Sept. 11, 2000 -- Few things make a mother or father feel more helpless than watching a child have a seizure, an experience that is often more traumatic to the parent than to the child.
Prompt medical attention is important, and there are steps parents can take to help, but often the most important thing they can do is to remain calm, doctors say. Most seizures are not serious, and most children who have one seizure will never have another. While some 10% of all children will have a single seizure during their lifetimes, only 1% to 2% of the total population have recurrent seizures.
Epilepsy, which brings recurrent seizures, has many causes and is not a single disease. On the other hand, when a child has a single seizure, there's often an underlying reason that is easily addressed. High fever is a common and readily detectable cause, and seizures can also be brought on by infection, low blood sugar, or drug withdrawal.
Experts say it's important to treat a child's first seizure promptly and to have a doctor do a thorough evaluation so that the cause can be found and, if needed, measures taken to prevent future seizures.
In their new recommendations for treating children who have a first seizure that is not caused by a fever, the Quality Standards Subcommittee of the American Academy of Neurology, along with the Child Neurology Society and American Epilepsy Society, call for routine screening with electroencephalogram (EEG), an electrical tracing of the brain waves. The EEG is important to help doctors evaluate what caused the seizure and what future steps to take, they say in a report in the journal Neurology.
"Ultimately, the EEG helps us [determine] if there is a risk for future seizures, and, if so, what type of epilepsy it may be if the patient has further seizures," says Greg Sharp, MD, chief of pediatric neurology at Arkansas Children's Hospital in Little Rock, who commented on the new recommendations for WebMD.
An EEG involves placing electrodes, which measure electrical activity, on the child's head. The procedure causes no discomfort, but it is not a perfect test. This is where the patient's history comes in, and both the Quality Standards Subcommittee (QSS) and Sharp emphasize its importance.
If there is a history of seizures in the family, they say, your child's doctor needs to know. But other things you may not think of could also be important. Has your child been sick recently, or been around other sick children in the family, day-care center, neighborhood, or school? Are there any medicines or poisons the child may have gotten into? Above all, parents should fully explain the events surrounding the seizure to help the doctor make an accurate diagnosis.
Other diagnostic tools may also be used, depending on what the physician discovers or believes is most appropriate to treat the child, the QSS reports. Sometimes, a spinal tap, in which fluid is drawn from the spine, may be required to rule out infections. Blood tests may be ordered to make sure the child isn't diabetic. If necessary, a brain scan, usually using magnetic resonance imaging (MRI), may be done to rule out any brain abnormalities.
The main thing to remember, experts say, is that while a seizure is frightening and traumatic, more than likely it will be a one-time occurrence in your child's life.
Sharp outlines some steps you should take if your child has a seizure:
- Get the child away from anything that could cause harm -- out of the tub, away from stoves or heaters, away from tables and shelves where items may fall off and cause an injury.
- Roll the child on his or her side, as a seizure victim may vomit and could choke if lying on his or her back.
- If you can, tilt the child's chin forward, CPR-style, to help open the breathing passage.
- Do not put anything in the child's mouth. A tongue cannot be swallowed; this is a myth. If you put your hand in the child's mouth, you may end up being bitten, because a seizure victim will often clamp down uncontrollably. A spoon or other object thrust into the child's mouth will not help breathing, but may result in injury to the mouth and teeth.
"Once the convulsive component [of the seizure] is over and the child then is sleepy, groggy, or not very responsive, the emergency component is essentially over," Sharp tells WebMD. The child should be taken calmly, at normal driving speed, to the emergency room for evaluation and care.
There is one circumstance under which to call 911, Sharp warns. A seizure that is still continuing after five minutes is an emergency, and calls for prompt medical attention.