A seizure in a baby is a sudden, involuntary condition that can cause muscle twitching, neurological deficits, and loss of consciousness. The reason for this is a malfunction of the nerve cells in the brain, which give false signals and impulses. A seizure may be confined to one area of the body (focal) or spreading and affecting the whole body (generalized). An epileptic seizure, or so-called epilepsy, is said to occur when more than 2 events have occurred without any apparent cause.
The causes of the onset of a seizure in babies are very diverse. They are the result of abnormal, uncontrolled discharges of nerve cells in the brain. The cause of this sudden disturbance of brain activity, in addition to hereditary predisposition, may be various types of damage to the brain due to accidents, a prolonged lack of oxygen, inflammatory changes as a result of meningitis, medications, other toxic substances or congenital malformations. Malignant tumors as a trigger of seizures rarely occur in babies. An increasing influence has a sudden increase in fever, flickering light, sleep deprivation or poisoning.
The Sturge-Weber syndrome may be a cause of seizures and epilepsy in infants, this is a malformation of the nervous system and the skin.
Spastic cerebral palsy also causes seizures in premature babies. It is a damage to the brain.
After a vaccination, the babies are confronted with the usual side effects, such as fever, fatigue, dehydration and a possibly occurring mild influenza infection. Nevertheless, seizures may develop as part of a too rapid increase in fever. This form of seizures are the so-called febrile convulsions, which are common in babies between the age of 6 and 7 years and usually run uncomplicated.
A seizure in the baby can be triggered in some cases by screaming. This is a so-called affect spasm. They usually occur in the first or second year of life and are triggered by anxiety or strong excitement. If the baby screams hard and just can not calm down, the face turns blue and the baby's lips go pale, as it does not get enough air with oxygen. Due to the acute lack of oxygen, the babies are unresponsive for a short moment and sometimes it comes at the end of the event to twitching of the extremities, which appear like a seizure.
In babies, as in adults, spasms can develop in the abdomen. This leads to tension in the muscles of the organs, which lead to wavy or spasmodic pain. In addition to disturbances in the fluid or electrolyte balance, the cause of such spasms may be food intolerance. In babies, these abdominal complaints occur especially in the first three months of life in combination with strong screaming and are referred to as three-month colic.
Febrile seizure or fever-associated seizure occurs when a child has a seizure (cerebrum) at the age of 6 months to 5 years with a temperature increase above 38 ° C.
This must exclude seizures that occurred after an epileptic seizure or occurred due to inflammation of the central nervous system. About 3% of children in Germany suffer from febrile convulsions, usually during the second year of life.
It is known that cramping occurs as the fever rises, because at that time the seizure threshold is lowered. The exact cause of this has not yet been found out. Depending on the severity, a distinction is made between an uncomplicated and complicated febrile convulsion. The uncomplicated febrile convulsion takes place between the 6th month and the 5th year of life once within 24 hours for a total duration of 15 minutes. The complicated febrile seizure takes place beyond these times and can lead to speech disorders immediately following the spasm.
Depending on the cause, various symptoms can be observed as part of a seizure. Sometimes signs such as headache, dizziness, irritability, nausea, or even changes in sensory perception occur. In the context of the attack, muscle twitching, grimacing or even eye roaring can be observed. In addition to vomiting, it can also lead to wetting, Einkoten, Lautieren, increased salivation or even a tongue bite. Sometimes the babies can hear a groan or a short cry. As part of the seizure, a respiratory arrest and a brief loss of consciousness is also possible. After the attacks, the babies can often appear very sleepy and beaten off. In some cases, seizures can also be relatively mute, so you almost did not notice.
A special significance in the diagnosis of seizures in babies is the collection of a detailed anamnesis with the help of the parents. When and how often do the seizures occur, are there triggers, how long is the duration, what do they look like, what additional symptoms are there and is there a family burden. This is followed by a physical examination. By measuring the brain waves by means of electroencephalography (EEG), the spasm readiness of the brain and possible seizure-specific changes can be demonstrated. A derivation of the EEG in sleep, throughout the day or under stress can provide further evidence. If there is a suspicion of a structural or tumorous change, MR imaging can be performed. To exclude meningitis or other inflammatory changes, an examination of the cranial nerve water is made.
The seizure in the child is difficult to distinguish from other diseases with similar symptoms, which is why a precise description and inquiry of the events are essential.
In the context of an infection, it can also lead to about 10-20 seconds long, harmless loss of consciousness with cramping of the emptiness (convulsive syncope) in which the child twitches. Disquiet also leads to periods of feverish delirium when children behave and move funny.
In addition, chills during a temperature increase can be misinterpreted as twitching. Here, the muscle tone is increased, the children, however, in contrast to the generalized seizure with full awareness. There are also REM sleep behavioral disorders associated with extraordinary movements. In addition, in babies until the 4th month of the Moro reflex triggers, also called encircling reflex. This manifests itself by spreading the arms, spreading the fingers and opening the mouth as soon as the child falls jerkily from the seat to the back.
Typical for a seizure are rhythmic twitching, eye twirling, open eyelids and urine discharge. If you are unsure of twitching of the child, you should consult a doctor in any case. This can then cause further examinations, such as an EEG and a blood sample.
For clarification and extensive diagnostics in most cases a hospital stay is necessary. Depending on the cause of the seizure then a corresponding therapy is initiated. In inflammatory changes, such as inflammation of the meninges, depending on the pathogen, an antibiotic or antiviral therapy is started.
To adequately treat a seizure disorder in the form of epilepsy, antiepileptic therapy is initiated. The drugs used have the effect of suppressing the seizures and to ensure the absence of seizures. As these medicines, like all other medications, also have some side effects, you should start with just one preparation. It is also important to have a regular check by a pediatric neurologist to determine if the dose of the medication is sufficient and if a sufficient level of effect is achieved. If a preparation is not sufficient, further information may be added in consultation with the attending physician. In rare cases babies do not respond to drug therapy. If a mass is the cause of seizures, it may be necessary to undergo surgical treatment. If the seizures are triggered by factors such as stress, fever, sleep deprivation, or flashes of light, try to avoid these factors or counteract them as early as possible.
Seizures in babies may have a different prognosis depending on the cause. Fever or affect cramps usually cause no consequential damage and the seizures stop over time. Seizures due to inflammatory changes require rapid treatment. If the therapy is initiated on time, usually no sequelae can be expected. Seizures in the context of a convulsive disorder in most cases also do not cause developmental damage. With a sufficient drug setting the babies can live as far as possible without seizures and depending on the form of the seizures stop in the course of growth.