Patient's question:
My son just turned one month old. Sometimes he has jerky movements in his hands and feet, and sometimes his eyes roll back (for about 2 seconds). After having an electroencephalogram at the hospital, the results showed an abnormal sleep electroencephalogram. Sleep physiological waves were visible on both sides, along with some sharp waves, sharp-slow bursts, which were more prominent in the posterior regions, with a slight predominance on the right side.Could you please tell me what this condition is? If it's a seizure, will it develop into epilepsy?
Doctor's answer:
Seizures, also known as convulsions, are colloquially referred to as "fainting fits" and are relatively common emergency symptoms in children, caused by temporary dysfunction of the cerebral cortex. The younger the age, the higher the incidence, with infants and toddlers being particularly affected. There are many causes of seizures, and the pathological changes are also complex, but in infancy and early childhood, they are often triggered by hypoglycemia, hypocalcemia, or high fever; in older children, they may be caused by dysentery, lobar pneumonia, or epilepsy.(1) Clinical Manifestations
A few cases may have prodromal symptoms before a seizure. If any of the following clinical signs are observed during questioning or physical examination, a seizure should be suspected: extreme restlessness or sudden "startles," mental tension; panic, sudden increase in muscle tone in the limbs; sudden rapid, paused, or irregular breathing (especially in newborns); abrupt rise in temperature, dramatic change in complexion; unequal pupil size; irregular margins. Most seizures occur suddenly. The typical presentation includes sudden loss of consciousness or falling, eyes rolling upward or staring, head tilting backward or to one side, frothing at the mouth, clenched jaw, and tonic or clonic convulsions of the face and limbs accompanied by breath-holding, cyanosis, and incontinence of urine and feces. The seizure may last for seconds, minutes, or tens of minutes before stopping, followed by a state of drowsiness. On examination during or shortly after the seizure, signs such as dilated pupils, delayed light reflexes, and positive pathologic reflexes may be observed, with consciousness returning shortly after the seizure stops. In cases of hypocalcemic seizures, the child may remain conscious. If another seizure occurs before consciousness returns or if seizures recur in a continuous state, it indicates a severe condition, which may lead to death due to cerebral edema or respiratory failure. If the focal convulsion site is fixed, it often has localizing significance. In some cases, only slight twitching of the corners of the mouth or eyes, or twitching of one limb or alternating twitching of both limbs, may occur. Newborn seizures are rarely generalized convulsions; instead, they often manifest as irregular or paused breathing, episodic cyanosis or pallor, staring eyes, nystagmus, blinking movements, or sucking and chewing motions. The duration of seizures varies, sometimes being very brief, requiring careful observation for an accurate diagnosis.
(2) Main Types
1. Seizures with High Fever: Some are purely due to high fever, most common in infants and toddlers, occurring even at temperatures of 39–40°C, and are referred to as "febrile seizures." Others are due to septic shock and are more severe.
2. Seizures with Temporary Loss of Consciousness: Mental clarity returns after the seizure stops. Seen in hypoglycemia, hypocalcemia, and hyponatremia syndrome.
3. Persistent Seizures with Light Coma and Fair Respiratory Circulation: Seen in febrile seizures, early central nervous system inflammation, or early infectious toxic encephalopathy.
4. Persistent Seizures with Deep Coma and Poor Respiratory Circulation: Severe generalized convulsions, irregular and shallow breathing, and clear cyanosis (hypoxia), or accompanied by peripheral circulatory failure. Seen in conditions like "meningococcal meningitis," "Japanese encephalitis," and toxic dysentery.