Seizure Disorders and Birth Injury
Disclaimer: Please know that our website is owned by a medical malpractice law firm that focuses exclusively on birth injury cases. We try to provide useful medical information to our readers, but we cannot provide treatments or medical advice. If you think your child may be having a seizure, please call 911/your country’s emergency number or your doctor.
Neonatal seizures often occur in babies who have experienced a birth injury, such as brain damage from oxygen deprivation (hypoxic-ischemic encephalopathy), traumatic force to the head, or a newborn infection. In some babies, a seizure is a one-time event. In others, they recur and manifest in a seizure disorder that may extend into childhood and possibly adulthood. Regardless of whether a patient has a one-time seizure or a seizure disorder, doctors should provide prompt treatment, because seizures can worsen existing brain damage.
Here, we will provide a broad overview of seizures and seizure disorders in children.
What Are Seizures?
Seizures are indicative of an underlying brain problem, which may be a short or long-term issue (1). They occur when there is an abnormal surge of electrical activity in the brain, due to chemical changes in nerve cells. Typically, there is a balance between excitatory and inhibitory brain cells. The former causes activity and the latter prevents it. Seizures can occur when this balance is disrupted and there is either too much or too little activity (2).
What Is a Seizure Disorder?
The term “seizure disorder” is often used interchangeably with “epilepsy.” Generally, children will be diagnosed with a seizure disorder/epilepsy if they have two or more “unprovoked” seizures. A “provoked” seizure is one that occurs shortly after an acute brain insult/injury. An “unprovoked” seizure is one with a less recent trigger (3). In many cases, unprovoked seizures can still be linked back to a specific cause (such as a birth injury) – the distinction is that more time has elapsed between the initial insult and the seizure(s).
Causes of Seizure Disorders in Children
Seizures in infants and children can be triggered by a variety of different problems, including:
- Hypoxic-ischemic encephalopathy (HIE)
- Birth injury/trauma
- Congenital issues
- Genetic factors
- Metabolic/chemical imbalances
- Medication side effects
- Brain tumors
Signs and Symptoms of Seizure Disorders in Children
Signs of seizures include twitching, spasms, and loss of consciousness. There may also be changes in certain sensations and behaviors (4). It is important to know that seizures are often very subtle and do not necessarily involve the dramatic convulsions that most people think of (1). It is important for parents/guardians to seek medical attention if they suspect their child may be having a seizure.
Seizures can be placed into two main categories: focal (or partial) onset and generalized onset.
Types of Seizures in Children: Focal Onset Seizures Vs. Generalized Onset Seizures
Focal onset seizures: Focal onset seizures, sometimes referred to as partial seizures, begin in one side of the brain. In some cases, children may experience an “aura” prior to the seizure. This may involve changes in visual, auditory, or olfactory processing (5), or strange feelings such as euphoria, fright, or déjà vu (6).
- Complex focal seizures usually last one to two minutes and involve the temporal lobe, which controls emotion and memory. Consciousness is typically lost during complex focal seizures. Children may also exhibit strange behaviors such as lip smacking, gagging, or running. After the seizure, the child may feel sleepy.
- Simple focal seizures generally last less than one minute, and consciousness is not lost. Exact symptoms will depend on which part of the brain is involved. Often, an isolated muscle group (such as fingers or larger muscles in the limbs) will be affected. Sweating and nausea may also occur.
Generalized onset seizures: Generalized onset seizures involve both sides of the brain. There will usually be a loss of consciousness (though the child may still appear to be awake) and a period of sleepiness after the seizure (postictal state).
- Absence seizures, which are sometimes referred to as petit mal seizures, typically last for 30 seconds or less. The child may stare into space or have strange facial movements. Immediately after the seizure, the child may not realize anything has occurred, and simply proceed as normal. Absence seizures usually start when a child is between four and 12.
- Atonic seizures, or “drop attacks,” are characterized by a loss of muscle tone that may cause the child to suddenly fall or lower their head, become limp, and stop responding.
- Febrile seizures occur in children who have fevers. They are most common between the ages of six months to five years.
- Generalized tonic-clonic seizures, also known as grand mal seizures, have five phases. The body and limbs of the child will flex, extend, and shake, then go into a period during which muscles contract and relax, and finally a postictal period. In the postictal period, the child may be sleepy, as well as struggle with vision and speech, or complain of aches and pains.
- Infantile spasms may last for only a few seconds and involve the movement of the neck, trunk, or legs. They most often occur when a child is waking or going to sleep. Infants may experience hundreds of these seizures in one day, and they can have serious, long-term effects.
- Myoclonic seizures usually occur in clusters, multiple times in a day or for multiple days in a row. They involve sudden jerking movements (5).
Diagnosing Seizure Disorders in Children
Seizure disorder diagnosis may involve both physical examinations as well as diagnostic tests, such as:
- Electroencephalogram (EEG)
- Computed tomography scan (CT or CAT scan)
- Magnetic resonance imaging (MRI)
- Lumbar puncture (also known as a spinal tap)
Managing Seizure Disorders in Children
Appropriately managing a child’s seizure disorder depends on a number of factors, such as the child’s age, general health, and the type of seizure occurring. Treatments for childhood seizure disorders may include:
- Seizure medications: There is a wide variety of medications that can be prescribed to children with seizure disorders. Doctors should perform tests, such as blood work, urinalysis, and EEGs, in order to see how patients are responding to a given medication and adjust the dosage or type of medication as necessary.
- Ketogenic diet: This diet is high in protein and fat, and low in carbohydrates. It will cause the body to produce ketones, which are necessary for energy when someone does not have enough carbohydrate intake. The production of ketones is very important to the success of this diet when it comes to controlling seizures. The ketogenic diet should only be attempted with oversight from medical professionals.
- Vagus nerve stimulation (VNS): This is a procedure in which a small battery is surgically implanted into the chest, with small wires that travel to the vagus nerve (located in the neck). When a child feels a seizure coming on, they can hold a magnet over the battery, which can prevent the seizure.
- Brain surgeries: If a child’s seizures cannot be controlled via other means, brain surgery may be an option. This involves removing the part of the brain where seizures are occuring or preventing the spread of seizure-causing electrical currents. When considering brain surgery for seizures, it is of course critically important to consider what other functions may be affected by the removal of seizure-causing portions of the brain (6).
To determine the best treatment options for your child, consult with qualified medical professionals. The safest and most effective seizure treatment options will vary greatly based on individual symptoms.
In addition to medical intervention, some parents choose to get a seizure dog. These animals are trained to respond to seizures by alerting family members, protecting the child from harm during uncontrolled movements, or activating an alarm system. In some cases, they are also able to predict seizures before they occur. To learn more about seizure dogs, click here.
Legal Help for Seizure Disorders Caused By Birth Injury
If you suspect that your child’s seizures stem from a birth injury that could have been prevented with appropriate medical care, you may be interested in pursuing a medical malpractice lawsuit. This can provide you with the financial means to obtain the best treatments available, and resources necessary to maximize your child’s future.
The malpractice attorneys at Reiter & Walsh ABC Law Centers focus on birth injuries and have helped many children affected by seizure disorders, hypoxic-ischemic encephalopathy (HIE), cerebral palsy (CP), and other lifelong conditions. We have numerous awards and verdicts that attest to our success, and you pay nothing unless we win your case. Please contact us today to learn more.
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