Is it a seizure?

Pediatrician Wendy Mitchell, MD Neurology, shares advice for parents on how to tell if your child has had a seizure and explains the things that are commonly mistaken as a seizure in children
How To Tell If Your Child Had A Seizure
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Is it a seizure?

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Lots of things cause people to lose consciousness or suddenly lose function. The most obvious one is fainting or syncope. A person who has syncope is losing consciousness because they are losing blood supply to their brain or they are losing oxygen to their brain as the primary event. A person who is having a seizure is having the loss of consciousness because of the abnormal electrical activity in the brain. In one case, the primary problem is loss of blood flow or oxygen. In the other case, the primary problem is an electrical disturbance. So the most common thing we see mistaken for seizures or even that actually precipitates a brief seizure is fainting. Now, what makes people faint? The benign things that are very, very common are things like getting a blood test, seeing your blood when you have cut your finger, pain, something suddenly surprising you in a way that you don´t expect, even a minor pain like crunching your finger in the door or the other fairly common things are things like standing at attention for too long a time, standing in a warm room for too long a time, or the one that people don´t commonly recognize is what is called hair combing syncope. And that is typically where mostly little girls are standing in front of mom getting their hair done or braided and mom is not looking at their face because they are facing away from them and they suddenly go down. And that is fainting from standing still too long essentially and from having their hair pulled. And you actually can precipitate a brief convulsion. Now, that´s not a seizure in the sense of an epileptic seizure. The other things that commonly get mistaken for seizures are behavior problems. So people fairly often send me a patient and say this child has rage attacks and horrible temper tantrums, couldn´t this be epilepsy? And about 99.9% of the time the answer is no, it is not epilepsy. Maybe they also have epilepsy, but those episodes where they get mad at mom or they get mad at their brother or sister and wacking their friend upside the head or throwing their toys out the window, that is not seizure. Seizures do not hardly ever cause purposeful misbehavior. They may cause agitation. They may cause somebody to fight against being restrained or held down during a seizure. But they don´t cause somebody to get agitated and injure somebody else or hit somebody else or break something.

Pediatrician Wendy Mitchell, MD Neurology, shares advice for parents on how to tell if your child has had a seizure and explains the things that are commonly mistaken as a seizure in children

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Wendy Mitchell, MD

Pediatrician, Neurology, Children’s Hospital Los Angeles

Wendy Mitchell, MD, is Professor of Clinical Neurology, Keck School of Medicine, University of Southern California. She is acting Division Head of Neurology at Childrens Hospital Los Angeles, where she has practiced for over 30 years. She is a native of Los Angeles. Her current research interests include cognitive and behavioral aspects of childhood epilepsy, clinical research in anticonvulsants, and a rare immune-mediated syndrome, opsoclonus-myoclonus (or dancing eyes syndrome). In her free time she enjoys scuba diving and yoga.

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Transcription: 
Lots of things cause people to lose consciousness or suddenly lose function. The most obvious one is fainting or syncope. A person who has syncope is losing consciousness because they are losing blood supply to their brain or they are losing oxygen to their brain as the primary event. A person who is having a seizure is having the loss of consciousness because of the abnormal electrical activity in the brain. In one case, the primary problem is loss of blood flow or oxygen. In the other case, the primary problem is an electrical disturbance. So the most common thing we see mistaken for seizures or even that actually precipitates a brief seizure is fainting. Now, what makes people faint? The benign things that are very, very common are things like getting a blood test, seeing your blood when you have cut your finger, pain, something suddenly surprising you in a way that you don´t expect, even a minor pain like crunching your finger in the door or the other fairly common things are things like standing at attention for too long a time, standing in a warm room for too long a time, or the one that people don´t commonly recognize is what is called hair combing syncope. And that is typically where mostly little girls are standing in front of mom getting their hair done or braided and mom is not looking at their face because they are facing away from them and they suddenly go down. And that is fainting from standing still too long essentially and from having their hair pulled. And you actually can precipitate a brief convulsion. Now, that´s not a seizure in the sense of an epileptic seizure. The other things that commonly get mistaken for seizures are behavior problems. So people fairly often send me a patient and say this child has rage attacks and horrible temper tantrums, couldn´t this be epilepsy? And about 99.9% of the time the answer is no, it is not epilepsy. Maybe they also have epilepsy, but those episodes where they get mad at mom or they get mad at their brother or sister and wacking their friend upside the head or throwing their toys out the window, that is not seizure. Seizures do not hardly ever cause purposeful misbehavior. They may cause agitation. They may cause somebody to fight against being restrained or held down during a seizure. But they don´t cause somebody to get agitated and injure somebody else or hit somebody else or break something.