rule out other conditions, such as nonepileptic seizures. These may resemble seizures, but are often caused by other factors such as drops in blood sugar or pressure, changes in heart rhythm, or emotional stress.

Your description of the seizure is important to help your doctor with the diagnosis. You should also consider bringing the entire family into the doctor's office. The siblings of children with epilepsy, even very young kids, may notice things about the seizures that parents may not. Also, you may want to keep a video camera handy so that you can tape your child during a seizure. This may sound like an insensitive suggestion, but a video can help the doctor enormously in making an accurate diagnosis.

Some kinds of seizures, such as absence seizures, are especially difficult to catch because they may be mistaken for daydreaming.

"Nobody misses a grand mal (generalized tonic-clonic) seizure," says William R. Turk, MD, chief of the Neurology Division at the Nemours Children's Clinic in Jacksonville, Florida. "You can't help but notice when a person falls to the ground, shakes, and sleeps for three hours." But absence or staring seizures may go unnoticed for years.

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