Generalized Tonic-Clonic Seizure Disorder, Child

A generalized tonic-clonic seizure disorder is a type of epilepsy. Epilepsy means that a person has had more than two unprovoked seizures. A seizure is a burst of abnormal electrical activity in the brain. Generalized seizure means that the entire brain is involved. Generalized seizures may be due to injury to the brain or may be caused by a genetic disorder. There are many different types of generalized seizures. The frequency and severity can change. Some types cause no permanent injury to the brain while others affect the ability of the child to think and learn (epileptic encephalopathy).

SYMPTOMS

A tonic-clonic seizure usually starts with:

  • Stiffening of the body.

  • Arms flex.

  • Legs, head, and neck extend.

  • Jaws clamp shut.

Next, the child falls to the ground, sometimes crying out. Other symptoms may include:

  • Rhythmic jerking of the body.

  • Build up of saliva in the mouth with drooling.

  • Bladder emptying.

  • Breathing appears difficult.

After the seizure stops, the patient may:

  • Feel sleepy or tired.

  • Feel confused.

  • Have no memory of the convulsion.

DIAGNOSIS

Your child's caregiver may order tests such as:

  • An electroencephalogram (EEG), which evaluates the electrical activity of the brain.

  • A magnetic resonance imaging (MRI) of the brain, which evaluates the structure of the brain.

  • Biochemical or genetic testing may be done.

TREATMENT

Seizure medication (anticonvulsant) is usually started at a low dose to minimize side effects. If needed, doses are adjusted up to achieve the best control of seizures. If the child continues to have seizures despite treatment with several different anticonvulsants, you and your doctor may consider:

  • A ketogenic diet, a diet that is high in fats and low in carbohydrates.

  • Vagus nerve stimulation, a treatment in which short bursts of electrical energy are directed to the brain.

HOME CARE INSTRUCTIONS

  • Make sure your child takes medication regularly as prescribed.

  • Do not stop giving your child medication without his or her caregiver's approval.

  • Let teachers and coaches know about your child's seizures.

  • Make sure that your child gets adequate rest. Lack of sleep can increase the chance of seizures.

  • Close supervision is needed during bathing, swimming, or dangerous activities like rock climbing.

  • Talk to your child's caregiver before using any prescription or non-prescription medicines.

SEEK MEDICAL CARE IF:

  • New kinds of seizures show up.

  • You suspect side effects from the medications, such as drowsiness or loss of balance.

  • Seizures occur more often.

  • Your child has problems with coordination.

SEEK IMMEDIATE MEDICAL CARE IF:

  • A seizure lasts for more than 5 minutes.

  • Your child has prolonged confusion.

  • Your child has prolonged unusual behaviors, such as eating or moving without being aware of it

  • Your child develops a rash after starting medications.