Dr. Greene, my nephew's 2-year-old fell shortly after learning to walk and was unconscious for a short time. She was seen and was found to have mild concussion. Since that time she has bumped her head on a few occasions. When this happens she becomes rigid and unresponsive for about 30 seconds and then goes limp. Shortly thereafter she begins to respond. About 8 weeks ago she began to limp. The limp has progressed to dragging her left foot. Their family doctor suspected some kind of bone disease and has done a full set of X-rays with no findings. She is scheduled for a bone scan. She has no pain and continues to be very active. I think they should be looking at her head rather than her legs. A friend has suggested ongoing, cumulative bleeding on her brain or a scare as the possible source of the problem. They are frantic! Please Help!

These could be seizures. Normally our brains coordinate the intricate affairs of our bodies with an orchestra of electrical impulses. Occasionally this harmonious energy is interrupted by the clash of many brain cells sounding off at once in a disorganized storm of electro-chemical noise. This burst of simultaneous, contradictory signals is called a seizure or convulsion. The seizure impulses override the normal functioning of the brain. Over 3 percent of children will have a seizure before the age of fifteen.

When most people think of seizures, they picture rhythmic jerking movements of the arms and legs. Seizures can look like this image, but can also have many different appearances depending on which brain cells are affected. Often the actual appearance of a seizure is so different from what people expect that the diagnosis of seizure is missed.

Seizures are classified as generalized or partial depending on how much of the brain is involved (International Classification of Epileptic Seizures, 1981). Seizure activity seizes control of normal brain function. Some partial seizures affect areas of the brain that direct movement; others stimulate areas of the brain that perceive reality or that regulate the body's internal functions.

Partial Seizures

Uncontrolled muscle activity is the most common form of partial seizure. This can either be tonic (increased muscle tone) or clonic (rhythmic muscle contractions). Usually this involves the face, neck, or limbs. One classic appearance is the forceful turning of the head and eyes to one side. Sometimes complex movements such as lip-smacking, sucking, or swallowing can occur. These might be confused with the tics of Tourette's syndrome. Sometimes partial seizures can appear somewhat intentional, as when a seizure makes someone pull at clothing or caress an object. A partial seizure in the part of the brain that directs the "flight" response might even send someone running aimlessly.

Sensory seizures are more difficult to detect. An explosion of activity in the auditory centers of the brain might cause someone to suddenly hear things that aren't there. If the seizure is in the back of the head, all manner of visual disturbance might occur, from temporary blindness, to flashes of light, to complex visual hallucinations. Auditory or visual hallucinations might even be misdiagnosed as schizophrenia or some other mental illness.Olfactory seizures, in which people smell aromas that are not present, may be either pleasant or revolting. Gustatory seizures, with bursts of taste sensation, are rare.

Suddenly the world starts to spin out of control, and you are falling. Paroxysmal vertigo is another type of partial seizure. Terror!!! Seizures in primitive reaches of the brain can produce states of absolute fear. Or states of vague anxiety can be partial seizures. Hopelessness :^( Seizures in the limbic system of the brain can produce spasms of depression -- or the sensation of total well-being.

Seizures can thrust vivid memories into consciousness, or distorted, mangled memories. They can create dream-like states, sudden nightmares, and states of unreality or detachment. Partial seizures can slow time to a syrupy pace, or make it seem to rush by in fast-action fury.

Sometimes partial sensory seizures are as subtle as periods of numbness, discomfort, or pain in parts of the body.