Shakes and Seizures

Q. My 9 year old daughter has 'shakes' that mostly wake her at night. She also has these shakes when she is awake. They don't happen all the time and I've been unable to see a pattern for when the do happen. Her pupils dilate, her breathing is shallow and rapid and she shakes only on her right side (hand and eye lid) along with her lips and tongue. She is able to answer questions and do things upon request during her 'shakes' but she is unable to tell that she'll have one. I'd like to know what these are and why they have become more pronounced these past 2 years (since her father died, if that could have anything to do with it) and what can be done for them. Forrest, Atascosa, TX

A. When they think of seizures or epilepsy, most people picture a grand mal seizure, in which a child passes out and begins to shake violently all over. Although this type of generalized seizure can often affect children, it is import to keep in mind that there are many different types of seizures.

Many people would assume that what you are describing couldn't be a seizure because your daughter is awake and answers questions, but there are some types of seizures during which a child could remain aware and awake the whole time. These are in fact the most common type of seizures that people have and are called partial seizures.

According to the Epilepsy Foundation, 'virtually any movement, sensory, or emotional symptom can occur as part of a partial seizure, including complex visual or auditory hallucinations.' So a person having a simple partial seizure might have:

• uncontrollable movements
• sudden feelings of fear, anger, or rage
• strange sensations that can affect any sense, simulating smells, tastes, feelings, noises, etc.

Complex partial seizures are easier to recognize as a seizure, since the affected child has a loss of consciousness. They may not always pass out, but during a complex partial seizure a child will not be able to talk or interact with you at all, appearing to be in a trance.

If you think that your child may be having seizures, the next step would likely be to see a Pediatric Neurologist. An EEG might help determine if her episodes with the 'shakes' are seizures or not.

Other Types of Seizures

In addition to the generalized seizures and partial seizures discussed above, children can also have:

• Absence Seizures - which are also called staring spells or petit mal seizures and last for only a few seconds
• Atonic Seizures - with a sudden loss of muscle tone (drop attacks)
• Myoclonic Seizures - causing rapid, brief jerks of a child's muscles, such as their arms, hands, or feet