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Temporal Lobe Seizures In Children

WHAT YOU NEED TO KNOW:

What is a temporal lobe seizure?

A seizure is an abnormal burst of electrical activity in your child's brain. A temporal lobe seizure starts in the temporal lobe of the brain. One temporal lobe is on each side of the brain, near the temples. This part of the brain controls memory, emotions, and language processing. A temporal lobe seizure is called a focal seizure because it starts in one part of your child's brain. The seizure usually lasts 60 to 90 seconds. It may be simple or complex. Simple means your child stays aware of his or her surroundings. Complex means he or she loses awareness. The seizure can become a generalized tonic-clonic (grand mal) seizure. This may cause your child to have convulsions.

What increases my child's risk for temporal lobe seizures?

  • Epilepsy (condition that causes repeated seizures), or a family history of epilepsy
  • A history of febrile seizures (caused by a high fever)
  • A traumatic brain injury or a brain tumor
  • An infection in your child's brain, such as meningitis
  • Scarring in part of your child's brain from a past injury, including birth injuries
  • Problems with blood vessels in your child's brain, or a stroke

What are the signs and symptoms of a temporal lobe seizure?

  • Sudden bursts of anger or aggression
  • An aura (warning sign of a seizure), such as nausea or smelling something that is not real
  • Staring with no awareness of his or her surroundings
  • Not responding when spoken to
  • Lip smacking, chewing, or picking at his or her clothes without knowing he or she is doing it
  • Confusion and speech or behavior problems after a seizure
  • A headache or muscle pain after a seizure

How is a temporal lobe seizure diagnosed?

Your child's healthcare provider will ask about your child's health conditions and medicines. If your child is old enough, have him or her describe how he or she felt before and after the seizure. Include details about the side of your child's body that seemed more affected. Tell the provider how close together the seizures were if your child had more than one. Your healthcare provider will ask for a detailed description of each seizure. If you did not see the seizure, try to bring someone with you who did. Nose wiping is common after a temporal lobe seizure. Your child's provider may ask which hand your child used to wipe his or her nose. That hand will usually be on the opposite side from where the seizure started. Depending on your child's age, he or she may also need any of the following:

  • An EEG records the electrical activity of your child's brain. It is used to find changes in the normal patterns of brain activity. A temporal lobe seizure may not show up on an EEG.
  • CT or MRI pictures may be used to check for abnormal areas. Your child may be given contrast liquid to help his or her brain show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
  • A PET scan is used to see activity in areas of your child's brain. Your child is given radioactive material that helps healthcare providers see the activity better.
  • A SPECT scan uses radioactive material to find where the seizure started in your child's brain. This scan may be done if other scans do not show where the seizure started.

How is a temporal lobe seizure treated?

The goal of treatment is to try to stop your child's seizures completely. Your child may need any of the following:

  • Medicines will help control your child's seizures. Your child may need medicine daily to prevent seizures or during a seizure to stop it. Do not let your child stop taking this medicine unless directed by a healthcare provider.
  • Surgery may help reduce how often your child has seizures if medicine does not help. Ask your child's healthcare provider for more information about surgery.

What can I do to help my child prevent a seizure?

You may not be able to prevent every seizure. The following can help you and your child manage triggers that may make a seizure start:

  • Have your child take antiepileptic medicine every day at the same time. This will also help prevent medicine side effects. Set an alarm to help remind you and your child.
  • Help your child manage stress. Stress can be a trigger for seizures. Exercise can help your child reduce stress. Talk to your child's healthcare provider about exercise that is safe for him or her. Illness can be a form of stress. Offer a variety of healthy foods and plenty of liquids during an illness. Talk to your child's healthcare provider about other ways to manage stress.
  • Set a regular sleep schedule. A lack of sleep can trigger a seizure. Try to have your child go to sleep and wake up at the same times every day. Keep your child's bedroom quiet and dark. Talk to your child's healthcare provider if he or she is having trouble sleeping.

What can I do to help my child manage temporal lobe seizures?

  • Keep a seizure diary. This can help you find your child's triggers and avoid them. Possible triggers include illness, lack of sleep, hormonal changes, lights, and stress. Write down the dates of your child's seizures, where he or she was, and what he or she was doing. Include how your child felt before and after the seizure.
  • Record any auras your child has before a seizure. The aura may happen seconds before a seizure, or up to an hour before. Your child may feel, see, hear, or smell something. Examples include part of your child's body becoming hot. He or she may see a flash of light or hear something. He or she may have anxiety or déjà vu. If your child had an aura, include it in the seizure diary.
  • Ask what safety precautions your child should take. Talk with your adolescent's healthcare provider about driving. Your adolescent may not be able to drive until he or she is seizure-free for a period of time. You will need to check the law where your adolescent lives. Also talk to your child's healthcare provider about swimming and bathing. Your child may drown or develop life-threatening heart or lung damage if he or she has a seizure in water.
  • Have your child carry medical alert identification. Have your child wear medical alert jewelry or carry a card that says he or she had a seizure. Ask your child's healthcare provider where to get these items.
  • Talk to school officials about the seizures. Tell your child's teachers and other school officials what to expect during and after a seizure. Your child may have trouble concentrating or remembering for a few days after a seizure. Work with your child's teachers to make sure he or she does not fall behind in school. Your child may also have behavior problems or mood swings. Help his or her teachers understand how to be patient with your child.

How can others keep my child safe during a seizure?

Give the following instructions to your child's family, friends, babysitters, school officials, and coworkers:

  • Do not panic.
  • Do not hold the child down or put anything in his or her mouth.
  • Gently guide the child to the floor or a soft surface.
    First Aid: Convulsions
  • Place the child on his or her side to help prevent him or her from swallowing saliva or vomit.
    First Aid: Convulsions
  • Protect the child from injury. Remove sharp or hard objects from the area, or cushion the child's head.
  • Loosen the clothing around the child's head and neck.
  • Time how long the seizure lasts. Call 911 if the seizure lasts longer than 5 minutes or if the child has a second seizure.
  • Stay with the child until the seizure ends. Let the child rest until he or she is fully awake.
  • Perform CPR if the child stops breathing or you cannot feel his or her pulse.
  • Do not give the child anything to eat or drink until he or she is fully awake.

Call 911 for any of the following:

  • Your child's seizure lasts longer than 5 minutes.
  • Your child has a second seizure within 24 hours of the first.
  • Your child has trouble breathing after a seizure.
  • Your child has diabetes and has a seizure.
  • Your child has a seizure in water, such as a swimming pool or bathtub.

When should I seek immediate care?

  • Your child is injured during a seizure.

When should I contact my child's healthcare provider?

  • Your child feels he or she is not able to cope with temporal lobe seizures.
  • Your child's seizures start to happen more often.
  • Your child is confused longer than usual after a seizure.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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