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 a congenital condition (one that is present at birth). 

Seizures Signs and Symptoms

Depending on the type of seizure, a child can experience a wide variety of symptoms. Some signs of seizures are easy to recognize, such as 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 off into space
• 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 daze
• Rapid eye blinking

Types of Seizures

A seizure is 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

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

Focal seizures, previously called partial seizures, begin with electrical activity in a small region of the brain and may or may not spread to other areas of the brain. They can occur in any lobe of the brain. Symptoms vary based on the brain regions involved. 

According to the Epilepsy Foundation, these can include motor or non-motor symptoms. A person having a focal aware seizure, previously called a simple partial seizure, will be aware but might be unable to talk or respond during the event.

Complex Partial Seizures

In complex partial seizures, a 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.

Absence Seizures

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.

Atonic Seizures

Also called a "drop attack," atonic seizures involve a sudden loss of muscle tone and may cause your child to go limp and be unresponsive.

More common in children than adults, atonic seizures are relatively rare, with an estimated 1% to 3% 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.

Tonic-Clonic Seizures

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

This type of seizure 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 a tonic-clonic seizure are caused by abnormal activity in the region of the body that is controlled by the injured area of the brain.

Myoclonic Seizures

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.

Febrile Seizures

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. These usually happen when a child's temperature is over 102 degrees F. However, they don't usually happen with higher temperatures (over 103 degrees F).

A febrile seizure can last between a few seconds to 10 or 15 minutes. Signs that a child is having a febrile seizure include rolling back of the head and stiffening of an arm or leg. In some cases, they result in full-body convulsions with loss of consciousness. 

Other Causes of Shaking

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). These tremors run in families and most often appear during adolescence.
  Tics: There are two types of involuntary tics—motor tics (such as shrugging the 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 body's ability to shiver is a a built-in mechanism for warming itself up. 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 typically resolved after eating.

If you suspect your child is having seizures, contact your pediatrician. Your healthcare provider may refer you to a pediatric neurologist who can perform an electroencephalogram (EEG), a test that measures abnormal brain activity). This might help determine if the episodes are seizures or not.