A seizure represents a sudden, temporary disruption of the normal electrical activity in the brain. This disruption can cause a wide range of symptoms, including uncontrolled muscle movements, changes in behavior, or a brief loss of consciousness. Seizures are common in childhood, but most are manageable and do not indicate a long-term neurological disorder. Understanding the different types of seizures that affect children is important for knowing how to respond, especially identifying the most frequent type seen in the pediatric population.
Febrile Seizures: The Most Frequent Childhood Event
The most common type of seizure event experienced by children are febrile seizures, which are convulsions triggered by a fever. These seizures typically occur in children between six months and five years old, with the highest risk around 12 to 18 months of age. Febrile seizures affect approximately 2% to 5% of all children, establishing them as the leading seizure event in this age group. They are defined as a seizure associated with a fever greater than 100.4°F (38°C) that is not caused by a central nervous system infection or a prior history of afebrile seizures.
The seizure is thought to be triggered by the rapid rate of temperature rise, rather than the height of the fever itself. During the event, the child commonly loses consciousness, and their arms and legs will twitch or convulse rhythmically. Most of these events are classified as simple febrile seizures, meaning they are generalized, last less than 15 minutes, and do not recur within 24 hours.
A smaller percentage of children experience complex febrile seizures, which may last longer than 15 minutes, occur multiple times, or be confined to one side of the body. Simple febrile seizures do not cause brain damage, intellectual disability, or long-term neurological issues. The long-term outlook is excellent, as most children outgrow the tendency to have them by age five.
Distinguishing Other Common Pediatric Seizure Types
While febrile seizures are the most common overall event, other non-fever-related seizures are frequently seen in children, often associated with an epilepsy diagnosis. The Generalized Tonic-Clonic Seizure, previously known as a “grand mal” seizure, is a recognized generalized type. These involve the entire body, causing a sudden loss of consciousness, stiffening (tonic phase), and then rhythmic jerking movements (clonic phase).
The Absence Seizure, or “petit mal” seizure, is another common type, particularly in young people. These seizures are characterized by a brief staring spell, typically lasting less than 15 seconds, where the child abruptly stops activity. They may display subtle movements like eyelid fluttering and can occur multiple times a day, often affecting school performance.
Focal Seizures, sometimes called partial seizures, originate in only one area of the brain, leading to varied symptoms depending on the affected region. These can manifest as uncontrolled twitching or stiffening in a single limb, or involve sensory symptoms like experiencing a strange taste or smell. A focal aware seizure means the child remains conscious and alert, while a focal impaired awareness seizure involves a change in consciousness.
Immediate Response and Emergency Protocol
The priority during any seizure event is to protect the child from injury and ensure their airway remains clear. If a child begins to have a seizure, gently ease them to the floor and remove any nearby hard or sharp objects. Place something soft and flat, like a folded jacket, under the child’s head to provide cushioning.
The child should be carefully turned onto their side, which helps prevent choking and keeps the airway clear. Avoid placing anything into the child’s mouth, as this can cause injury to the teeth or jaw. Do not attempt to restrain the child or stop their movements, as this will not stop the seizure and could cause injury.
Caregivers should immediately note the time the seizure began and stay with the child until the event is over. Emergency medical assistance must be called if the seizure lasts longer than five minutes or if the child has trouble breathing after the seizure stops. Immediate care is also necessary if the child is injured, if it is their first-ever seizure, or if they do not wake up and respond normally afterward.