Seizures are very common in children who have cerebral palsy; up to 35% of all children with cerebral palsy suffer from seizures. Hypoxic ischemic encephalopathy (HIE) is a common cause of cerebral palsy, and HIE is the most common cause of seizures in newborns. Children with HIE, seizures and cerebral palsy face numerous challenges. It’s very frightening for parents to watch their children have seizures, knowing that seizures can cause permanent brain injury.
The award winning birth injury law firm Reiter & Walsh ABC Law Centers has been focusing on birth injury cases for decades. The firm is currently listed as one of the best medical malpractice law firms in the America by U.S. News and World Report 2014, which also recognized the firm’s president, Jesse Reiter, as being one of the best medical malpractice attorneys in the nation. The attorneys at Reiter & Walsh focus solely on birth injury cases and they help children all over the country. They give personal attention to each child and family they help, and the attorneys are available to speak with families 24/7.
What Are Seizures?
Seizures are abnormal electrical discharges in the brain. They can cause a child to lose control of her movements and she may even stop breathing. Due to the potential for seizure activity to cause brain damage, it is very important for the medical team to promptly recognize and treat seizures. There may be no obvious signs of seizure activity in a baby, which is why frequent EEG monitoring is very important for any newborn suspected of suffering a birth injury or that had any difficulties during labor and delivery.
Indeed, detecting seizure activity may alert the physician to the possibility that the baby has hypoxic ischemic encephalopathy, thereby allowing crucial HIE treatment (hypothermia / brain cooling therapy) to be given within the requisite time frame. Hypothermia treatment halts almost every damaging process that occurs when the brain is injured due to a lack of oxygen, and the treatment can help prevent the child from developing cerebral palsy.
What Are Signs and Symptoms of Seizures?
Seizures in a baby are often subtle and short, which can make diagnosis difficult. Listed below are signs and symptoms of seizures.
- Apnea (periods in which the baby stops breathing for 20 seconds or more)
- Repetitive facial movements, including sucking, chewing, or eye movements
- Unusual bicycling or pedaling movements
- Clonic seizures are characterized by rhythmic jerking movements that may involve the muscles of the face, tongue, arms, legs or other body regions
- Tonic seizures involve stiffening or tightening of muscle groups; the head or eyes may turn to one side, or the baby may bend or stretch one or more arms or legs
- Myoclonic seizures are characterized by quick, single jerks involving one arm or leg, or the entire body
What Can Parents Do To Decrease The Likelihood of Further Seizures in Their Child?
Seizure activity should be quickly diagnosed by the medical team. Parents may also notice signs of seizures in the baby, and this should immediately be reported to the child’s physician. There are many treatment options for seizures, although some are controversial. Listed below are recommendations for parents as well as treatment options to help prevent seizures.
The ketogenic diet. Research shows that this diet is a safe and effective treatment for infants and children with seizures that are not easily controlled by anti convulsant medications. The diet consists of a high-fat diet, very few carbohydrates and adequate protein. The diet is believed to trigger biochemical changes that eliminate the short circuits in the brain’s signaling system that causes seizures. The effectiveness of the diet is largely due to the ketones it causes the body to produce. Babies can be fed a formula-only ketogenic diet, and for children, there are many quality high-fat foods that can be eaten. The key with this diet is precise measurements of fats and carbohydrates. Thus, parents should discuss the diet plan with a nutritionist and the child’s physician.
Anti seizure/anti convulsant medications. Anti seizure medications can be toxic to a baby’s brain, so physicians must be very careful when giving these medications to babies. Researchers recently did an in-depth examination of neonatal seizure medications, and they found the following:
- The first-line choice for seizure treatment is Phenobarbital because physicians have much more experience with this medication
- The newer drugs levetiracetam and topiramate seem promising in babies who cannot tolerate phenobarbital
- Medications that do not contain compounds toxic to the baby’s brain should be used Hospitals should have specific guidelines for use of seizure medications
- In most cases, term babies should receive different medications than preterm babies because they have different channels in the brain
- Babies receiving hypothermia treatment must be assessed differently than babies not receiving brain cooling treatment. Topiramate may be beneficial when administered along with hypothermic treatment
- A drug called bumetanide seems to be the most promising drug for term newborns due to its very specific mode of action. In addition, research indicates that bumetanide used in combination with phenobarbital may actually reverse damage in the brain caused by seizures
- Dosages for seizure medications should be based on gestational age
- Seizures must be timely controlled, and when possible, treatments that protect the brain should be used
Brain surgery. Children whose seizures do not respond to medications may be candidates for brain surgery that involves removing the part of the brain causing the seizures. The part removed may be very tiny, or it can be an entire lobe of the brain. Specialized tests are done to determine the exact part of the brain causing the seizures.
Implanting a device that stimulates the vagus nerve. In children over the age of 12, a device can be implanted in the chest that intermittently stimulates a nerve in the neck, the left vagus nerve. Often, this device must be used for several months before benefits are seen.
How Should Parents Care For Their During a Seizure?
When a seizure occurs, it is important to prevent the child from harming herself. Parents can do the following:
- Place the child on her side to keep her throat clear and allow secretions to drain. Do not try to stop the child’s movements, put anything in her mouth, or try to hold the child’s tongue. If a child bites her tongue, it usually will not cause serious harm.
- Keep an eye on the time. Seizures that last more than 5 minutes require immediate treatment.
- Move the child away from potential hazards, such as furniture, stairs or traffic.
- Stay by the child’s side until the seizure stops. Allow the child to sleep after the seizure and explain what happened. Let the child know she is safe.
- The child’s physician should be notified of the seizure and a post-seizure care plan should be developed. Additional anti seizure medication may need to be given, the medication may need to be changed, or other treatments may need to be considered.
- An ambulance should be called if the seizure lasts for more than 5 minutes. One person should stay with the child while help is called. If the child hurts herself during the seizure, has difficulty breathing, looks blue during or post-seizure, has another seizure right after the original one, or cannot be aroused after the seizure, an ambulance should be called.
Hypoxic Ischemic Encphalopathy (HIE), Seizures, and Cerebral Palsy
Hypoxic ischemic encephalopathy (HIE) is often a precursor to seizures and cerebral palsy. HIE is an injury to the brain caused by a lack of oxygen. This oxygen deprivation in the brain can be caused by a lack of oxygen in the baby’s blood or a restriction of blood flow in the brain.
HIE is frequently caused by events that occur during or near the time of delivery. Conditions that can cause or lead to HIE, seizures and cerebral palsy include the following:
- Tight nuchal cord (cord wrapped around baby’s neck), umbilical cord prolapse, short cord and cord in a true knot
- Placental abruption
- Uterine (womb) rupture
- Post-term pregnancy
- Intrauterine growth restriction (IUGR)
- Premature Rupture of Membranes (PROM)
- Chorioamnionitis and villitis
- Meconium aspiration
- Malposition of the baby, such as breech or face presentation
- Delayed emergency C-section
- Severe maternal hypotension (very low blood pressure)
- Maternal hypertension (high blood pressure)
- Fetomaternal hemorrhage
- Intracranial and extracranial hemorrhages (brain bleeds)
- Traumatic delivery, which can occur when forceps or vacuum extractors are used, and when shoulder dystocia occurs (shoulder is trapped behind mother’s pelvis)
- Excessively strong and frequent uterine contractions, called hyperstimulation, which can result from improper use of Pitocin or Cytotec
- Gestational diabetes, especially when accompanied by severe IUGR
- Stroke around the time of birth (perinatal stroke) – the majority of babies with ischemic perinatal stroke develop seizures
Help for Children Who Have Seizures, HIE, and Cerebral Palsy
If your child has seizures, hypoxic ischemic encephalopathy (HIE) and/or cerebral palsy, contact the award winning birth injury lawyers at Reiter & Walsh ABC Law Centers. Reiter & Walsh is a national birth injury law firm that has been helping children for decades. Attorney Jesse Reiter, president of the firm, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy.
Jesse is currently recognized as one of the best medical malpractice attorneys in America by U.S. News and World Report 2014, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a permanent disability, such as cerebral palsy, a seizure disorder, hypoxic ischemic encephalopathy (HIE) or periventricular leukomalacia (PVL), the award winning lawyers at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our award winning lawyers are available 24/7 to speak with you.