1 n Seizures Without Fever n (Nonfebrile Seizures) What causes seizures? When a child has a seizure without a high fever There are many possible causes. For some children with  or other known cause, medical evaluation is needed. seizures, the cause is unknown. Nonfebrile (without fever) seizures are sometimes a sign of epilepsy, a treatable disease involving Some causes of seizures other than epilepsy include the  repeated seizures. However, many other causes following: are possible. You should always call our office when your child has had a seizure, with or without fever. Fever or infections.  Head injuries.  Toxic substances, including medication side effects  and drug abuse. What are seizures? Abnormal heart rhythms.  Seizures are involuntary, uncontrollable muscle move- ments and/or behavior changes. Many kinds of seizures Low blood sugar (hypoglycemia).  can occur in children. The most common type, febrile sei- t, Other events may look like seizures but really aren ’  zures, result from a high fever. When seizures occur, medi- such as breath-holding spells, fainting, chills and shiver- cal evaluation is needed to identify the cause. ing, and many others. Rarely, events similar to seizures Less than one third of seizures in children are caused by may be a symptom of a mental health problem. (These epilepsy, a disease in which repeated seizures are triggered pseudoseizures, “ are called but are not true seizures.) ” from within the brain. Epilepsy is defined as repeated sei- zures not caused by other medical conditions (such as fever, infection, or head injury). Many children who have a sei- What are some possible zure without fever or other known cause never experience another seizure. complications of seizures? The seizure itself, if brief, does no harm to the child.  What do they look like? Your child may be injured during seizures, especially if  they are violent. Several types of seizures are possible: Although it is rare, brain injury may occur if a seizure is  Your child may experience sudden, rapid, repeated shak-  very prolonged. ing of the arms and legs on one or both sides of the body. His or her eyes may be rolled back in the head. When the whole body is involved, it may be called a “ grand mal ” What puts your child at or “ generalized (tonic-clonic) seizure. ” risk for seizures? Your child s entire body may become very tense or very ’  relaxed. Sometimes there is no movement at all your — Any of the causes listed above, such as head injuries or  child simply becomes unresponsive during the seizure. low blood sugar. Parts of the body, such as an arm or leg, may shake or  If you or anyone else in your family has had epilepsy or  ’ t make it become stiff. Even holding onto the part doesn other seizure disorders, your child may be at higher risk. stop shaking. If your child has had one seizure, he or she is at risk of  Seizures usually last for only a few minutes but can last  having additional seizures. However, less than half of longer. children with one seizure without fever go on to experi- ence a second seizure. Your child may have other symptoms, such as numbness  or pain in a specific area, may make involuntary noises, and may lose control over urination or bowel move- Can seizures be prevented? ments. Anticonvulsant drugs may be used to control seizures for Your child may be conscious or unconscious during the   epilepsy and other seizure disorders. seizure. Afterward, he or she may be very sleepy. Copyright 2007 by Elsevier 147

2 Seizures Without Fever (Nonfebrile Seizures) n 148 An electroencephalogram (EEG) may be performed.  How are seizures treated? This is a painless test that measures patterns of electrical If your child has a seizure at home: activity in your child ’ s brain (brain waves). The results s may help in identifying the cause of your child ’ Place your child on his or her side to prevent choking on  seizure and in predicting the risk of future seizures. food or vomit. We may recommend a visit to a specialist in brain and  Do not give any medications or anything by mouth dur-  nervous system diseases (a neurologist). This specialist ing the seizure to avoid the risk of choking. ’ has the expertise to diagnose the cause of your child s It is always important to call our office when your child  seizure and recommend the most appropriate treatment, ! has had a seizure. if any. Diagnosis: If this is your child ’ s first seizure, we will not likely rec- ommend any treatment at first. This is especially likely if ’ s office or hospital, provide as much infor- At the doctor  there were no other unusual features and if no specific mation as possible on the seizure as well as any factors medical problem is suspected. Even if no specific cause is that you think might have contributed to it. identified, many children with an initial seizure never have Depending on the history and type of seizure, certain  another seizure. tests can help to determine the cause of seizures: If your child has repeated seizures, further evaluation and treatment will be recommended. Detailed evaluation of your If your child has had a head injury, special types of  s seizures will guide the choice of treatment. child ’ x-rays (called CT or MRI scans) may be done to see if there is any damage to the brain. Treatment will likely include anticonvulsant drugs. These  medications have many possible side effects. Your child Blood or urine tests may be done.  will need careful follow-up. Other treatments may be If your child has fever or other symptoms of infection recommended as well.  of the brain (such as meningitis), a test called lumbar If a specific cause is identified, treatment may help to  ” spinal tap, “ may be performed. The test puncture, or control the risk of future seizures. is safe and is generally not very painful. A spinal tap is more likely to be performed if your child has a sei- When should I call your office? zure with fever. The doctor may perform a test called a ” spinal tap, “ lumbar puncture, or to be sure your child Call our office any time your child has a seizure — whether  does not have meningitis. This test is done by placing or not there is a fever and whether or not your child has a needle between the bones of your child ’ s spine and had a seizure before. removing a small amount of fluid (called cerebrospi- nal fluid). Your child will receive anesthetics so that If the seizure has not stopped within a few minutes, call an  ! he or she will not feel the needle. ambulance or seek other medical attention immediately. Copyright 2007 by Elsevier

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