Seizure In Developing Infant, Toddler, Children

An infant, toddler, or child, may be more predisposed to seizure if they have a relative with seizures, and also if they had a traumatic birth.

Not only that, my son demonstrated, and I saw him, cry out, and then his arm was in the air while he slept and it was jerking back and forth. This happened to my son one night about the same time I was having seizures myself. My son was also observed by grandparents, to be in severe pain, and arching his back with what seemed to be stomach pain. Below are some articles about seizures in children and potential problems with learning and brain:


Mechanisms of seizure-induced brain damage
Co-Existing Disorders > Developmental Disorders > Childhood-specific epilepsies with DD > Mechanisms of seizure-induced brain damage

Author: GL Holmes

The reasons that seizures during development can be harmful are myriad. The developing brain is highly plastic, and seizures during early development could have pronounced effects on brain development. A wide range of activity-dependent phenomena may be perturbed, including

* cell division and migration
* sequential expression of receptors
* formation and strengthening of synapses
* myelination

Much of the early work on seizure-induced brain damage concentrated on cell death. Only recently has it been demonstrated that seizures can alter brain development through mechanisms other than necrosis and programmed cell death.

Adapted from: Holmes GL. Childhood-specific epilepsies accompanied by developmental disabilities: Causes and effects. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;23-32.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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The National Institutes of Health. In short, there doesn’t seem to be any relation between febrile seizures and death. There is no indication of brain damage and there also doesn’t seem to be a major link with epilepsy, although the numbers are a bit higher for some children.

Are febrile seizures harmful?

Although they can be frightening to parents, the vast majority of febrile seizures are harmless. During a seizure, there is a small chance that the child may be injured by falling or may choke from food or saliva in the mouth. Using proper first aid for seizures can help avoid these hazards (see section entitled "What should be done for a child having a febrile seizure?").

There is no evidence that febrile seizures cause brain damage. Large studies have found that children with febrile seizures have normal school achievement and perform as well on intellectual tests as their siblings who don’t have seizures. Even in the rare instances of very prolonged seizures (more than 1 hour), most children recover completely.

Between 95 and 98 percent of children who have experienced febrile seizures do not go on to develop epilepsy. However, although the absolute risk remains very small, certain children who have febrile seizures face an increased risk of developing epilepsy. These children include those who have febrile seizures that are lengthy, that affect only part of the body, or that recur within 24 hours, and children with cerebral palsy, delayed development, or other neurological abnormalities. Among children who don’t have any of these risk factors, only one in 100 develops epilepsy after a febrile seizure.



Where can I get more information?

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
http://www.ninds.nih.gov

Information also is available from the following organizations:

Epilepsy Foundation

8301 Professional Place

Landover, MD 20785-7223

postmaster@efa.org

http://www.epilepsyfoundation.org

Tel: 301-459-3700 800-EFA-1000 (332-1000)

Fax: 301-577-2684
Read the whole article at http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm
Sources: http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm
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// About Epilepsy / FAQs / Do Seizures Damage the Brain? Email Article Print Comment
Do Seizures Damage the Brain?

A great deal of epilepsy research in humans and animals has focused on the question of whether seizures cause brain damage, existing underlying brain damage causes seizures, or a combination of both. Because there are so many different factors involved, including the specific epilepsy syndrome, other health conditions, the age of the child, the age at which epilepsy began, the treatment regimen, and the child’s particular characteristics, this is a difficult question to answer.

The discussion over whether single, brief seizures cause brain damage continues. It is not clear whether single seizures can cause cell death or if it is the cumulative effect of many seizures that cause damage.

We know that:

*
While children who have multiple seizures over a long period of time are at risk for long-term effects, children who have only one or a few brief seizures in their lives usually do not have long-term consequences.
*
In animal studies, seizures lasting more than 30 minutes and frequent, recurrent seizures appear to cause some brain cell death and may affect learning and memory. We don’t yet know how these animal studies translate to the care of children.
*
If the child’s epilepsy is caused by underlying abnormalities of the brain, this problem or abnormality may also cause learning and behaviour problems.
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Vol. 13, No. 6, 1975
Free Abstract Article (PDF 974 KB)

Paper

Developmental Brain Damage after Chemically Induced Epileptic Seizures
Claude G. Wasterlain

Department of Neurology, Cornell University Medical College, New York, N.Y.

Address of Corresponding Author

Eur Neurol 1975;13:495-498 (DOI: 10.1159/000114705)

goto top of page Key Words

* Brain development
* Brain damage
* Epilepsy
* Convulsions
* Neonatal seizures

goto top of page Abstract

25 Wistar rats were subjected twice daily to epileptic seizures induced by the convulsant gaz Flurothyl. Compared with littermates of the same sex and birth weight, the brain of seizure-treated rats showed a reduction of 6% (5.2 million cells) after 5 days and 17.6% (33.4 million cells) after 10 days of treatment.

Copyright © 1975 S. Karger AG, Basel

goto top of page Author Contacts

Claude G. Wasterlain, MD, Department of Neurology, Cornell University Medical College, 1300 York Avenue, New York, NY 10021 (USA)

goto top of page Article Information

Received: March 26, 1975
accepted: April 2, 1975
Published online: January 25, 2008
Number of Print Pages : 4
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Press Room

FOR IMMEDIATE RELEASE
June 11, 2004
Aaron Patnode
617-355-5337
aaron.patnode@childrens.harvard.edu
Drug May Protect Against Brain Injury and Seizures in Newborns
Implications for future treatment of cerebral palsy and epilepsy
An existing drug already approved by the FDA may protect newborns from brain injury and long-term neurologic problems caused by excitotoxicity, or over-activation of neurons, report two NIH-funded studies from Children's Hospital Boston. The drug, topiramate, is currently approved to control seizures in adults and in children over age 3, but the findings may provide the basis for a protective therapy that could be given to babies immediately after traumatic birth events that compromise the brain's blood and oxygen supply. Such events can cause long-term neurologic abnormalities that underlie serious conditions like cerebral palsy and epilepsy. Premature infants, who are surviving in greater numbers, are especially vulnerable to excitotoxicity.

When the brain's blood and oxygen supply are compromised, a condition known as hypoxia-ischemia, the chemical glutamate accumulates in brain tissues. Glutamate binds to receptors on neurons and over-activates them, causing the brain cells to die. The Children's Hospital researchers, led by Dr. Frances Jensen, have found that the neurons of premature infants and other newborns have more glutamate receptors than the adult brain, making them very vulnerable to excitotoxic brain injury from hypoxia-ischemia. In two studies, they investigated whether compounds that block a certain type of glutamate receptor, known as AMPA, can dampen the harmful effects of excitotoxicity in the immature brain.

The first study, published in the May 5 issue of The Journal of Neuroscience, examined a type of brain damage called periventricular leukomalacia (PVL) that underlies cerebral palsy. PVL is most common in the preterm infant and is thought to be caused by excitotoxic damage to oligodendrocytes, cells that produce a substance called myelin. Myelin insulates neurons and enhances signal transmission; without it, neurons cannot communicate efficiently and neuromotor problems result.

In the study, Jensen, Dr. Pamela Follett and colleagues first showed that developing human oligodendrocytes have peak numbers of AMPA glutamate receptors at 23-32 weeks' gestation, the time of greatest risk for PVL. They then tested topiramate, which blocks AMPA glutamate receptors, in a rodent model for PVL. When topiramate was given immediately after a hypoxic-ischemic event, rats were protected from oligodendrocyte injury and showed fewer neuromotor abnormalities than the untreated rats. The researchers went on to show that topiramate does not affect the normal development of oligodendrocytes.

''The finding that treatment with a drug prevents injury when given after the insult is tremendously significant,'' says Jensen, of the Department of Neurology and Program in Neuroscience at Children's. ''Many studies of injury protection have demonstrated an effect of pretreatment, a much more clinically limited paradigm. Because premature infants are typically maintained in a continuously monitored, intensive care setting, it's feasible to commence treatment even within a few minutes after an insult.''

A second study, published in the June issue of Epilepsia, found that topiramate may also be useful in preventing epilepsy, again by blocking AMPA glutamate receptors. Jensen and her team, including Dr. Sookyong Koh, investigated a condition called hypoxic encephalopathy, the most common cause of seizures in newborns. Infants with neonatal seizures due to hypoxia-ischemia can develop epilepsy, often in association with neuromotor deficits. ''Currently, there is no effective intervention for these newborns to prevent brain injury and long-term brain abnormalities,'' notes Jensen.

Animal studies have suggested that seizures in the immature brain can cause permanent changes making the brain more prone to seizures. ''In a rat model, we have shown that early life seizures induced by hypoxic encephalopathy increase susceptibility to seizure-induced neuronal injury later in life,'' says Jensen. ''We also know that this early seizure activity appears to be dependent on the AMPA subtype of glutamate receptors. We therefore examined whether topiramate might curb the excitotoxicity associated with neonatal seizures.''

Rats treated with topiramate prior to perinatal hypoxia-induced seizures indeed were less susceptible to seizures later in life. More significantly, topiramate given for 48 hours after hypoxia-induced seizures also reduced susceptibility to seizure-induced damage later in life. ''In human babies, pretreatment is not always clinically practical, so post-seizure treatment would represent a therapeutic advance,'' says Jensen. ''Appropriate intervention after early-life seizures may prevent the development of epilepsy and neurocognitive deficits, as well as brain injury associated with repeated seizures in adulthood.'' While therapeutic doses of the drug do not appear to alter normal brain development in the rat, topiramate's safety in children under age three has not been studied.

Taken together, results from these studies suggest that topiramate treatment may be useful for premature infants at risk for PVL and for neonatal seizures due to perinatal hypoxia. ''By further studying unique mechanisms of injury in the newborn brain, we hope to continue to elucidate new therapies for use in this age group,'' says Jensen. ''However, since agents already approved for use in adults are also effective, our results indicate that a clinical trial should be considered to determine topiramate's safety and efficacy in newborns.''

Children's Hospital Boston is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults for over 100 years. More than 500 scientists, including eight members of the National Academy of Sciences, nine members of the Institute of Medicine and 10 members of the Howard Hughes Medical Institute comprise Children's research community. Founded in 1869 as a 20-bed hospital for children, Children's Hospital Boston today is a 300-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's also is the primary pediatric teaching affiliate of Harvard Medical School. For more information about the hospital visit: www.childrenshospital.org.