This article provides a clear understanding of what seizures are in toddlers, how they might appear, and guidance on recognizing different types and immediate actions to take. This information is for general awareness and should not replace professional medical advice from a qualified healthcare provider.
What Seizures Are in Toddlers
A seizure occurs when there is a sudden, abnormal burst of electrical activity in the brain. This electrical disturbance temporarily disrupts the brain’s normal signals, leading to changes in awareness, muscle control, behavior, or senses. While some seizures are linked to underlying medical conditions, many occur without a clear cause. In toddlers, seizures can be provoked by factors like a high fever, a head injury, or an infection. If a child experiences two or more seizures without an identifiable cause, it may indicate epilepsy.
Recognizing Different Seizure Types
Seizures in toddlers can manifest in various ways, from subtle staring spells to overt body movements. The specific appearance depends on which part of the brain is affected by the abnormal electrical activity.
Generalized Tonic-Clonic Seizures
Generalized tonic-clonic seizures, often known as grand mal seizures, involve two phases. The tonic phase causes the child’s muscles to stiffen, and they may cry out, lose consciousness, and fall. This is followed by the clonic phase, characterized by rhythmic jerking movements of the arms and legs, and possible loss of bladder or bowel control. The child’s breathing may become shallow, and their lips might appear bluish.
Absence Seizures
Absence seizures, also called petit mal seizures, can be mistaken for daydreaming or inattentiveness. These brief seizures, usually lasting only a few seconds, involve the child staring blankly, blinking rapidly, or making chewing movements. The child remains unresponsive, often resuming their activity as if nothing happened. These seizures typically begin between ages 4 and 14.
Focal Seizures
Focal seizures, previously known as partial seizures, originate in one specific area of the brain. Their symptoms vary depending on the affected brain region. A child might experience unusual sensations like strange smells or tastes, or display repetitive, involuntary movements such as lip-smacking, fiddling with clothes, or grunting. The child may appear confused or have altered awareness.
Myoclonic Seizures
Myoclonic seizures involve sudden, brief jerking movements, often affecting the head, neck, shoulders, or arms. These jerks can be mild or strong enough to cause a child to fall. They frequently occur in clusters, appearing multiple times a day, particularly in the morning or during drowsiness. Infantile spasms, a type of myoclonic seizure in the first year of life, often involve a sudden jerk followed by stiffening, where the arms might fling outward and the body bends forward.
Atonic and Tonic Seizures
Atonic seizures cause a sudden loss of muscle tone, leading to a child becoming limp and unresponsive. This can cause the child to drop their head or fall, potentially resulting in injury. These seizures are typically brief and occur without warning. Tonic seizures, conversely, involve a sudden stiffening of the body or parts of the body.
Immediate Actions During a Seizure
When a toddler has a seizure, remaining calm is important. The primary goal is to keep the child safe and prevent injury. Gently guide the child to the floor or a soft surface if they are standing or sitting. Move any nearby objects that could cause harm, such as sharp furniture or hot items, away from the child.
Turn the child gently onto their side to help prevent choking, especially if they vomit or have excessive saliva. Placing something soft and flat, like a folded jacket or pillow, under their head can offer protection. Loosen any tight clothing around their neck to ensure clear breathing.
Avoid restraining the child or trying to stop their movements during a seizure. Do not place anything into the child’s mouth, as this can cause injury or block the airway. Seizures usually run their course. Time the seizure’s duration, as this information is important for medical professionals.
When to Contact Medical Professionals
While most seizures in children are brief and resolve on their own, certain circumstances require immediate medical attention. Call emergency services (such as 911) if it is the child’s first seizure, if a seizure lasts longer than five minutes, or if the child has multiple seizures without fully regaining consciousness between them.
Contact emergency services if the child has trouble breathing, appears bluish, or remains unresponsive after the seizure. Also call if the seizure occurred in water or if the child sustained an injury. Even if a seizure is brief and resolves quickly, follow up with your child’s doctor to determine the cause and discuss next steps.
Distinguishing Seizures from Other Events
Toddlers can exhibit behaviors that might resemble seizures but are not. Differentiating these non-epileptic events from actual seizures helps caregivers respond appropriately. Conditions like breath-holding spells, night terrors, and benign sleep myoclonus of infancy are sometimes confused with seizures.
Breath-holding spells typically occur when a child becomes upset or cries intensely, leading them to hold their breath until they may briefly lose consciousness or become stiff. Unlike seizures, these spells are usually triggered by emotional events.
Night terrors involve a child waking up screaming or thrashing but remaining asleep and unresponsive, often with no memory of the event. Seizures, in contrast, are distinct electrical events in the brain.
Benign sleep myoclonus of infancy involves brief, sudden jerks that occur only during sleep, particularly as the infant is falling asleep. These movements are usually isolated and do not involve changes in consciousness or other seizure characteristics. Tics are repetitive movements or sounds that can often be suppressed voluntarily for a short period and typically occur when the child is awake. While these events can be concerning, they do not involve the abnormal electrical brain activity seen in seizures.