Shakes and Seizures in Children

Observing your child shake, space out, or pass out from a seizure is frightening. Children can develop seizures from a fever, a neurological condition such as epilepsy, a head injury, or other congenital conditions. 

Depending on the type of seizure, a child can experience a wide variety of symptoms. Some seizures are easy to recognize and have classically thought of symptoms like shaking and losing consciousness. Others are less obvious and may have no outward signs at all. 

Signs that your child may be experiencing a seizure include: 

• staring
• tremors
• convulsions or jerking movements in the arms and legs
• stiffening of the body
• loss of consciousness
• no response to noise or words for short periods of time
• appearing confused or in a haze
• rapid eye blinking

Some children experience focal seizures, previously called partial seizures, which, according to the Epilepsy Foundation, can include motor or non-motor symptoms. A person having a focal aware seizure, previoiusly called a simple partial seizure, will be aware but might unable to talk or respond during the event.

Seizures are an involuntary altering of consciousness or movement caused by abnormal, erratic electrical activity in the brain. In children, seizures can present in a number of ways.

Generalized seizures involve both sides of the brain and children typically lose consciousness. There are several different types of generalized seizures including absence, tonic or atonic, tonic-clonic, and myoclonic seizures.

Focal seizures begin with electrical activity in a small region of the brain and may or may not spread. They can occur in any lobe of the brain and symptoms vary based on the brain regions involved. 

In complex partial seizures, the affected child often experiences loss of consciousness. They may not always pass out, but during a complex partial seizure, a child will not be able to talk or interact with you at all, appearing to be in a trance.

An absence seizure, often referred to as petit mal seizure, is a non-convulsive seizure that is often not recognized as a seizure at all. A typical absence seizure manifests as a staring spell that usually lasts less than 10 seconds.

Also called a drop attack, atonic seizures involve a sudden loss of muscle tone and may cause drop attacks. During the seizure, your child will go limp and be unresponsive.

More common in children than adults, atonic seizures are relatively rare, with an estimated 1 percent to 3 percent of children with epilepsy experiencing atonic seizures.

Atonic seizures can be either focal or generalized. They sometimes begin with jerking motions, last for a short period, and have a quick recovery, provided no injuries were sustained from the fall.

A tonic-clonic seizure, formerly called a grand mal seizure, is the "classic" type of seizure most people are familiar with.

It involves loss of consciousness or awareness, plus uncontrolled jerking and stiffness of the arms, legs, or body. It generally lasts just a few seconds to a couple of minutes.

The jerking motions and stiffness associated with this type of seizure are caused by abnormal activity in the region of the body that is controlled by the injured area of the brain.

Myoclonic seizures most commonly occur in the morning and often occur in clusters (more than one).

Sometimes, myoclonic seizures can involve both sides of the body or more than one body part, such as an arm and a leg.

Myoclonic seizures don’t usually cause a complete loss of consciousness or severe shaking or jerking. Your child may feel tired or sleepy afterward, though that is not always the case.

A seizure related to a high temperature is known as a febrile seizure. It is most common in children between 6 months and 5 years. They usually happen when a child's temperature is over 102 degrees F. However, they don't usually happen when the temperature is at it's highest.

A febrile seizure can last between a few seconds to 10 or 15 minutes. Signs that a child is having a febrile seizure can be as minor as eyes rolling back in the head and stiffening of an arm or leg or as complete as full-body convulsions with loss of consciousness. 

Not all jerking movements or shakes are due to seizures. Other conditions that may appear similar to seizures include:

• Tremor: Involuntary shaking movements in an otherwise healthy child may be due to an essential tremor (also called a familial tremor), which runs in the family and most often appears during adolescence.
  Tics: Involuntary tics come in two main varieties—motor tics, such as shrugging their shoulders, and vocal tics, such as clearing the throat. Many people assume tics are associated with Tourette's Syndrome, but that is not always the case. Many of these tics are transient and can be due to anxiety.
• Shivering: Our bodies have a built-in mechanism for warming itself up—shivering. However, babies do not have the ability to shiver. This symptom in a baby or child who is not cold can be due to low blood sugar and is resolved after eating.

If you suspect your child is having seizures, contact your pediatrician. Your doctor may refer you to a pediatric neurologist who can perform an EEG might help determine if these episodes are seizures or not.