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Re: Is this a seizure?

Posted By HFHS.M.D.-HSW on November 08, 1998 at 16:12:54:

In Reply to: Is this a seizure? posted by Dana on November 07, 1998 at 22:37:34:

I am trying to find out about something scary
that has been happening to my nephew. I hope
this is an appropriate place to post this.
He is ten months old and has been having some
kind of seizure. When he gets startled by some-
thing his eyes roll back in his head for a few
seconds. His parents are very concerned because
he has had minor health problems since birth
(minor colds, infections, etc.).
They are waiting to hear the results from an
EKG (maybe it was an EEG?) that was done last
I'm not sure if this is related but he is not
crawling yet although he seems to be bright and
happy. His grandparents noticed some irregular
shape on the back of his head; we are not sure if
they have always been there.
If you have any ideas, please let us know.
Dear Dana
It is encouraging to learn that your nephew's development appears to be within the broad range of normal and that he is continuing to demonstrate new capacities. I presume he gets to sitting position and sits without support, supports weight on his legs, uses his hands to pick up small objects, transfers such objects readily between his hands and to his mouth, and has a few recognizable sounds like ma-ma or da-da although they may not be used appropriately yet.
Your nephew's pediatrician should be able to explain the shape of the head. I have a hunch that normal bony prominences will be the explanation.  
Hypersensitivity to sudden stimuli does occur among children who have rare degenerative disorders of the nervous system. Arching of the back and other bizarre movements occur in response. However, such children lose gains they have made in development. Your nephew is still making developmental progress.
Seizures are not usually provoked by sudden sounds or movements although there is a form of startle epilepsy. From your note I cannot tell if he immediately returns to normal after these spells. If so, they are not likely to represent seizures.
There does exist a condition called hyperexplexia or genetic startle disease. Generally, much more of the body is involved in the response and falls often occur. There should be a history of others in your family with such behavior.
5% of infants and young children have breath-holding spells. Pallid breath-holding spells (infant or toddler turns pale) are provoked by startling. In pallid breath-holding spells, the breath-holding itself may not be evident. However, consciousness is briefly lost in both types of breath-holding spell.
An electroencephalogram may be useful in sorting this out, although I doubt from your description a seizure is the explanation of your nephew's behavior.
I hope this information will be useful to you and your family. It is provided for educational purposes only.
KEYWORDS: seizure, hyperexplexia, breath-holding spell

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