Types of Seizures
Children with epilepsy, like adults, have seizures that can be divided into two broad groups: generalized seizures and partial seizures.
When the electrical disturbance involves the whole brain, the seizure is called generalized. When only part of the brain is affected, it is called partial. If the electrical disturbance starts in one part of the brain and then spreads, it is called a partial seizure secondarily generalized.
Some children have just one type of seizure, others have two or more.
Generalized tonic clonic (Grand Mal)
Often called a convulsion, it starts with a sudden cry, fall, body stiffness followed by jerking movements as muscles tense, then relax, tense and relax. Breathing may be shallow or stop briefly. Skin may be bluish. Possible loss of bladder or bowel control as muscles relax. Usually lasts a minute or two, after which normal breathing returns. Child may be confused or tired afterwards and fall into a deep sleep. May complain of sore muscles or bitten tongue.
A blank stare, beginning and ending abruptly, lasting only a few seconds, often frequent, May be accompanied by rapid blinking, upward rolling of the eyes, chewing movements. Children may drop what they are holding. Out of touch during seizure, but they quickly return to full awareness once it stops. Often mistaken for daydreaming or inattention.
Atonic (also called drop attack)
A sudden loss of muscle tone makes the child collapse and fall. In some children all that happens is a sudden drop of the head. After a few seconds to a minute he or she recovers, regains consciousness. Drop attacks can cause injuries because of the force of the fall. Protective helmets may help, at least when the child is playing outside.
Sudden, brief, involuntary muscle jerks, a bit like the kind everyone has when a foot or leg suddenly jerks in bed. May be mild and affect only part of the body, or be strong enough to throw the child abruptly to the floor. May occur as a single seizure or a cluster of seizures.
Simple partial Seizures affect movement, usually on one side of the body, but child stays aware of surroundings. May cause jerking movements that start in fingers, toes, or other parts of the body, eventually affecting the whole of one side. May progress to a generalized convulsion. Partial seizures affecting sensations may cause things to look, sound, taste, smell, or feel different. Effects can include stomach pain, nausesa, a rising feeling in the stomach, or sudden fear or anger.
Alters consciousness. Child won’t know what he’s doing or where he is during the seizure. Often starts with blank stare, followed by chewing, followed by repeated movements that seem out of place and mechanical. Child may seem dazed and mumble. May pick at clothes, pick up and put down objects, try to take clothes off. May run, appear afreaid. May struggle of flail at restraint. Same pattern of actions may happen with each seizure. Lasts only a minute or two, but child may remain frightened and confused for longer time afterwards. There’ll be no memory of what happened during the seizure.
Partial seizures can arise from any part of the brain. The symptoms that the child experiences will depend on the seizure location. Most complex partial seizures arise from the brain’s temporal lobe and will have symptoms similar to those described above.
If the seizures are coming from the frontal lobe, they may produce weakness or stiffness. They often occur in sleep and may include thrashing movements, fear, screaming, bicycling movements of the legs.
Seizures arising from the occipital lobe are more likely to disturbances of vision, in which the child “sees” things that are not really there.