Re: seizure

Posted By CCF NSG MD /gsh on August 07, 1998 at 09:48:24:

In Reply to: seizure posted by Jan on August 06, 1998 at 13:36:04:






Myranda, 3 years old, has had some episodes that might be seizures.  
The episodes began about one year ago.  I took her our family doctor.  I
explained that Myranda had fallen while playing, bumping the back of
her head.  She cried out then her eyes rolled back and she arched her back.
She lost consciousness and she did not breathe for about 20 seconds.  Her
body did not jerk or tremor, but neither was it limp.  
The doctor said that this was nothing to worry about, just a reaction
having to do with hyperventiliation.  The doctor said to let her know if
Myranda ever has a similar reaction that is not in response to some kind of
trauma.  Myranda has continued to have this response to minor injuries--once
about every six weeks.  So she has had a total of about 8 episodes.  Each
one seems to have gotten a little longer.  
Last Saturday night, Myranda fell off the edge of the bed.  She did
not fall hard, there were blankets and pillows on the floor at the time.  
She did not cry or get up so I ran to check on her.  She was not breathing
and was not responsive, but her eyes were open.  About the time I expected
her to recover, she took a breath; her body jerked; and she stiffened.  
Her eyes bulged out, and she stared out with her eyes wide open.  She wasn't
breathing.  She lost color in her face but there appeared to be a charcoal
colored bruising around her mouth.  This discoloration disappeared when
she started breathing again and regained color.  I checked her airway
to make sure she didn't have popcorn in her throat (she had been eating
popcorn just before she fell) but there was nothing I could find.  The
entire episode lasted about one and a half minutes, I think. It worried me
because this episode was different than the previous ones in that her eyes
did not roll back and it lasted significantly longer.  I was really
frightened that Myranda might not breathe again.  I called our doctor
who said that Myranda needs a neurological evaluation.  
I am sure that Myranda is fine before she falls.  On each occasion, she
has been playing, suffered a minor injury, and then had this "seizure-
type" activity.  When I made the appointment with the neurolgist, the nurse
suggested a "drop seizure" and assumed that Myranda was having a seizure
before the fall and I had not noticed it.  I know that this is not true.  It
always occurs directly after a fall, and I suspect it has to do with the
motion or with breathing changes resulting from the injury.  Myranda also
has mild exercise induced asthema.
I am going to take Myranda to a neurologist next week.  Does this sound
like seizure activity?  Should I give Myranda respirations when this occurs?
Should I call an ambulance?  Does this sound dangerous?  I really don't
want Myranda to have to undergo extensive testing and medication trials
if it is nothing serious.
_____


_____


Dear Jan,
It certainly is possible that your daughter is having seizures, though it
isn't typical that minor trauma would induce them.  You are doing the correct
thing in getting an evaluation by a neurologist.  He or she may choose to order
an EEG and/or an MRI depending on the impressions from the clinic visit.  
Clearly if your daughter has an episode where she is unresponsive, stops breathing
and turns blue you should act appropriately.  Call for help if this occurs,
and begin CPR if necessary.
Good luck.