Convulsions
Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly.
The term "convulsion" is often used interchangeably with "seizure," although there are many types of seizures, some of which have subtle or mild symptoms instead of convulsions. Seizures of all types are caused by disorganized and sudden electrical activity in the brain.
See also:
If a person has recurring seizures, and no causes can be identified, that person is said to have epilepsy. Epilepsy can usually be controlled well with medication.
Pay attention to:
DO NOT DO NOT
Keep fevers under control, especially in children.
The term "convulsion" is often used interchangeably with "seizure," although there are many types of seizures, some of which have subtle or mild symptoms instead of convulsions. Seizures of all types are caused by disorganized and sudden electrical activity in the brain.
See also:
- Epilepsy
- Fever (febrile) convulsions in children
- Generalized tonic clonic seizure
- Partial (focal) seizure
- Petit mal (absence) seizure
- Seizure
If a person has recurring seizures, and no causes can be identified, that person is said to have epilepsy. Epilepsy can usually be controlled well with medication.
Pay attention to:
- Which arms or legs are shaking
- Whether there is any change in consciousness
- Whether there is loss of urine or stool
- Whether the eyes move in any direction
- Alcohol use
- Barbiturates, intoxication or withdrawal
- Brain illness or injury
- Brain tumor
- Choking
- Drug abuse
- Electric shock
- Epilepsy
- Fever
- Head injury
- Heart disease
- Heat illness (see heat intolerance)
- Illicit drugs, such as angel dust (PCP), cocaine, amphetamines
- Low blood sugar
- Meningitis
- Poisoning
- Stroke
- Toxemia of pregnancy
- Uremia
- Very high blood pressure (malignant hypertension)
- Venomous bites and stings (see snake bite)
- Withdrawal from benzodiazepines (such as Valium)
- Brief blackout followed by period of confusion
- Drooling or frothing at the mouth
- Eye movements
- Grunting and snorting
- Loss of bladder or bowel control
- Sudden falling
- Teeth clenching
- Temporary halt in breathing
- Uncontrollable muscle spasms with twitching and jerking limbs
- Unusual behavior like sudden anger, sudden laughter, or picking at one's clothing
- Fear or anxiety
- Nausea
- Vertigo
- Visual symptoms (such as flashing bright lights, spots, or wavy lines before the eyes)
- When a seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.
- Cushion the person's head.
- Loosen tight clothing, especially around the person's neck.
- Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit is not inhaled into the lungs.
- Look for a medical I.D. bracelet with seizure instructions.
- Stay with the person until he or she recovers, or until you have professional medical help. Meanwhile, monitor the person's vital signs (pulse,rate of breathing).
DO NOT DO NOT
- DO NOT restrain the person.
- DO NOT place anything between the person's teeth during a seizure (including your fingers).
- DO NOT move the person unless he or she is in danger or near something hazardous.
- DO NOT try to make the person stop convulsing. He or she has no control over the seizure and is not aware of what is happening at the time.
- DO NOT give the person anything by mouth until the convulsions have stopped and the person is fully awake and alert.
- This is the first time the person has had a seizure.
- A seizure lasts more than 2 to 5 minutes.
- The person does not awaken or have normal behavior after a seizure.
- Another seizure starts soon after a seizure ends.
- The person had a seizure in water.
- The person is pregnant, injured, or has diabetes.
- The person does not have a medical ID bracelet (instructions explaining what to do).
- There is anything different about this seizure compared to the person's usual seizures.
Keep fevers under control, especially in children.
Seizures
Seizures are symptoms of a brain problem. They happen because of sudden, abnormal electrical activity in the brain. When people think of seizures, they often think of convulsions in which a person's body shakes rapidly and uncontrollably. Not all seizures cause convulsions. There are many types of seizures and some have mild symptoms. Seizures fall into two main groups. Focal seizures, also called partial seizures, happen in just one part of the brain. Generalized seizures are a result of abnormal activity on both sides of the brain.
Most seizures last from 30 seconds to 2 minutes and do not cause lasting harm. However, it is a medical emergency if seizures last longer than 5 minutes or if a person has many seizures and does not wake up between them. Seizures can have many causes, including medicines, high fevers, head injuries and certain diseases. People who have recurring seizures due to a brain disorder have epilepsy.
Most seizures last from 30 seconds to 2 minutes and do not cause lasting harm. However, it is a medical emergency if seizures last longer than 5 minutes or if a person has many seizures and does not wake up between them. Seizures can have many causes, including medicines, high fevers, head injuries and certain diseases. People who have recurring seizures due to a brain disorder have epilepsy.
Epilepsy
Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness.
Epilepsy has many possible causes, including illness, brain injury and abnormal brain development. In many cases, the cause is unknown.
Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy.
Epilepsy has many possible causes, including illness, brain injury and abnormal brain development. In many cases, the cause is unknown.
Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy.
Febrile seizures
A febrile seizure is a convulsion in a child triggered by a fever. These convulsions occur without any brain or spinal cord infection or other nervous system (neurologic) cause.
Causes Causes About 3 - 5% of otherwise healthy children between ages 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. Febrile seizures often run in families.
Most febrile seizures occur in the first 24 hours of an illness, and not necessarily when the fever is highest. The seizure is often the first sign of a fever or illness
Febrile seizures are usually triggered by fevers from:
A child is likely to have more than one febrile seizure if:
Febrile seizures may begin with the sudden contraction of muscles on both sides of a child's body -- usually the muscles of the face, trunk, arms, and legs. The child may cry or moan from the force of the muscle contraction. The contraction continues for several seconds, or tens of seconds. The child will fall, if standing, and may pass urine.
The child may vomit or bite the tongue. Sometimes children do not breathe, and may begin to turn blue.
Finally, the contraction is broken by brief moments of relaxation. The child's body begins to jerk rhythmically. The child does not respond to the parent's voice.
A simple febrile seizure stops by itself within a few seconds to 10 minutes. It is usually followed by a brief period of drowsiness or confusion. A complex febrile seizure lasts longer than 15 minutes, is in just one part of the body, or occurs again during the same illness.
Febrile seizures are different than tremors or disorientation that can also occur with fevers. The movements are the same as in a grand mal seizuregrand mal seizure.
Exams and Tests Exams and Tests The health care provider may diagnose febrile seizure if the child has a grand mal seizure but does not have a history of seizure disorders (epilepsy). In infants and young children, it is important to rule out other causes of a first-time seizure, especially meningitis.
In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, the child will not need a full seizure workup, which includes an EEG, head CT, and lumbar puncture (spinal tap).
To avoid having to undergo a seizure workup:
Focus your attention on bringing the fever down:
Outlook (Prognosis) Outlook (Prognosis) The first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage. However, simple febrile seizures are harmless. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.
A small number of children who have had a febrile seizure do go on to develop epilepsy, but not because of the febrile seizures. Children who would develop epilepsy anyway will sometimes have their first seizures during fevers. These are usually prolonged, complex seizures.
Nervous system (neurologic) problems and a family history of epilepsy make it more likely that the child will develop epilepsy. The number of febrile seizures is not related to future epilepsy.
About a third of children who have had a febrile seizure will have another one with a fever. Of those who do have a second seizure, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime.
Most children outgrow febrile seizures by age 5.
Possible Complications Possible Complications
If the seizure is lasting several minutes, call 911 to have an ambulance bring your child to the hospital.
If the seizure ends quickly, drive the child to an emergency room when it is over.
Take your child to the doctor if repeated seizures occur during the same illness, or if this looks like a new type of seizure for your child.
Call or see the health care provider if other symptoms occur before or after the seizure, such as:
Causes Causes About 3 - 5% of otherwise healthy children between ages 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. Febrile seizures often run in families.
Most febrile seizures occur in the first 24 hours of an illness, and not necessarily when the fever is highest. The seizure is often the first sign of a fever or illness
Febrile seizures are usually triggered by fevers from:
- Ear infections
- Roseola infantum (a condition with fever and rash caused by several different viruses)
- Upper respiratory infections caused by a virus
A child is likely to have more than one febrile seizure if:
- There is a family history of febrile seizures
- The first seizure happened before age 12 months
- The seizure occurred with a fever below 102 degrees Fahrenheit
Febrile seizures may begin with the sudden contraction of muscles on both sides of a child's body -- usually the muscles of the face, trunk, arms, and legs. The child may cry or moan from the force of the muscle contraction. The contraction continues for several seconds, or tens of seconds. The child will fall, if standing, and may pass urine.
The child may vomit or bite the tongue. Sometimes children do not breathe, and may begin to turn blue.
Finally, the contraction is broken by brief moments of relaxation. The child's body begins to jerk rhythmically. The child does not respond to the parent's voice.
A simple febrile seizure stops by itself within a few seconds to 10 minutes. It is usually followed by a brief period of drowsiness or confusion. A complex febrile seizure lasts longer than 15 minutes, is in just one part of the body, or occurs again during the same illness.
Febrile seizures are different than tremors or disorientation that can also occur with fevers. The movements are the same as in a grand mal seizuregrand mal seizure.
Exams and Tests Exams and Tests The health care provider may diagnose febrile seizure if the child has a grand mal seizure but does not have a history of seizure disorders (epilepsy). In infants and young children, it is important to rule out other causes of a first-time seizure, especially meningitis.
In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, the child will not need a full seizure workup, which includes an EEG, head CT, and lumbar puncture (spinal tap).
To avoid having to undergo a seizure workup:
- The child must be developmentally normal.
- The child must have had a generalized seizure, meaning that the seizure was in more than one part of the child's body, and not confined to one part of the body.
- The seizure must not have lasted longer than 15 minutes.
- The child must not have had more than one febrile seizure in 24 hours.
- The child must have a normal neurologic exam performed by a health care provider.
- You may want to slide a blanket under the child if the floor is hard.
- Move him only if he is in a dangerous location.
- Remove objects that may injure him.
- Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up.
- If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach. This is also important if it looks like the tongue is getting in the way of breathing.
Focus your attention on bringing the fever down:
- Insert an acetaminophen suppository (if you have some) into the child's rectum.
- Do NOT try to give anything by mouth.
- Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol may make the fever worse.
- After the seizure is over and your child is awake, give the normal dose of ibuprofen or acetaminophen.
Outlook (Prognosis) Outlook (Prognosis) The first febrile seizure is a frightening moment for parents. Most parents are afraid that their child will die or have brain damage. However, simple febrile seizures are harmless. There is no evidence that they cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.
A small number of children who have had a febrile seizure do go on to develop epilepsy, but not because of the febrile seizures. Children who would develop epilepsy anyway will sometimes have their first seizures during fevers. These are usually prolonged, complex seizures.
Nervous system (neurologic) problems and a family history of epilepsy make it more likely that the child will develop epilepsy. The number of febrile seizures is not related to future epilepsy.
About a third of children who have had a febrile seizure will have another one with a fever. Of those who do have a second seizure, about half will have a third seizure. Few children have more than three febrile seizures in their lifetime.
Most children outgrow febrile seizures by age 5.
Possible Complications Possible Complications
- Biting oneself
- Breathing fluid into the lungs
- Complications if a serious infection, such as meningitis, caused the fever
- Injury from falling down or bumping into objects
- Injury from long or complicated seizures
- Seizures not caused by fever
- Side effects of medications used to treat and prevent seizures (if prescribed)
If the seizure is lasting several minutes, call 911 to have an ambulance bring your child to the hospital.
If the seizure ends quickly, drive the child to an emergency room when it is over.
Take your child to the doctor if repeated seizures occur during the same illness, or if this looks like a new type of seizure for your child.
Call or see the health care provider if other symptoms occur before or after the seizure, such as:
- Abnormal movements
- Agitation
- Confusion
- Drowsiness
- Nausea
- Problems with coordination
- Rash
- Sedation
- Tremors
Fever
A fever is a body temperature that is higher than normal. It is not an illness. It is part of your body's defense against infection. Most bacteria and viruses that cause infections do well at the body's normal temperature (98.6 F). A slight fever can make it harder for them to survive. Fever also activates your body's immune system.
Infections cause most fevers. There can be many other causes, including
Infections cause most fevers. There can be many other causes, including
- Medicines
- Heat exhaustion
- Cancers
- Autoimmune diseases
Partial (focal) seizure
All seizures are caused by abnormal electrical disturbances in the brain. Partial (focal) seizures occur when this electrical activity remains in a limited area of the brain. The seizures may sometimes turn into generalized seizures, which affect the whole brain. This is called secondary generalization.
Partial seizures can be further characterized as:
Patients with simple focal seizures do not lose consciousness and will be aware of and remember the events that occur at the time.
Patients with complex partial seizures will have abnormal consciousness and may or may not remember any or all of the symptoms or events surrounding the seizure.
Partial seizures can be further characterized as:
- Simple -- not affecting awareness or memory
- Complex -- affecting awareness or memory of events before, during, and immediately after the seizure, and affecting behavior
- Epilepsy
- Seizures
- Generalized tonic clonic seizure (grand mal seizure)Generalized tonic clonic seizure (grand mal seizure)
- Petit mal seizure
Patients with simple focal seizures do not lose consciousness and will be aware of and remember the events that occur at the time.
Patients with complex partial seizures will have abnormal consciousness and may or may not remember any or all of the symptoms or events surrounding the seizure.
- Abnormal muscle contraction
- Muscle contraction/relaxation (clonic activity) -- common
- Affects one side of the body (leg, part of the face, or other area)
- Abnormal head movements
- Forced turning of the head
- Complex, repetitive movements (such as picking at clothes) -- these are called automatisms and include:
- Abnormal mouth movements
- Lip smacking
- Behaviors that seem to be a habit
- Chewing/swallowing without cause
- Forced turning of the eyes
- Abnormal sensation
- Hallucinations
- Abdominal pain or discomfort
- Nausea
- Sweating
- Flushed face
- Dilated pupils
- Rapid heart rate/pulse
- Blackout spells -- periods of time lost from memory
- Changes in vision
- Sensation of deja vu
- Changes in mood
Petit mal seizure
A petit mal seizure is the term commonly given to a staring spell, most commonly called an "absence seizure." It is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain.
Petit mal seizures occur most commonly in people under age 20, usually in children ages 6 to 12. They can occur as the only type of seizure but can also happen along with other types of seizures such as generalized tonic-clonic seizures (also called grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures).
For more information, see:
Symptoms Symptoms Most petit mal seizures last only a few seconds. Most commonly they involve staring episodes or "absence spells."
The person may stop walking or talking in mid-sentence, and start again a few seconds later. The person usually does not fall. The person is usually wide awake and thinking clearly immediately after the seizure.
"Spells" can be uncommon or occur up to hundreds of times in one day. They may occur for weeks to months before they are noticed, and may interfere with school function and learning. The seizures may sometimes be mistaken for a lack of attention or other misbehavior. Unexplained difficulties in school and learning difficulties may be the first indication of petit mal seizures.
Symptoms of typical petit mal seizures may include:
Petit mal seizures occur most commonly in people under age 20, usually in children ages 6 to 12. They can occur as the only type of seizure but can also happen along with other types of seizures such as generalized tonic-clonic seizures (also called grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures).
For more information, see:
Symptoms Symptoms Most petit mal seizures last only a few seconds. Most commonly they involve staring episodes or "absence spells."
The person may stop walking or talking in mid-sentence, and start again a few seconds later. The person usually does not fall. The person is usually wide awake and thinking clearly immediately after the seizure.
"Spells" can be uncommon or occur up to hundreds of times in one day. They may occur for weeks to months before they are noticed, and may interfere with school function and learning. The seizures may sometimes be mistaken for a lack of attention or other misbehavior. Unexplained difficulties in school and learning difficulties may be the first indication of petit mal seizures.
Symptoms of typical petit mal seizures may include:
- Muscle activity changes
- No movement
- Hand fumbling (especially with longer spells)
- Fluttering eyelids
- Lip smacking (especially with longer spells)
- Chewing (especially with longer spells)
- Consciousness changes
- Staring episodes (unintentional)
- Lack of awareness of surroundings
- Sudden halt in conscious activity (movement, talking, etc.)
- May be provoked by hyperventilation or flashing lights, in some cases
- Abrupt beginning of seizure
- Each seizure lasts no more than a few seconds
- Full recovery of consciousness, no confusion
- No memory of seizure
- Unintentional staring
- Lack of awareness of surroundings
- Sudden stop of conscious activity (movement, talking, etc.)
- Hand fumbling
- Fluttering eyelids
- May be provoked by hyperventilation, in some cases
- May have slower, gradual beginning of seizure
- Each lasts only seconds to minutes
- Recovery may be slower
- May have short period of confusion or bizarre behavior
- No memory of seizure
- May change into a different type of seizure (such as a grand mal or atonic seizure)