Symptoms and signs
There are two basic categories of seizures -- generalized seizures involving the whole brain and partial (or focal) seizures involving only one area of the brain. Within each of these categories, there are different types of seizures. Symptoms vary depending on what type of seizure a child has.
Generalized tonic-clonic seizures (grand mal seizures) usually begin with sudden stiffness (tonic phase) across the entire body. This lasts approximately 30 seconds and may be accompanied by a scream. Then the child loses consciousness and falls to the ground.
After this comes shaking or twitching in the face, arms and legs (clonic phase), as the muscles tense up and relax repeatedly. This phase can last from 30 seconds to a few minutes, and sometimes up to a few hours. The child may bite his tongue, and because of spasms or cramps in the jaw muscles may have frothing from the mouth.
Seizures can interfere with breathing, which may cause the skin to appear bluish in color due to a lack of oxygen. In most cases, the child will be getting enough air to breathe.
Loss of urine and/or stool may also occur during a seizure.
After a seizure is over, it may take several minutes or more before the child wakes up. He or she will still be confused and disoriented, may not understand what has happened, and will often be tired and wish to sleep. This is called the post-ictal period.
Another type of generalized seizure is an absence seizure (petit mal). During this brief seizure, the child will suddenly stop what he is doing, appear to stare, and get a faraway look in his eyes. The child will not respond to your voice. After the seizure, which typically only lasts for a few seconds, the child will go back to his usual activities.
There are no jerking movements with this type of seizure and the child will not be sleepy or confused afterwards. Children with absence seizures can have several seizures each day, which can affect their overall attention and learning ability.
Because of the frequency of seizures, children with absence seizures can seem distracted, inattentive, restless and hyperactive. This creates problems, particularly in a school environment.
There are several types of partial seizures, including simple and complex.
During simple partial seizure, a person has symptoms depending on where the epileptic activity in the brain occurs, but he remains completely conscious. For example, if an area of the brain that controls certain movements is affected, the symptoms may include shaking in only an arm or leg. If the area of the brain that controls vision is affected, the seizure may cause visual symptoms such as blinking, eye tremors, or double vision.
Complex partial seizures involve one part of the brain and cause impaired consciousness.
During these seizures, the child may wander around or do strange things without being completely aware of what she is doing. She may smack her lips, make a chewing motion with their mouths, or have unusual hand movements. During the seizure, she may or may not respond to verbal commands.
Partial seizures can, in some circumstances, become generalized seizures.
