Seizures: A Developmental Perspective

Early childhood educators are servicing an increasing number of children with chronic illness such as seizures. With this central nervous system disorder, there are increasing concerns, frustrations, and fears related to medications and long-term implications. This paper examines recent developments in seizure mechanisms and management. In particular, emphasis is directed toward neurodevelopmental sequelae and important genetic/environmental influences. The presence of unusual movements, atypical behaviors, or uncommon reactions in children should alert early childhood specialists to the possibility of a seizure. The acute phase is medically based with a differential assessment, diagnostic tests looking for specific causes, and immediate treatment, if necessary. Once stabilized, long-term issues emerge. The family becomes apprehensive about the future. Was there brain injury? Will there be cognitive, language, or motor difficulties as a result of the seizure? How should developmental specialists address such complex inquiries? Before examining this problem, a few terms should be clarified. A seizure is an episodic, involuntary alteration in consciousness, movement, behaviors, or sensation (Wright et al., 1982). Along the same continuum, epilepsy refers to recurrent nonfebrile seizures. Lastly, a febrile seizure consists of a seizure occurring between 3 months and 5 years of age; it is associated with fever but carries no evidence of an intracranial process or a defined cause (Millichap, 1981). The extent of seizures and their sequelae can be examined epidemiologically. The estimated number of children with seizures, worldwide, is approximately 4 to 5 per thousand with a range from 1.