Seizure vs. Reflex: Identifying Infantile Epilepsy

Seizure vs. Reflex: Identifying Infantile Epilepsy

Infantile epilepsy is a condition that can go undiagnosed until the seizures have already had a devastating impact on the development of a baby’s brain. Positive outcomes are dependent on rapid diagnosis and treatment. So, why are these seizures so devastating and why are they so often overlooked?

Listen to Dr. Sarah Weatherspoon, Director of Le Bonheur's Infantile Epilepsy Center, discuss this condition in the Peds Pod, a podcast by Le Bonheur Children's Hospital.

Seizure or Reflex?

Infantile epilepsy consists of seizures that occur during the first year of life. One of the most devastating forms of infantile epilepsy is infantile spasms.

Unfortunately, infantile spasms are often overlooked as a simple reflex. Babies are born with a reflex called a “Moro reflex.” This is a natural reaction to stimuli where a baby makes involuntary movements when startled. This reflex starts to go away around 3 to 4 months old. Infantile spasms can look similar, but typically begin around 4 to 9 months old – the time when the Moro reflex is naturally going away.

Symptoms of Infantile Epilepsy

If your child is experiencing any of the symptoms below, it is important to take them to a pediatrician quickly. The sooner a child having infantile spasms is treated, the better their developmental outcomes.

Signs of infantile spasms:

  • Small movements – forward crunch of the body, outward movement of the arms
  • Last only one to two seconds
  • Occur repeatedly in a short time frame
  • Happen mainly when awake
  • Do not occur as a reaction to stimuli (unlike Moro reflex)

Although infantile spasms do not appear to be bad from the outside, the longer they go untreated, the more negative the impact on their development and the greater the risk of having more devastating types of seizures.

Diagnosis

When it comes to getting an accurate diagnosis for your child, parents should trust their instincts. Even if your pediatrician doesn’t suspect infantile spasms and seizures, if you are still concerned about your child’s health, you should arrange for your child to be evaluated by a pediatric neurologist as quickly as possible.

The easiest method of diagnosis is an electroencephalogram (EEG), a brain wave test – that will often show abnormalities if your child has infantile epilepsy. Other imaging and genetic tests help to identify what kind of seizures a child is having and help the neurologist decide what treatment is best.

Treatment and Outcomes

Treatment for infantile spasms is well-established but different from treating other types of epilepsy. The current best treatment is combination therapy of ACTH, a hormone given as an injection, and vigabatrin. Taken together they can stop infantile spasms in their tracks.

It is crucial that treatment is initiated as quickly as possible. For the best outcomes, treatment should begin within a month of spasms starting – ideally within one week. The longer spasms go untreated, the greater the impact on development.

If you have any concerns that your child has infantile epilepsy such as infantile spasms, Le Bonheur’s Infantile Epilepsy Center has the tools for diagnosis and rapid treatment. Learn more at https://www.lebonheur.org/our-services/neuroscience-institute/infantile-epilepsy-center/.

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