Early diagnosis of infantile seizures crucial to brain development

When caring for a baby who is younger than 2 years old, you may focus on the usual development milestones like weight gain and head circumference. However, it may be worthwhile for pediatric specialists and parents to work together to identify if the baby has any neurological disorders.

While it is difficult to recognize seizures in infants, early detection is important. Seizures are secondary to some other problem more often during infancy than at any other time of life.

This is a critical period of brain development, so the consequences are a lot more severe. If a baby's brain can't process information well they may lose a lot in terms of their ultimate development."

Douglas Nordli, Jr., MD, chief of child neurology at the University of Chicago Medicine Comer Children's Hospital

In turn, undiagnosed seizures can lead to future trouble concentrating, remembering and ability to learn. It can even be life-threatening.

About 100 per 100,000 infants will suffer seizures, which may be difficult to recognize, even as an expert or parent.

Some clues to various types of infantile seizures include:

• Random and abrupt pause in activity with the eyes slightly gazing to the side
• Arms or legs moving repeatedly and rhythmically and cannot be stopped
• Repeated spasms
• Sudden tonic posturing -; the forearms are held flexed or extended for several seconds

Generalized convulsing is rarely seen in infants. Instead, focal seizures and epileptic spasms are more common. A spasm can be as subtle as upward eye deviation or brief stiffness in the baby's back. More pronounced signs may include the baby's arms coming up with a slight head nod and their eyes rolling up. While this type of movement may look like the baby is just startled, spasms may occur for five to ten seconds in a cluster for several minutes when the baby first wakes up or is going to sleep. The baby may appear calm or cry in between the spasms and they are likely to occur every day.

Parents who think they have seen these symptoms are encouraged to record the baby during a suspected seizure. However, if the caregiver is confident the baby has had any of these symptoms, it is important to see a specialist as soon as possible.

Experts at the New Onset Seizure Clinic at Comer's Children Hospital have the skill, experience and technology to make a definitive epilepsy diagnosis and identify the appropriate treatment. Comer Children's is a Level 4 Epilepsy Center. The team of specialists may conduct a thorough evaluation using diagnostic testing that may be a combination of tactics from neuroimaging studies to video EEG (VEEG). An MRI can pinpoint structural abnormalities in the brain and an EEG can identify any abnormal activity. With a diagnosis, experts can create a treatment plan. Treatment may start with hormones for infantile spasms and medication for focal epilepsy. If medications do not work, the ketogenic diet or surgery for structural problems may be an option.