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Seizures are relatively common in children with cerebral palsy, but it’s important to note that not all children will experience them. Those who do may have different types of seizures ranging from mild to severe. It is essential to recognize the signs of a seizure and know how to keep a child safe until it ends.
What Are Seizures?
According to the Epilepsy Foundation, a seizure is defined as a surge of electrical energy to the brain that affects the body for a period of time. Chemical changes in nerve cells cause the body to convulse or move in distinctive ways and, sometimes, cause a change or loss of consciousness.
Anyone is susceptible to having a seizure at any time and at any age, regardless of health. Seizures can occur for different reasons, such as fever in a young child, exposure to a toxin, metabolic and electrolyte abnormalities, and brain injury, among others. Children with cerebral palsy are more likely to suffer from a seizure disorder known as epilepsy because specific areas of their brains have already been damaged.
Seizures are typically triggered when the electrical activity in the brain misfires somehow, and there are many possible causes, including:
- Brain damage
- Head injuries
- Reaction to certain medications
- Electrolyte imbalances
- High fever
- Low blood sugar
- Genetic factors
Cerebral Palsy and Seizures
Children with cerebral palsy are likely to have at least one or more seizures during their lifetime. In many instances, they will experience both generalized and partial seizures. Generalized seizures affect the entire brain, whereas partial seizures affect one side or one part of the brain.
According to a study published by the U.S. National Institutes of Healthy, “spastic tetraplegia was the commonest type of CP associated with seizures.”
About Generalized Seizures
Generalized seizures, considered more serious than partial seizures, include several different types. The most common and most severe kind of generalized seizure is called tonic-clonic. When a child experiences a tonic-clonic seizure, they may have repetitive body movements, convulsions, and loss of consciousness.
Tonic-clonic seizures usually subside within a few minutes, but children may experience incontinence and cuts inside the cheek or on their tongue from biting down during the seizure. The child’s face and lips may also appear pale or bluish. After the seizure, there is almost always a period of exhaustion, and recovery time can range from a few minutes to a few hours.
Absence seizures are another form of generalized seizures. These events can happen quite frequently and typically last around 20 seconds or less.
When a child has an absence (also known as petit mal) seizure, they will often have a blank stare with their eyes looking upwards. Sometimes the eyes and eyelids will jerk briefly during the seizure. The child will not respond to you, but they regain full consciousness and return to their previous activity as soon as it’s over.
Other symptoms of absence seizures include repetitive facial movements such as lip-smacking or chewing, turning the face or looking away, or even being very still for a few moments. Absence seizures can begin in early childhood or during the early teen years, but they usually go away by the time the child is 18.
A myoclonic seizure is another type of generalized seizure marked by involuntary jerking movements of the arms, torso, legs, or face. This type of seizure seems to happen out of nowhere and usually subsides within seconds. It typically involves only one side or part of the body.
Atonic seizures occur when muscle tone is temporarily lost, usually for a minute or less. In most instances, the child’s head will drop down, and control of the posture is gone, causing them to become limp and fall. For children who experience atonic seizures, a helmet to protect their heads during a fall is necessary as these seizures can happen numerous times a day, and the child can fall at any time.
Since partial seizures only involve one side of the brain, they are not as serious as general seizures, but it’s still important to understand how to protect your child when these occur.
Partial seizures are common in people with epilepsy, and the symptoms depend on what part of the brain is conducting the electrical activity. In general, common symptoms include:
- Auditory hallucinations
- Sensory problems
- Unorganized behavior
- Uncontrollable body movements
Brain Damage and Seizures
For children with cerebral palsy, brain damage is the root cause of seizures. Brain injuries in newborns most commonly happen during the birth process when the infant is deprived of oxygen or injured by the tools used to assist in a difficult delivery.
When brain injuries occur, seizures are likely to result, and the type of seizure will depend upon the location of the damage in the brain. If a severe injury happens during the birthing period, the risk of developing seizures heightens significantly.
Seizures after a brain injury may start in early infancy but may be hard to detect as infants have a tendency to make unexpected or repetitive movements. It’s important to work with your child’s physician to look for signs of seizures so you can help identify them and keep your baby safe when they occur.
Treatment for Seizures
There is no cure for seizures, but certain medications and diet plans have proven to help curb the frequency of seizures and control their severity in many children.
Anticonvulsant medications are the most common treatment used for children with cerebral palsy. Along with reducing the frequency of seizures, anticonvulsant drugs can also help children with mood swings and emotional outbursts.
Diet is used to help control the frequency of seizures only when medications fail. Specifically, the ketogenic diet, which is low in carbs and high in fat, is used for children that do not respond to anti-seizure medications. It is a difficult diet for children to maintain and requires constant monitoring for the presence of ketones, which are increased in this diet and seem to affect the seizure pattern. As there are many medication options currently, the need for this extreme dietary measure is relatively rare.
If medications and diet fail to help, the last resort in some cases is surgery. The type of surgery will depend on what kind of seizures the child has and the severity. Surgeries for children with uncontrollable seizure disorders include:
- Focal Resection: A portion of the brain is removed, and subdural electrodes are implanted to help control the seizures.
- Hemispherectomy: Almost an entire side of the brain is removed to disable the portion of the brain that’s causing the seizures. This surgery is used only in rare cases.
- Corpus Callosotomy: The corpus callosum in the brain is cut to reduce generalized seizures. No portion of the brain is removed with this type of surgery.
If your child has seizures, see your doctor right away. They can do tests and develop the right treatment plan.
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- Schachter, MD, S., Shafer RN, MN, P., & Sirven MD, J. (2014, March 19). What is a Seizure? Epilepsy Foundation.
Retrieved from: https://www.epilepsy.com/learn/epilepsy-101/what-seizure
- Gururaj AK , et al. (n.d.). Epilepsy in children with cerebral palsy. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/12566235
- Types of Seizures. (2018, September 27). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/epilepsy/about/types-of-seizures.htm
- Ciattei, J. (2019, February 18). Treatment for Epilepsy & Seizures | Neurology and Neurosurgery. Johns Hopkins Medicine, based in Baltimore, Maryland
Retrieved from: https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/treatment.html