It can be extremely distressing to witness seizures, when your little one’s arms and legs may jerk involuntarily and she may even stop breathing brieﬂy. Here, the experts tell EVELINE GAN what you should do if it happens.
1 Blink, and you may miss it
Remember those frightening depictions of fits you see in TV dramas where the person suddenly starts convulsing and blacks out? In babies and young kids, fits may look nothing like that.
In fact, the signs can be easily missed. Sometimes, it can be difficult, even for experts, to differentiate seizure signs from normal movements in very young children, says Dr Christelle Tan, a specialist in paediatrics at Raffles Specialists, Raffles Holland V.
“A baby’s brain is still immature and developing, and cannot produce the coordinated response that you see in generalised tonic-clonic seizures that most people are familiar with,” she explains.
It is also easy to mistake your newborn’s Moro reflex for a seizure, Dr Tan says. When your little one is startled, by a loud sound for example, she may suddenly extend her arms outwards with her fingers spread out before pulling them in. This is a normal startle response that babies have up to the age of three to four months.
In a real seizure, the jerking movements usually cannot be stopped even if you change your baby’s position or hold down the limb, she adds.
2 Not all seizures look alike
Typically, in a seizure, your child’s arms and legs will jerk involuntarily, and she may roll her eyes upwards or clench her teeth, shares Dr Junaidah Badron, senior staff registrar at KK Women’s and Children’s Hospital’s department of emergency medicine. She may also lose bladder and bowel control and feel sleepy after the episode.
But not every kid experiences the same thing, as the signs depend on where the seizure occurs in the brain. Some make chewing, lip-smacking or cycling movements. In addition, look for pale skin-tone or blue lips; some babies may stop breathing briefly, Dr Tan says.
Some types can cause your child to stare blankly into space, as if she is daydreaming, or go limp and unresponsive suddenly. Kids don’t always black out during a seizure, either. For example, if your child has a type known as simple partial seizure, the jerking movements may involve only one arm or leg and she will remain awake.
Since the signs aren’t always clear-cut, Dr Tan suggests video-recording your child’s movements to show to her doctor if you suspect that something is amiss.
3 Watch your baby’s body temperature
A high fever, especially when the temperature hits 38.5 deg C or higher, can cause your little one to experience what doctors call a febrile fit. Your baby may roll her eyes, and her limbs may stiffen, twitch and jerk. This is quite common in young ones from six months to around six years old, Dr Tan says.
Simple febrile fits usually last a few minutes. While it can be distressing to witness a fever fit, Dr Junaidah says it does not cause brain damage or delays in your child’s development.
Try bringing her fever down and keep her temperature to under 38.5 deg C with either medication prescribed by the doctor or sponging her regularly, Dr Junaidah advises. But do not feed your child medication while she is still drowsy.
Dr Junaidah advises seeing a doctor if your child:
+has a febrile fit for the first time
+has a febrile fit that lasts more than 15 minutes
+cannot move one side of her body, such as arms or legs, after the fit
+is unusually irritable or drowsy after the fit, or;
+injured herself during the fit, such as sustaining a head injury from falling off the couch.
4 Some kids outgrow their seizures
Besides a high fever, there are many possible reasons why your little one can get fits – these include infections like meningitis (brain infection), a head injury, birth trauma, or lack of oxygen. They can also occur if she has any underlying brain abnormalities or has low sodium or sugar imbalance.
Whether your kid grows out of her seizure spells depends on what’s causing them.
“Most kids outgrow fever fits by five to six years old. If it’s due to low salt levels from severe diarrhoea, the fits don’t recur as long as the cause is treated,” Dr Tan says.
There’s a higher chance the doctor will find an abnormality if your baby is under six months old, she adds. Your kid may be diagnosed with epilepsy if her seizures keep coming back and are triggered by something that cannot be identified and reversed.
But take heart, research shows that many children with epilepsy outgrow it. One study published in the journal Epilepsia in 2010 found that seven in 10 children with the condition stop having seizures by the time they reach 20.
Place your child on her side, on a flat surface, to prevent her from choking on her own saliva. Make sure there are no hard or sharp objects nearby that may hurt her.
5 Keep calm and do not use a spoon during a fit
Sticking a spoon, your finger or any other object into your kid’s mouth is likely to do more harm than good during a seizure. This will only cause unnecessary injury. Don’t attempt to feed her medication during a fit, too, Dr Junaidah warns.
Instead, place your child on her side, on a at surface, to prevent her from choking on her own saliva. Make sure there are no hard or sharp objects nearby that may hurt her, she adds.
6 Dial 995 if it lasts more than five minutes
A seizure is considered a medical emergency when the child loses consciousness and her breathing is affected for a prolonged period of time. Most episodes typically last only for about one to two minutes, Dr Tan shares.
Call an ambulance if it goes beyond five minutes, the doctors advise. A seizure can become deadly if it continues for more than 30 minutes. Upon approval Please sign: Name and Date:
7 Recurring fits can damage your child’s brain
While short seizure spells do not cause brain damage, Dr Junaidah says that those that last longer or occur repeatedly during illness can be dangerous.
For example, prolonged and/or recurrent fits that occur with a high fever, called complex febrile fits, can cause damage to the brain due to insufficient oxygen, she shares. See a doctor if your child’s febrile fit lasts longer than 15 minutes or occurs repeatedly. Always seek medical attention if you are unsure.
If your child has a high chance of having more seizures, the doctor may put her on medication to prevent future episodes, Dr Tan says.
It is important to put a stop to recurrent seizures. In the long run, the repeated spells may affect her development in critical thinking, memory, attention and problemsolving skills, Dr Tan shares. Plus, your kid could injure herself anytime.
“If the child falls unexpectedly while having a seizure, it can be catastrophic if she is in the middle of certain activities like bathing or crossing the road,” she warns.