Patient's question:
The newborn baby was shaking hands while sleeping on the eleventh day, and the whole body trembled as if it were very cold (body temperature was 37.1 degrees, no fever, room temperature was around 24-25 degrees). What could be the reason? Is it a lack of nutrients?Doctor's answer:
Seizures are the most concerning diseases for parents during childhood, partly because the symptoms can be terrifying, and partly because if not treated promptly and appropriately, they can lead to adverse consequences, even death. There are many factors or causes of seizures, and the forms of recurrence are often different. Some are only temporary, with quick recurrence and equally quick disappearance, and there are no subsequent adverse consequences or repeated occurrences. Such seizures do not require excessive concern from parents. However, other types of seizures last longer, can occur repeatedly, and if not treated early, can cause significant harm to a child's physical and mental health.This article briefly introduces several diseases that commonly cause seizures in children, providing a reference for parents who encounter similar conditions. The factors or causes of seizures vary with age. Generally, in the neonatal period after birth, the most common causes are birth injuries and congenital brain malformations. Other common factors include inflammatory diseases of the brain (such as encephalitis, meningitis, etc.), drug effects, and electrolyte imbalances.
After 6 months until the age of 2, febrile seizures are the most common, followed by inflammatory diseases of the brain. Other diseases are less frequent. Between the ages of 2 and 6, inflammatory diseases of the brain are most common, followed by epilepsy. After the age of 6, epilepsy is the most common cause. Therefore, based on age differences, we can first consider the most likely disease and make a rapid diagnosis.
Guidelines: Below, we will distinguish the most common diseases at each age based on medical history and symptoms:
1. Birth Injuries: Seizures caused by birth injuries are mostly traceable to a history of difficult labor during delivery or injuries or cyanosis (bluish discoloration due to lack of oxygen) at birth. The duration and form of seizure recurrence vary depending on the location, severity, and extent of the injury. Some may later lead to epilepsy or affect intelligence, often requiring long-term medication for control.
2. Febrile Seizures: These are related to fever, most commonly occurring during the peak of the fever. However, they can also occur when the temperature rises or falls rapidly. This condition is quite common in children aged 6 to 18 months and can be triggered by high fever from conditions like roseola or colds. 8% of all children experience febrile seizures. The duration of seizures is short, most stopping completely within 15 minutes after recurrence. Repeated episodes are rare, usually not occurring more than two or three times consecutively. Sometimes, there is a family history, with parents also experiencing similar symptoms in childhood. Of course, these seizures do not occur without fever. The prognosis is generally good, with rarely any permanent effects. However, when a child has a fever and seizures, it is important to consider the possibility of encephalitis or meningitis, which should be closely monitored. If encephalitis or meningitis is suspected, a lumbar puncture can easily diagnose the condition and appropriate treatment can be administered.
3. Epilepsy: If a child experiences recurrent seizures without fever or other obvious causes, epilepsy should be the first consideration. Epilepsy has many types, the most important of which can be divided into grand mal, petit mal, and psychomotor seizures, with different forms and locations of recurrence. Grand mal seizures can last more than 15 minutes, while petit mal seizures may last only a few seconds. Typical patients have a history of recurrent seizures, and family members often have similar cases. An electroencephalogram (EEG) can help confirm the diagnosis. After diagnosis, long-term antiepileptic medication is needed to prevent future recurrences. Sometimes, epilepsy can also cause seizures during fever, making it difficult to distinguish from febrile seizures. In such cases, an EEG can be performed 10 days after the seizure. If it is a febrile seizure, the EEG should usually return to normal within 10 days. If a febrile seizure occurs only once, long-term medication is not necessary. If there are repeated episodes, treatment may be needed for several months to several years to prevent future recurrences.
4. Brain Tumors: If a brain tumor occurs, the most common symptom is local functional impairment, such as poor vision or hearing in one eye, or partial limb movement issues. Sometimes, local or generalized seizures may also occur, but these patients often have concurrent symptoms like headaches and vomiting, which worsen over time. In such cases, seizures should not be treated alone, and further examination is necessary.
There are many other factors or causes of seizures, such as lead poisoning from toys, brain vascular malformations, high blood pressure caused by kidney disease, or cerebral embolism caused by heart disease.
The most important principle is that parents should not panic when their child has a seizure. First, ensure the patient's airway is clear. Use a soft but firm object, such as a spoon wrapped in cloth, to gently open the child's teeth and remove any saliva, then immediately take them to the hospital for treatment. The greatest harm from prolonged seizures is due to impaired breathing and oxygen deprivation, which can cause brain cell damage or even death.