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Babies and epilepsy

Contents

The causes of epilepsy in babies
Types of seizures
Diagnosis
Treatment
Long-term development
Further information

Introduction

This information relates to babies who are up to one month old.

The causes of epilepsy in babies

There are many causes of seizures in babies. In around seven to eight out of 10 babies with seizures, a cause will be found. These are the most common ones.

  • Being born more than two or three months early. If your baby is born so early, they are at risk of having bleeding inside their brain. This is called intracranial haemorrhage.
  • Being born on time but suffering a lack of oxygen to the brain. This is called perinatal hypoxia and can cause an injury to the brain called ‘hypoxic-ischaemic encephalopathy’.
  • Having low levels of glucose, calcium or sodium in the blood.
  • Having an infection such as meningitis or encephalitis.
  • Being born with an abnormal brain. This is called cerebral dysplasia or dysgenesis. Cerebral means relating to the brain. Dysplasia or dysgenesis means abnormal development.
  • Inheriting a medical condition, such as benign neonatal convulsions.

Epilepsy Action has more information about inheriting epilepsy and benign neonatal convulsions

Types of seizures

Seizures in babies can be difficult to recognise. They are often brief and affect only some parts of the body. 

  • Your baby may have jerking or stiffening of an arm or leg that can switch from side to side. Or their whole upper body may suddenly jerk forward. Or both their legs may jerk up towards their stomach, with their knees bent. These are usually called myoclonic or, if the jerks happen repeatedly in clusters, clonic seizures.
  • Sometimes, only the baby’s face is involved. Their eyes twitch and their head turns to one side. These are usually called focal seizures.
  • If your baby’s body stiffens with or without eyelid flickering, these are usually called tonic seizures.
  • Your baby may go bright red in the face and their breathing and heart rate may change. They will be less alert than usual. You may notice that, for a short time, you can’t attract your baby’s attention. Or you might notice your baby’s eyes are not focusing. These are usually called subtle seizures.

Epilepsy Action has more information about types of seizures.

Diagnosis

It can be difficult to recognise seizures in babies.  That’s why it’s important that they are referred to a doctor who has had specialist training in diagnosing and treating epilepsy. The specialist will ask you about:

  • any behaviour changes that are unusual for babies at that age
  • whether all the seizures look the same, and last the same length of timehether the seizures happen while your baby is awake or  asleep, or both
  • whether the seizures are caused by changes in your baby’s posture or when they are doing different things
  • whether the seizures interfere with, or stop, your baby’s activities such as feeding
  • whether you can stop the seizures after they have started.

If you can record any behaviour changes (maybe on a mobile phone) to show the specialist what happens, this might be very important. It can help with making the diagnosis.

Epilepsy Action has more information about diagnosing epilepsy.

The specialist may then arrange for some, or all, of the following tests.

Electroencephalogram (EEG)

Electrical activity is happening in our brain all the time. A seizure happens when there is a sudden burst of intense electrical activity. This intense electrical activity causes a brief disruption to the way the brain normally works, meaning that the brain’s messages become mixed up. The result is an epileptic seizure.

An EEG gives information about the electrical activity that is happening in your baby’s brain at the time of the test. The electrical activity shows on the EEG as a particular brainwave pattern. EEGs can be very useful in older children and adults, but are less valuable in helping to diagnose epilepsy in babies. This is because the brains of babies are immature, and can’t usually show the changes in brainwave patterns that are seen in older children. This means that even during an epileptic seizure the EEG may not show anything abnormal.

However, if the EEG is very abnormal, it will tell the doctors more about your baby’s epilepsy.

Epilepsy Action has more information about EEGs.

CT scans (computed tomography)

A CT scan is a type of X-ray that shows the physical structure of the brain. It doesn’t show if your baby has epilepsy. However, it may show if there is anything in your baby’s brain, such as a scar, or damaged area, that could cause epilepsy. Not every baby will need to have a CT scan.

Epilepsy Action has more information about CT scans

MRI scans (magnetic resonance imaging)

An MRI scanner uses radio waves and a magnetic field to show the physical structure of the brain. An MRI scanner is more powerful than a CT scanner. An MRI scan has a higher chance than a CT scan of showing something in your baby’s brain that could cause epilepsy. Not every baby will need to have an MRI scan.

Epilepsy Action has more information about MRI scans.

Blood tests

Blood tests are used to check your baby’s general health, and to look for any medical conditions that might be causing their epilepsy. They can also be used to find out if the seizures are not caused by epilepsy, but another medical condition. An example would be low blood sugar (glucose) or low calcium levels. 

Some babies will be referred to a genetics department for further testing. This will depend on the individual baby, whether they have any other medical issues, and their family history. The referral will  be made by the paediatrician or the paediatric neurologist.

Treatment

There is a large range of epilepsy medicines used to treat seizures in babies. The choice of medicine will depend on:

  • the baby’s seizure type
  • the age when the epilepsy began
  • the cause of the epilepsy, if known
  • whether the baby has any other medical conditions, or takes any other medicines
  • the likely outlook for their particular type of epilepsy.

Some of the epilepsy medicines used in babies include phenobarbital, phenytoin, clonazepam, carbamazepine, sodium valproate, levetiracetam, and vigabatrin. Pyridoxine, (vitamin B6) is also sometimes used.

Epilepsy Action has more information about treating epilepsy.

Long-term development

  • If a baby’s seizures are caused by bleeding in their brain or severe lack of oxygen at birth, they will often start having infantile spasms (West syndrome) in their first year of life. They may carry on having seizures that are difficult to treat throughout their childhood. They will also have learning disabilities and many will have cerebral palsy.
  • If a baby’s seizures are caused by meningitis, they may have seizures during childhood and develop learning disabilities and cerebral palsy.
  • Babies who have a low level of glucose in their blood have seizures during childhood and are likely to have learning disabilities. They may also have impairment of their sight.
  • If a baby has seizures caused by cerebral dysplasia or dysgenesis, they are likely to have difficult to control epilepsy. Cerebral dysplasia or dysgenesis means abnormal development of the brain. Most of these infants will also have learning disabilities. These are usually moderate or severe. The outlook for babies who have a genetic abnormality will depend on their particular genetic abnormality.

Epilepsy Action had more information about West syndrome and learning disabilities.

Further information

Your health visitor, epilepsy nurse, or epilepsy specialist may be to give your information about your baby’s condition. 

The UK organisation Contact a Family freephone 0808 808 3555 (UK) or cafamily.org.uk may be able to provide information and details of self-help groups for children with specific conditions, including the less common types of epilepsy.

 

Pay it forward

This resource is freely available as part of Epilepsy Action’s commitment to improving life for all those affected by epilepsy.

On average it costs £414 to produce an advice and information page – if you have valued using this resource, please text FUTURE to 70500 to donate £3 towards the cost of our future work. Terms and conditions. Thank you


We can provide references and information on the source material we use to write our epilepsy advice and information pages. Please contact our Epilepsy Helpline by email at helpline@epilepsy.org.uk.
Code: 
F009.01

Epilepsy Action would like to thank Dr Richard Appleton, consultant paediatric neurologist at Alder Hey Children’s Hospital, Liverpool, UK. He has worked with Epilepsy Action to provide the background information for this page. It is based on his own research, experience and expertise.

This information has been produced under the terms of The Information Standard.

  • Updated January 2013
    To be reviewed January 2016

Comments: read the 4 comments or add yours

Comments

My daughter started with seizures at 6 days old and was put on pyrodoxine and phenobarbital. She is now off the pyridoxine . We we t moths without any seizures then she hit six months and they are back with a vengeance. She has has 3 in the past ten day with episodes of absence, will this have any effect on her development? I'm a first time mum who is terrified of what could happen xx

Submitted by natalie on

Hi Natalie

That sounds like a tough place to be with your baby daughter.

We aren't medically trained, so we won't be able to diagnose what is happening now, or what might happen in the future.

Hopefully you have already read through our information about babies and epilepsy: https://www.epilepsy.org.uk/info/newborn.

As you can see it is quite difficult to make an accurate diagnosis of exactly what might be happening for a baby, as they are at such an early stage in their development.

But it may be that the consultant thinks it would be a good idea for your daughter to go back on the pyridoxine. I am linking you to an article about this as it may be helpful: http://www.webmd.com/epilepsy/pyridoxine-dependent-seizures

It is definitely worth talking to your daughter's consultant again soon though.

I really hope you are able to get good medical advice soon.

Cherry
Epilepsy Action Advice and Information Team

Submitted by Cherry, Epileps... on

Hi my son is 16mths old he had his first seize on 7/12/15 he started shaking (fullbody) was not responsive oxygen levels was low sodium levels low and blood sugar low he was admitted to a&e and had 4 more seizures the doctors gave him some medicine to stop the seizures the first shot didn't work but the second lot did thank god other wise they told me they would of had to put him in a comma for his own safety after 5 days of been in hostpital they noticed he had tonsillitis so they put his seizures down to that on the 23/12/15 my son was playing then started shaking his legs first then his arms and body he went very pale and shallow breathing I took him hostpital he had low oxygen level and low blood sugar but no sign of infection so now they want him to go down the root of having a eeg done I'm very worried over my son as I don't know when they are gonna come im a single mum and don't have no family so it's terrifying when I witness my little boy going through this tonight he has been twiching like his body jerkin is this a little fit ?? Also my son has a big birthmark covering his knee is it true its some times a indecator which is linked to epilepsy ,thank you for reading

Submitted by selina on

Dear Selina
Thank you for your comment.

I appreciate that you are worried about your son. Seeing your son having his seizures will not be pleasant. If you haven’t already you may find it helpful to look at our first aid for seizures. It may help you feel a bit more in control.

Living with an unpredictable situation is not easy. So it’s understandable, you have concerns about your son’s safety. We have information on safety for people with epilepsy that I hope you will find helpful. We also have information on the EEG test that again I hope you will find helpful.

If it would help you to make contact with other parents we have an active presence on social media and we have our online community, forum4e.   

We cannot say if the twitching is epilepsy so it would be best to keep a dairy of anything that concerns you. This information can be very helpful for the doctor when making their diagnosis.

If you become more concerned about your little boys symptoms, it would be best to try contact his doctor. In some situation they my start a child on epilepsy medicine whilst waiting for the tests to be carried out.

The birth mark on his leg will unlikely to be connected to epilepsy.

I hope things improve for you and your son soon.

If we can be of any more help, please feel free to contact the helpline team directly. You either by email helpline@epilepsy.org.uk or phone the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards
Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on