Mount Sinai Health System Hospital Campuses: Beth Israel Medical Center • Beth Israel Brooklyn • The Mount Sinai Hospital
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Pediatric Epilepsy Center
Epilepsy Surgery Program
Developmental Disabilities Center (DDC)
Pediatric Epilepsy Center
Seizures and First Aid
What is a Seizure?
What are the Different Kinds of Seizures?
Partial seizures occur when the abnormal electrical discharges occur in only one part of the brain, and usually start with one part of the body jerking or twitching. Partial seizures are called complex if there is some impairment of consciousness. They are called simple if there is no impairment of consciousness.
Do Seizures Cause Brain Damage?
Does Brain Damage Cause a Seizure?
Seizures are more common in children who had bleeding in their brains at birth or who have cerebral palsy or tumors, or who are mentally retarded.
Can my Child Die from a Seizure?
Why Do Children Get Seizures?
Most cases of childhood seizures are idiopathic, that is, we don’t know why they occur. Idiopathic seizures have the best long-term prognosis, both in term of cure and in terms of the absence of long-term complications.
What Do I Do When My Child Has a Seizure?
How Do I Stop the Seizures?
If the Diastat Accudial does not stop the seizures, the child should be taken to the emergency room and the neurology team called by the parent and the emergency room personnel.
How Do I Stop the Seizures from Occurring?
What Blood Tests Will Be Done?
Can a Patient with Seizures Drive a Car?
Can a Patient with Seizure Drink Alcohol?
What Records Should I Keep?
Different Types of Seizures
Clinically, these absence seizures look like staring spells and may be very brief, only lasting a few seconds. Grand mal, or generalized tonic-clonic seizures, are what everyone thinks of as seizures -- a person stiff and jerking, often associated with incontinence, drooling, change in color. Again, both types occur when abnormal electrical discharges occur in the whole brain. Myoclonic seizures are another type of generalized seizures: they are jerking movements. Atonic seizures are drop attacks, when a person suddenly loses tone and falls to the ground.
Landau Kleffner Syndrome (LKS)Landau Kleffner Syndrome (LKS) is a rare form of epilepsy that only affects children, and causes them to lose their understanding of language. The main epileptic activity happens during sleep and is usually not obvious to others. It can be seen on brain wave recordings or EEGs. There may, however, also be visible seizures at night or during the day. As the condition is not well known and has complex effects on language and often also on behavior, it can take some time before the whole picture is recognized by both parents and professionals and it may take some time before LKS is diagnosed.
What Happens to the Child with LKS?
In most cases, the child has normal early development, including normal development of speech and language. Onset of LKS is usually between three and nine years and the child experiences deterioration in speech and language ability. This loss may be abrupt or gradual over a period of weeks or months and may be mistaken initially for deafness. Many children compensate naturally for the loss of language by using visual cues and gestures, and may initially hide the extent of their disability. The deterioration in skills is often called a regression, as the child seems to have returned to an earlier stage in their development.
There are often associated behavioral changes, including over-activity, reduced concentration span, irritability, tantrums and difficulties with social interaction. The child may also have problems with fine motor coordination and movement. These difficulties are thought to be a direct result of the disease and not simply an emotional reaction by the child to the loss of language. Some children have seizures and these may start before the initial regression.
The course of the illness is variable and not usually life-threatening, but it may significantly affect the child's functioning. Some children recover spontaneously but many require treatment with anti-epileptic medications or steroids. Recovery may be complete, but more often children are left with some degree of persistent difficulties with language, behavior or cognitive skills. The active phase often lasts years, until adolescence. During the active phase, children may experience repeated episodes of regression and recovery. The child's understanding and performance may be highly variable even within the same day. This may be related, in some children, to the treatment with corticosteroids and attempts to wean them.
A British charity, Friends of Landau Kleffner Syndrome, hosts a Website that provides information about LKS and related disorders.
Infantile SpasmsInfantile spasms are a severe form of epilepsy that usually begins in infancy. It is characterized by head drops with associated outstretched arms. (These spasms have also been described as nodding, salaam seizures, and jackknife seizures.) They occur suddenly, often when the child is startled or just falling asleep. Sometimes the baby cries afterward and appears to be upset. However, they are not always associated with noises. They can occur very frequently -- up to clusters of 10 or more in a few minutes. Infantile spasms usually begin in infancy, when the baby is 4 to 8 months old. The diagnosis is made based on the clinical description of the seizures, as well as by an EEG (test of the brain waves) that shows an abnormal pattern called hypsarrythmia.
Other events can imitate spasms. These include reflux (a kind of spitting up), tonic movements that occur in children with cerebral palsy, and increased reflexes.
Infantile spasms are usually diagnosed after a video EEG that shows the abnormal hypsarrythmia pattern. Treatment most often consists of (most often) injections of adrenocorticotropic hormone and/or other antiepileptic medications, most commonly topiramate or vigabatrin
The inpatient unit of the Beth Israel Comprehensive Pediatric Epilepsy Program is located in its own wing at Beth Israel Medical Center. It is a state-of-the-art six-bed unit, with its own nurse’s station, dedicated solely to the care of children with epilepsy.
There are two private and two double rooms, a playroom and a family room. Wireless Internet access is available. Each child has his or her own DVD player, CD player and video game system. Two children can be monitored in the playroom, which contains two video EEG hookups.
The family room has Internet access, television, books and cooking facilities, as well as comfortable couches and chairs. The Child Life staff and music therapists are available to comfort and play with all the children. Crafts, games, books, movies and toys, as well as a big-screen TV are located in the playroom.
If your child is being admitted to the Epilepsy Monitoring Unit (EMU), you should both watch the video on epilepsy monitoring. Copies of the video are available in the playroom. It will give you and your child a very clear understanding of what will happen during your stay.
In order to determine whether there is seizure activity, each child has electrodes glued to his or her head with a sticky substance called collidon. This procedure takes about an hour and a half. We recommend that you bring a button down shirt for your child to wear during this procedure, as it is sometimes difficult to get clothes on and off with the electrodes in place.
The procedure is not painful but it sometimes seems long to the children and the collodion has a very pungent odor. The children must remain relatively still during this procedure. For these reasons, we made a video machine or music available for your child to help pass the time. If your child would like a different activity, such as coloring or a puzzle, please let the staff know.
The electrodes will remain on for a period of time decided by the neurology team.
There are doctors, nurses, nurse practitioners, residents, and EEG technicians in the EMU. During your stay in the EMU, your child may have a seizure. If this occurs, please press the event button connected to the electrodes and pouch. There is also a microphone above the bed. Please talk into it when the seizure occurs. For example, say “I think I am seeing a seizure,” or “My child is staring now,” or anything else that might be helpful to the doctors in the evaluation process.
You will also be given a paper called the seizure record. Fill in as
much of this form as possible if a seizure occurs.
Beth Israel Pediatrics is located on the 6th floor of the Dazian Pavilion. To get there, enter through the Emergency Room entrance on 16th street between 1st Avenue and Stuyvesant Park.
In order to maintain a restful environment, a maximum of two visitors (including parents) is allowed in the patient's room. Additional visitors can wait either in the family lounge or in the lobby on the 1st floor.
As part of our family-centered care, we welcome one parent or legal guardian to sleep overnight at the bedside with each patient. Given the limited space, we cannot accommodate a second parent or guardian overnight, although they are welcome to continue to visit after visiting hours.
Babies do not have fully developed immune systems and get an infection very easily. For this reason, babies under the age of twelve months are not permitted on the pediatrics floor.
For the health of our patients, sick children may not visit.
Visitors are welcome to eat and drink in the family room, but food and beverages are not permitted in the patient's room.
Visiting children are permitted in the family lounge and the playroom when accompanied and supervised by an adult family member.
The playroom is considered a safe haven for children on the 6th floor. It is a place where children are free to make choices and where no medical procedures occur.
Staff and volunteers can assist your child in finding age-appropriate activities, which help to alleviate much of the stress and fear children often feel when they are in the hospital.
We have a large supply of games, crafts, and toys that can be brought to your child’s room. Our staff will help determine activities based on your child’s interests.
There is a recliner-rocker and a love seat that also reclines for any parent who needs to take a break. Among the amenities in this room are a flat screen TV, computer, fax, microwave, refrigerator, computer, and coffee pot. We also provide a kosher refrigerator.
Videos and Video Games
We also have a computer in the playroom so children can play computer games. All games and systems must be signed out. For the popular systems, only two games can be loaned to a child at one time.
The Louis and Lucille Armstrong Music Therapy Program
Upon referral, the therapists can see your child individually, or in a group with other patients. The therapy team also accompanies children to procedures.
Each Wednesday at 11 am, a Community Jam Session takes place in the play room. This is a special music gathering for patients, families, and staff and all are welcome.
Videotapes, Audiotapes, and Books
Each bedside also has a CD player. Music cassettes and videos are available for the children’s use, free of charge. They must be signed out.
Children’s books are available in the family lounge.
The Milton and Carroll Petrie Division of Beth Israel Medical Center is located at First Avenue and 16th Street.
Directions by car
There is limited meter parking and a limited number of parking spaces at the Beth Israel Garage just off 1st Avenue. The garage is open 24 hours a day, seven days a week.
Directions by Subway
Directions by Bus
Hotel and Housing Accommodations
Conway, Jr., MD, Chairman of Pediatrics, (212) 844-1333
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