25.01.2015
Hence, in order to prevent sleep seizures, one should understand the mechanism of daytime seizures. A seizure occurs when the brain functions abnormally, resulting in a change in movement, attention, or level of awareness.
Different types of seizures may occur in different parts of the brain and may be localized (affect only a part of the body) or widespread (affect the whole body). Around 3% of all children have a seizure when younger than 15 years, half of which are febrile seizures (seizure brought on by a  fever). A febrile seizure occurs when a child contracts an illness such as an ear infection, cold, or chickenpox accompanied by fever. Children with relatives, especially brothers and sisters, who have had febrile seizures are more likely to have a similar episode.
Children who have had a febrile seizure in the past are also more likely to have a second episode. Simple partial (Jacksonian) seizures have a motor (movement) component that is located in one portion of the body. Complex partial seizures are similar, except that the child is not aware of what is going on.
Convulsive seizures are noted by uncontrollable muscle jerking lasting for a few minutes-usually less than 5-followed by a  period of drowsiness that is called the postictal period. Absence seizures, also known as petit mal seizures, are short episodes during which the child stares or eye blinks, with no  apparent awareness of their surroundings.
Although seizures have many known causes, for 3 out of 4 children, the cause remains unknown. About one fourth of the children who are thought to have seizures are actually found to have some other disorder after a complete evaluation. Children with absence seizures (petit mal) develop a loss of awareness with staring or blinking, which starts and stops quickly. Partial seizures usually affect only one group of muscles, which spasm and move convulsively. All children who seize for the first time and many with a known seizure disorder should be evaluated by a doctor. Most children with first seizures should be evaluated in a hospital's emergency department. After the seizure has stopped and the child has returned to normal, contact your child's doctor for further advice. Most children who have seized for the first time should be taken to the emergency department for an immediate evaluation. Any child with repeated or prolonged seizures, trouble breathing, or who has been significantly injured should go to the hospital by  ambulance.
Children should receive medication for the fever such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil).
Depending on the age of the child, the doctor may order blood or urine tests or both, looking for the source of the fever.
If the child has had his or her first febrile seizure, then the doctor may want to perform a lumbar puncture (spinal tap) to test for  possible meningitis. Most children do not get a CT scan of the head, unless there was something unusual about the febrile seizures, such as the  child not returning to his or her normal self shortly afterward. Movement seizures, which include partial seizures and generalized (grand mal) seizures, can be very dramatic. If the child has returned to normal in the hospital, then the child will probably have a few tests performed.
If the child is on antiseizure medications, then the medication's levels in the blood are checked (if possible).


Most children undergo a CT scan or MRI (studies looking at the structure of the brain), but this may be scheduled for several  days later rather than in the emergency department. Most children eventually undergo an EEG, which is a study looking at the brain waves or electrical activity of the brain. Seizures of this type occur in young children and are often associated with other problems such as mental retardation.
Your initial efforts should be directed first at protecting the child from additionally injuring himself or herself.
After the seizure ends, place the child on one side and stay with the child until he or she is fully awake.
Do not try to give food, liquid, or medications by mouth to a child who has just had a seizure. Children with known epilepsy should also be prevented from further injury by moving away solid objects in the area of the child. During the first visit, many doctors cannot be sure if the event was a seizure or something else. Many seizure medications have side effects including damage to your child's liver or teeth.
Children who are known to have febrile seizures should have their fevers well controlled when sick. The biggest impact caretakers can have is to prevent further injury if a seizure does occur. A seizure in general is not harmful unless an injury occurs or status epilepticus develops. Children with febrile seizures "outgrow" them, but they often have repeated seizures when they develop fevers while they are young.
Tonic clonic seizures formerly known as grand mal seizures can be a result from an abnormal electrical activity in the entire brain, while absence seizures or petit mal seizures happen due to an abnormal electrical activity of certain neurons in the brain. Grand mal seizures or tonic-clonic seizures are a type of seizure disorder that is usually associated with epilepsy.
Loss of consciousness is then followed by tonic-clonic seizures (involuntary repeated contraction and relaxation of muscles). As a result of the contraction and relaxation of muscles, the whole body of the child shakes rapidly. Petit mal seizures in both children and adults are considered to be milder or less severe than grand mal seizures, when it comes to its signs and symptoms.
Usually, an episode of petit mal seizure involves a short and sudden absence of consciousness.
Compared to an episode of grand mal seizure that can last for several minutes, petit mal seizure in children will only usually last for only a few seconds and recovery of the patient is instant. For both seizure disorders in children, it is very important to keep children safe all the time.
For petit mal seizure, it is rare for children to lose consciousness, however, parents or guardians should be cautious and aware that petit mal seizures can cause life-threatening situations, such as while the child is swimming. For grand mal seizures, since it causes a child to lose consciousness, just make sure that the child is safe from any sharp objects and the head is away from hard objects and if possible, place a soft pillow underneath the child’s head. There are about 40 different types of seizure, and how they affect you depends on which areas of your brain are affected. Frequently, children with this type of  seizure repeat an activity, such as clapping, throughout the seizure.
The child should return to his or her normal self except for fatigue within  around 15 minutes. It is most common in children younger than 2 years, and most of these children have generalized tonic-clonic seizures.


These other disorders include fainting, breath-holding spells, night terrors, migraines, and psychiatric disturbances. A thorough description of the type of movements witnessed, as well as the child's level of alertness, can help the doctor determine what type of seizure your child has had.
It is important for the caregiver to tell the doctor about the child's medical history, birth history, any recent illness, and any medications or chemicals that the child could have been exposed to. The lumbar puncture should be performed in children younger than 6 months, and some doctors perform  them in children as old as 18 months. Children  suspected of having these seizures may have multiple lab tests done in the emergency department. Unless a specific cause is found, most children with first-time seizures will not be placed on medications. If several years pass without any seizures, doctors often stop the child's  medications and see if the child has outgrown the seizures. Children who develop status epilepticus  have a 3-5% risk of dying from the prolonged seizure. Both types of seizure disorders can happen to children, and both seizure disorders can cause life-threatening events not just in children, but to all people suffering from the said seizure disorders.
Even though the seizure activity is over, the child may still be unconscious for several minutes more. In children, petit mal seizures usually happen while they are sitting or they are not doing anything, rather than they are in the middle of an activity. Never force anything inside the mouth (spoon, tongue depressor, etc) during an attack of grand mal seizures. Seizures in newborns may be very different than seizures in toddlers, school-aged children, and adolescents.
Two to five percent of children have a febrile seizure at some point  during their childhood. Often the child may have incontinence (lose urine or stool), and it is normal for the child not to remember the  seizure.
If he or she is not breathing within 1 minute after the seizure stops, then start mouth-to-mouth rescue breathing (CPR). The exceptions occur with children who have other developmental disorders such as cerebral palsy and in children with neonatal seizures and infantile spasms. Seizures, especially in a child who has never had one, can be frightening to the parent or caregiver. Why some children have seizures with fevers is not known, but several risk factors have been identified. Children with this type of seizure may also behave strangely during the episode and may or  may not remember the seizure itself after it ends. These children are usually admitted to the hospital  and may even be referred to a pediatric specialty hospital.
Do  not try to do rescue breathing for the child during a convulsive seizure, because you may injure the child or yourself. In the hospital, these children undergo several days of testing to look  for the many possible causes of the seizures.



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