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What Is A Seizure?

What Is A Seizure?

Compiled from NNPDF Newsletter articles and family interviews. This page is not intended as medical advice. Consult with your physician before undertaking any treatment or therapy.

Seizures are temporary excessive discharges of groups of nerve cells in the brain. These discharges from brain cells result in changes in level of alertness and abnormal behaviors of abrupt onset, brief duration, and rapid recovery. The child will usually be very tired once the seizure ends.

The most common type of seizures that children with neurological diseases experience are the following:

  • Tonic-clonic (grand mal) seizures – the body becomes rigid with some rhythmic jerking of the limbs, the head and eyes may roll back and the child may stop breathing and temporarily turn blue (note: breathing almost always resumes after a seizure)
  • Absence (petit mal) seizures – the child stares vacantly and is out of touch (often thought to be “daydreaming”)
  • Atonic seizures – the whole body becomes completely limp (not to be confused with cataplexy)
  • Myclonic seizures – the whole body or parts of the body twitch
  • Partial seizures – the head turns in one direction with rhythmic twitching or stiffening of one side of the face and body
  • Gelastic seizures – the child has a change in alertness and appears to be laughing.

Atonic seizures and cataplexy are two different conditions. In cataplexy, there is an emotional trigger – usually laughter – that causes a loss of muscle control. The child remains alert (and may continue to laugh or smile) but cannot move. Once the trigger stops, normal movement and activity returns quickly.

With atonic seizures, there is also a loss of muscle control but no emotional trigger. The child is unresponsive during the seizure and often tired or lethargic after the seizure ends.

What should I do during a seizure?
Most times, when a child has a single seizure, no specific medical treatment is necessary. However, because the major risk of the seizures is that the child may stop breathing or aspirate oral contents, certain precautions should be taken.

Turn the child slowly and gently onto one side. The mouth should be directed downward in order to prevent choking, allow secretions to drain, and to open up the airway. Either hold the head gently or place something soft underneath it. Don’t restrain the child and don’t put anything in the mouth.

Most seizures are not medical emergencies. They end naturally after a moment or up to a minute or two. However, a critical situation may be occurring if normal breathing does not start again after the seizure stops, or if the seizure lasts five minutes or longer without stopping (“status epilepticus”).

If the child is not breathing for longer than fifteen to thirty seconds, oxygen and CPR can be administered and the rescue squad can be called. For a prolonged seizure, medicine may be administered at home, CPR can be initiated, and the rescue squad can be called. Some families who decide to arrange a “do not resuscitate” status for their child choose to provide only simple intervention at home, such as positioning, and “ride out” the attack even in an emergency.

Can seizures be treated?
There are a variety of medications that can be used to control seizures. Depakote and Tegratol are the most commonly prescribed for NPC children. Some families have found that seizure medication made their child lethargic or “zombie-like”. This is most often reported about Depakote but the other medications can also have this side effect.

When first taking any seizure medication, the child is likely to be somewhat lethargic. However, this should pass in just a few days. If your child appears very lethargic for a longer period, ask your doctor about changing to a different drug or reducing the dosage. Many families have found that standard dosages can be too strong, especially when the child is inactive (in a wheelchair or walking very little).

If a child has many seizures, medication may not prevent all seizures but it will reduce the number and the severity. Over time, the medication may become less effective at stopping the seizures and changing to a different prescription should be considered. Finally, as the disease progresses, it may become impossible to prevent seizures. When this happens, some families have felt that ending the medication benefited their child by eliminating negative side effects. You should consult with your doctor before ending any medication.

Diazepam (valium) has been found effective at interrupting prolonged or rapidly repeated seizures. Some families keep diazepam in suppository form (Diastat) and liquid diazepam. This is a temporary treatment only and should not be used unless you have consulted with your physician. Diazepam does not prevent seizures – it can only stop a seizure in progress. For most seizures, use of diazepam is not necessary.

For More Information
For additional information about seizures, including types, management and complications , please view one of the following excellent web sites that focus on this topic:

01/31/2017 jjb