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Seizures In Healthy Children

by Sue Hubbard, M.D.

I received a phone call from a patient whose 11 year old son had suffered a seizure, which actually occurred while he was playing a video game.

imagesIt is hugely coincidental that I  had just gone to a conference the day before (to get my required CME hours) where we discussed “First Seizures in Otherwise Healthy Children”.  A seizure, as defined from my lecture notes is “ the clinical manifestation of an abnormal excessive excitation and synchronization of a population of cortical neurons”.  In layman’s terms “it is the abnormal and excessive electrical activity within the brain that results in a change in movement, attention or level of awareness”.

About 3% of children under the age of 15 years will have a seizure.  The majority of these will be related to having a fever.  (We have discussed febrile seizures before.) When reviewing data I also found that even the Nintendo website states that 1 /4,000  people may have a seizure brought on by playing video games.  It is more common for children and teens to have a seizure due to a photosensitivity reaction which occurs while playing video games.

The first question that people as is what is the risk of having another seizure? The risk of having a second seizure is reported to be about 40 – 50% and several authors report that the recurrence rate after a second seizure is about 80%. In other words, more than half of the people who have a first seizure may never have another.  Having a second seizure within 6 months of the first is a risk factor for additional recurrences.  Having an abnormal EEG also increases the risk of having another seizure, and those patients with a normal EEG after a first seizure only have a 25% risk of recurrence.

Children who experience a seizure which is thought to be related to playing video games are not “forbidden” from playing video games but should be cautioned to take frequent breaks while playing, every 30 – 60 minutes. (This is another good reason to limit your child’s video game playing.)

It is also recommended that children not sit too closely to the TV and to use a smaller screen TV to play video games, and to have the room well lit.

The question then is this, should you treat a first seizure?  There are  both risks and benefits of treating with anti-epileptic drugs. Although treatment with anti-epileptic drugs does reduce the recurrence rate of another seizure by about 50%, it does not alter the long term prognosis.

In general most pediatric neurologists think that treatment of a first seizure in otherwise healthy children should be deferred until a second seizure has occurred.  This will require educating both the parent and the child about the risk of another seizure, how to handle a seizure and also warnings about bathing or swimming alone.  Close follow up with your pediatrician and a  child neurologist is recommended.

That’s your daily dose for today.  We’ll chat again tomorrow.

Send your question to Dr. Sue!

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2 Responses to “Seizures In Healthy Children”

  1. Konnie Williams says:

    Very Timely –as you well know — information regarding the danger of video game addiction and the consequence is finally reaching national attention. Please continue to update this subject

  2. Kelly says:

    Thanks for putting this article out there. Seizures are scary for parents especially when there don’t seem to be any triggers… i.e. no fever. My daughter had her first one when she was 4 months old. She was not playing video games, obviously nor did she have a high temperature. She had 5 total in a 2 week period and every EEG came back normal. Even so, she was put on anti-epileptic drugs. She stopped eating and was throwing up all the time because the medication upset her tummy. We finally took her off after she fell into the “failure-to-thrive” category and she hasn’t had a seizure since (it’s been 2.5 years)!

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