Recognizing Seizures in Infants.
When an infant baby has a seizure, it can look very different from a seizure that an older child or an adult has. That is because the baby’s brain is so young and still developing, so many times the baby is not able to make a coordinated response. This uncoordinated response results in a seizure that comes in fragments, which may include physical behavior including:
- Jerking or stiffening of the baby’s leg or arm, which can alternate side to side
- Changes or distortions to the baby’s facial expression, breathing pattern or heart rate
- Sudden jerking motion of the baby’s upper body, jerking forward motion
- Sudden jerking of the baby’s legs toward its belly, with its knees bent
- Stiffening of the baby’s body and flickering of its eyelids
- Impaired responsiveness, such as reaction to parental voices
When It’s Not a Seizure: Infant Behavior Mistaken as Seizures.
However, recognizing seizures in newborns is often very difficult, even for medical physicians and experts. That is because all normal babies exhibit sudden, often jerky, movements. It is completely normal for babies to have sudden grimaces, facial changes, jerky mouth movements, and jerking of the limbs. These types of sudden behavior may be a sign of epilepsy in an older child or an adult, but in a baby, these random, quick movements are often just normal activity for an infant.
Sometimes, babies exhibit a physical behavior known as “jitters,” where the baby shivers or shows tremors. These jitters are also completely normal behaviors of healthy infants, as they are simply similar physical shivers that older children and adults may show, often during temperature changes to the environment.
The” Moro reflex” is a common behavior in infants that can commonly be misdiagnosed as seizures. This reflex occurs when the baby is startled or surprised, for example when it hears a sudden loud noise, or sees a bright light, or loses support of its head. In these situations, the infant may display the Moro reflex, where it will suddenly stiffen, extend its arms and legs from its body and fan out its fingers. This reflex can continue through the first 3-5 months of the baby’s life as it continues to develop, and it is a completely normal, healthy response in babies.
When It Is a Seizure: Infant Behavior Supporting a Diagnosis of Seizures or Epilepsy.
But there are some signals of seizures, and perhaps epilepsy, in infants. One of the strongest symptoms of epilepsy or seizures in infants is when the physical behavior (such as jerking or facial distortions) are repeated, and when they are repeated, they are identical features of a similar duration. Another sign supporting a diagnosis of epilepsy in a newborn is if the physical episodes occur both when the baby is sleeping, as well as when it is awake. Diagnosis of seizures is also stronger when the physical behavior cannot be stopped by gentle manipulation of the baby’s body, arm or leg.
Causes of Infant Seizures.
There is no one cause of seizures in infants, and the reason is also not always known. It can vary from temporary issues that will resolve with time; in other situations, infant seizures can be a sign of epilepsy that may affect the child’s entire life. Some of the most common causes of infant seizures include:
- Benign Familial Neonatal Convulsions. Some newborns are born with a rare genetic disorder called benign familial neonatal convulsions. Newborns with this disorder show seizures within the first few days of the baby’s life. The disorder is often genetic, inherited through the parents by a dominant gene; other times, the disorder can be caused by a mutation of the baby’s DNA. Either way, the disorder is (as the name suggests) “benign:” the seizures typically cease after 6 to 9 months of age.
- Birth Injuries. Infant seizures can also be caused by injuries sustained during childbirth. These injuries can range from physical injuries sustained by physical trauma during birth, immediate physical trauma after birth, or even infection during pregnancy.
- Cerebral Palsy. The disorder known as “cerebral palsy” can also be a cause of seizures in infants. Cerebral palsy is typically caused by some sort of abnormal brain development or a disruption in the brain development in the baby. Sometimes, the cause occurs before the child is born, such as through maternal infections or genetic mutations. Other times, cerebral palsy is caused by physical trauma during birth, including asphyxia from lack of oxygen or traumatic physical injury to the baby’s brain.
- Shaken Baby Syndrome. Shaken baby syndrome is another common cause of seizures in infants. Also known as “abusive head trauma,” this condition is a serious brain injury resulting from the forceful shaking of an infant or toddler. The shaking damages the baby’s brain cells and prevents the baby’s brain from receiving proper oxygen. Shaken baby syndrome can lead to a number of physical disorders, developmental disorders, seizures and even death.
Diagnosis of Infant Seizures.
Pediatricians can help evaluate your baby to determine if it is suffering from seizure activity and potentially epilepsy syndrome. Your pediatrician can help evaluate the physical symptoms described above, as well as electronic measurements of your baby’s brain.
One of these electronic measurements is called the electroencephalogram, or “EEG” for short. The EEG measures abnormal (versus normal) patterns of electrical brain activity. EEGs in newborns can be helpful, but they are not always certain: electric brain activity in newborns is less clearly defined than that in adults, so the measurement can be more difficult to interpret.
Doctors can also use MRI imaging and CT scans to view the brain development and physical bone development of the baby. Some physicians may also analyze the baby’s blood to check for medical conditions, including genetic conditions, such as low calcium levels or low blood sugar.
Treatment of Seizures in Infants
The treatment of your baby’s seizures depends on the cause of the seizures. Sometimes the cause, such as the ones outlined above, can be determined and treated appropriately. For example, if the physician can conclude that the baby suffers from epileptic seizures, the doctor can prescribe physical therapy and prescription drugs to help reduce the symptoms of epilepsy. In other situations, the cause of the seizures may be more difficult to determine.
However, regardless of the cause, if your baby is having seizures it is always best to seek immediate professional medical advice. And the sooner the cause of the seizures is determined, the earlier your baby can receive the care and treatment it needs.
