Petit mal versus Grand Mal Seizure Activity in Children

Causes

Children who begin to show signs of petit mal (or absence) seizures are experiencing changes in the electrical activity within their brain. There are neurons and synapses that transmit the information across the brain and with a petit mal seizure; this action is traveling back and forth in a three-second pattern instead of completing the action in one fell swoop.

This causes an interruption in the brains activity and therefore an interruption in the child’s behavior. These changes may be very subtle; sometimes it is just like daydreaming or staring into space. Other sign include rapid back and forth eye movement or fluttering of the eyelids, movements of the hands or arms or the child may just stop whatever they are doing for a moment or two. Petit mal seizures last very briefly but they do damage and the child needs to be seen by the neurologist and sometimes medication will be prescribed.

Safety

Rarely will the child fall during a petit mal seizure but you must guard against certain activities such as swimming because in just that short amount of time the risk of drowning is extremely high. Also of a good note is that many children tend to grow out of having the petit mal seizures, however, if as a teenager the seizure activity is still occurring then driving also becomes a high-risk activity.

Physican Appointment Expectations

 

Only your physician can diagnose and evaluate your child. Often electrocardiogram, a picture of the brain wave activity and or an MRI (magnetic resonance imaging) may be given to properly diagnose the problem and again, medication may be prescribed.

Prepare for the physician appointment. Write down any symptoms you have noticed, ask questions such as what precautions to take, is there a generic form of the medication(to help with the cost) how long will your child have to take the medication, what to do if symptoms worsen or what are the side effects to watch for with the medication. Are there printed materials in his or her office that you can take with you to study? Ask a lot of questions and expect to receive in depth answers.  Hold onto your physician until you have all of your questions and worries answered to your specification. Physicians can be very busy, get their attention as long as possible. This is your child and you want the very best.

Last Word

Some of the causes of petit mal seizures are not known, some are genetic, some may be due to a growing brain, which is good because this will increase the chance your child will grow out of the seizure activity altogether! Sometimes it is the synapses that are the cause and the neurotransmitters are firing continuously. Whatever the cause constant vigilance and safety for the child is your main concern. Keep all your physician appointment and be sure to administer the medication, if any, is prescribed exactly as the doctor has ordered and call the physician if any complications occur. Sometimes learning difficulties is the main problem associated with petit mal seizures, as the child cannot pay attention. Sometimes the petit mal seizures will develop into a condition where the seizure activity lasts longer than just a moment or two.

Grand Mal Seizure Activity

Where petit mal seizures occur in isolated neurons in the brain, a grand mal seizure encompasses the electrical activity of the entire surface of the brain. It is a short-circuiting of all of the electrical impulses of the brain and can be very frightening, especially when it is happening to your child. Most grand mal seizures are caused by epilepsy itself, however, sleep deprivation, previous brain injury or trauma, stroke, use or misuse of mediations, even infection can trigger a grand mal seizure. 

Safety

The important thing to remember when you see a grand mal seizure is safety of the person having the seizure. Do not force anything, like a spoon or other object into their mouth. This used to be done in an attempt to keep the airway open however, the tongue cannot be swallowed and while a person may lose consciousness during a seizure, they will keep their airway open. All you have to do is turn them onto their side, put something soft, like a pillow, under their head, and push other objects, like furniture away from the person. This will protect the person and help prevent secondary injury. However, the seizure itself can cause injury, such as broken bones, if the fore of the seizure is too great or the person has repeated seizures.

Anyone who has a grand mal seizure should be seen by a physician immediately. A grand mal seizure is a 911 event in anyone and especially in children. Also, if the seizure activity continues or is repeated without rest periods call 911.

Phases and Treatment

Generally speaking, there are phases to a grand mal seizure. The first is called the tonic phase, where the child falls to the ground then the clonic phase, where the muscles are contracting and loss of movement occurs. This results in a jerking movement and tightening of muscles. Loss of consciousness, bowel and bladder function can occur during this phase. The final phase is called the postictal phase, where the child is awake but may be confused, extremely sleepy, and disoriented. Usually the tonic phase lasts around 10 to 20 seconds, the clonic phase lasts  anywhere from two to ten minutes and the postictal phase may be different every time.

Sometimes only one grand mal seizure will occur; sometimes they come in groups or clusters. Sometimes a grand mal seizure has a pattern and is the same every time. Sometimes there may be a cry just before the child falls to the ground; this is due to air being force out of the lungs by muscles contracting on the trachea.

Again, your child will need to be evaluated by a neurologist and the same tests are done for both petit mal and grand mal seizure activity. These tests are an EEG (electroencephalogram) and a MRI (magnetic resonance imaging) of the brain activity. Your child may need to be on seizure medication such as keppra, Dilantin, lyrica or phenobarbitol. Some of these medications cause extreme fatigue, rash, weight gain. A lot of times the  neurologists may not order any medication if there is only one seizure but this still means there is a need of special care and safety awareness for your child. One thing that is warned against is allowing the child to go swimming alone, as there is a real risk of drowning. For the same reason showers’ may be safer than a tub bath.

Be Your Child’s Advocate

Whether your child is having petit mal or grand mal seizures can only be diagnosed by your physician and usually there will be a neurologist in the care of your child. It is important to keep all physician appointments, take all medications to every appointment and a seizure log will also help the physician in determining the correct course of treatment.

Anyone, including children who are prone to seizures, needs to wear a medical alert bracelet. This will give information about whom to contact and the physician number. Following the advice of your child’s physician is paramount. Alert the physicians to side effects that may be occurring with your child but never stop the medications abruptly or without the doctor giving the OK. Everyone involved in the child’s care needs to be kept informed of all changes, including the last seizure, on a regular basis.

Grand mal seizures can be very frustrating, embarrassing and frightening, especially for a child. It is important that the child be educated as to what they can do if a grand mal seizure occurs. For instance, teach the child about what may occur prior to a seizure, a foul smell, a sense of doom; bright lights are all part of the aura that occurs before some seizure activity.

You are your child’s advocate. Be prepared to ask questions of your physician at all MD appointments, keep good records, including a seizure log, that tells how long each phase lasts and the child’s response following the seizure. On the other hand, other children may be frightened so prepare to teach any of your other children of what is happening and include them in their siblings care. The most comforting thought is that grand mal seizures are not as common in children as petit mal and that there is medication that can control the seizure activity. Continue to be your child’s best advocate, ask questions and follow your physician’s advice in order to give your child the best care they deserve.

 


What is written here does not now nor does it ever take the place of your physician’s advice and services of your physician.


Consult your physician every time for all things medically related and of course, if you feel you have any of the signs or symptoms of what has been written in this hub, please contact your physician for a consultation as soon as possible.


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Comments 22 comments

bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA

Great job! Rated up,of course!Didn't know if you would have time to write one this weekend.I was working on a new one, but scratched it for now ( zero searches per month...ha!)Am about to get another going.


RNMSN profile image

RNMSN 6 years ago from Tucson, Az Author

yes I just entered this one this morning at two in the AM!! only one for the week though...must find another "search" or hopefully two before the week starts as well but all is going well here how is it in the bayou?love to you barbara b


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA

b, everything is great here. School bus will come by Monday, and then I'll do a jig that I'm not teaching this year!Have agood week!


RNMSN profile image

RNMSN 6 years ago from Tucson, Az Author

ha that's so funny here I am dancing a jig that I AM working and you get to stay home and play!! well you just have yourself a good time girlfriend!!!but you know that means you are expected to do at least one article a day!!!haha love bb


aguasilver profile image

aguasilver 6 years ago from Malaga, Spain

My daughter suffered siezures and ended up on Depakin (a local name for Dilantin I presume) which almost turned her into a zombie in 18 months, eventually we found a Dr who had also trained as a naturopath and he got her balanced using specialist alternative treatments, and as we reversed out of the Depakin dosage (25 mg per day less every third day), she returned to some normality.

Finally we found that when we stopped her getting any gluten or hidden msg she stopped fitting.

She has been free for six months now, and needs no medicines, just careful diet and observance, I look forward to her being free for three years, when we can declare she has beaten the epilepsy.

The sad thing is that our specialist neurologist/paediatrician insisted that diet has NOTHING to do with epilepsy.... how many children have been ruined by continued drug usage, when a change of diet and specialist oglio and amino acid treatment would have restored them to health.


RNMSN profile image

RNMSN 6 years ago from Tucson, Az Author

how wonderful that you found a way to help your dtr...how we wish all kids were so easily cured eh? love to you, barbara b


MartieCoetser profile image

MartieCoetser 6 years ago from South Africa

Excellent hub with extremely interesting information. I was eleven when the girl next to me in class had an epileptic attack and thirteen when a teacher got one while opening the door of his classroom. Both these incidents had a deep impact on me. Thanks for the tip not to put something in the mouth, but the turn the person on his side. Now where does the myth come from – that a person can swallow his tongue? This bothered me since I heard it for the 1st time, and I’m still trying to figure it out!


RNMSN profile image

RNMSN 6 years ago from Tucson, Az Author

old nurses tale haha...we used to do it...i am one of those old nurses....poor patients... the things we have learned just since 1976!!!! hello and thank you for the vote up martie!! love to you, barbara b


jasper420 6 years ago

i suffer from epispy and i founed your hub to be usefull true intresting and well said


RNMSN profile image

RNMSN 6 years ago from Tucson, Az Author

thank you Jasper420...I hope you are well controlled with meds and all is well for you...love to you, barbara b


AnnabelleRHC profile image

AnnabelleRHC 5 years ago

Thank you for writing on this all too often when people think of seizures they think of epilepsy and the petite ones are overlooked. It is good to see that other types of seizures are being brought to the publics attention.


RNMSN profile image

RNMSN 5 years ago from Tucson, Az Author

hello Annabelle! You are welcome!! love to you!!! looking forward to reading more of your hubs :) I tweeted your poem to your mom dont know if i told you that :)now are you OK with that cause if I did that to Baby Girl Katie (28 yr but still...) dude would I be serious trouble :)

barbara b


AnnabelleRHC profile image

AnnabelleRHC 5 years ago

I take that as a compliment. Glad you enjoyed.


RNMSN profile image

RNMSN 5 years ago from Tucson, Az Author

:)

it is a compliment! love to you

barbara b


kt 5 years ago

I am reading all I can about seizures, my 12 yr old son had one last week, it scared the crap out of me. He had been having peti mal seizures and I thought he was just day dreaming. He has been put on meds. what im wondering is playing video games for long periods of time a problem for him.



frogyfish profile image

frogyfish 5 years ago from Central United States of America

Good detailed hub with info to practice.


RNMSN profile image

RNMSN 5 years ago from Tucson, Az Author

thank you!! nurse Kratchet to the fore eh?


jhosler profile image

jhosler 5 years ago

Wonderful and informative article.


RNMSN profile image

RNMSN 5 years ago from Tucson, Az Author

thank you jhosler!


kelleyward 4 years ago

Great hub. Glad to find other RN's here. I started out in the child and parent section and moved over here. I am diabetic and interested in many other health issues. I really enjoyed reading your point of view on seizures in children and how to keep them safe. They are very scary experience for parents. Thanks!


RNMSN profile image

RNMSN 4 years ago from Tucson, Az Author

yes and I am glad to find you too Kelly!!thank you for your kind comment!!

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