Seizures, Epilepsy and Febrile Convulsions

What is a Seizure?
Seizures are divided into two main categories: generalised seizures, in which abnormal electrical impulses affect the whole brain; and local or focal seizures in which a small, localised part of the brain is affected. The most widely known and dramatic of generalised seizures is the “tonic-clonic” (previously known as a “grand mal” seizure), in which a person loses consciousness and collapses. There is usually a stiffening and jerking of the entire body which may last for a couple of minutes before a deep sleep ensues. During the seizure it is not uncommon for involuntary urination to occur, along with bite injury to the tongue. Less dramatic total seizures include “absence seizures” (or “petit mal” seizures) often seen in children. The child may have a short loss of awareness of a few seconds, in which they stare blankly into space.

Partial seizures usually result in either jerking, muscle rigidity and spasms or unusual sensations affecting vision, hearing, taste, smell or touch. There may also be some repetitive actions such as lip smacking, chewing, fidgeting or walking.

What are Febrile Convulsions
Febrile convulsions occur in early childhood between the ages of 6 months and 5 years and are induced by a high fever and occur in up to 5% of children. There are few things more terrifying for a parent than watching their child have a febrile convulsion. Most parents are convinced that their child will be permanently damaged by their seizure. In reality, permanent damage or death from such an event is very rare.

Febrile convulsions often run in families, and it is not uncommon for an affected child to have up to three convulsions through their early childhood. These convulsions occur directly as a result of high or rapidly climbing body temperature, usually over 38ºC.

While they are terrifying to watch, there is no evidence that febrile convulsions cause or are caused by brain damage, epilepsy, mental retardation, or learning difficulties.

What causes Seizures?
Seizures can be triggered by many disorders:

• Hereditary, ie. occur in families
• Head injuries
• Strokes and other conditions that affect the blood supply to the brain
• Brain tumours, alcoholism and Alzheimer’s dementia
• Infectious disease, eg. meningitis, encephalitis
• Developmental disorders, eg. cerebral palsy
• Environmental causes, eg. lead poisoning, street drugs and alcohol, lack of sleep, drug withdrawal.

Prevention and Treatment

What to do in a febrile convulsion
A febrile convulsion can look just like a tonic-clonic seizure. If your child has a seizure leave them laying on the floor, and move away any objects which may cause injury. DO NOT move your child unless they are in a dangerous location such as on a road. Loosen any tight clothing, especially around the neck. Turn them onto their side or into the recovery position to prevent choking on saliva, mucus or vomit. DO NOT try to force anything into the mouth to stop tongue biting and DO NOT try to restrain or restrict movements in any way. Pay attention to lowering the fever by removing clothing; bathing the body (especially the neck and forehead) with lukewarm water. DO NOT give anything by mouth. After the seizure it is vital that you seek medical assistance to assess the cause of the fever. If the seizure lasts more than several minutes, call an ambulance.

Epilepsy
Epilepsy is a common neurological condition affecting 1–2% of the population, causing recurring spontaneous seizures as a result of random bursts of electrical activity in the brain. These electrical bursts are the result of an imbalance in the chemicals responsible for the transmission of impulses in the brain. The most common forms of epilepsy are: absence epilepsy (also known as petit mal), temporal lobe epilepsy, frontal lobe epilepsy, occipital lobe epilepsy and parietal lobe epilepsy.

Petit Mal epilepsy
Petit Mal epilepsy or “absence seizures” is the most common form of epilepsy in children. It is characterised by brief, sudden lapses of conscious activity, lasting for several seconds. The child usually stares into space, sometimes accompanied by lip smacking, eyelid fluttering or chewing movements. These episodes may recur hundreds of times a day. Petit mal epilepsy can be controlled with drugs, and most children outgrow their condition by adolescence.