Epilepsy is a neurological condition (affecting the brain and nervous system) where a person has a tendency to have recurrent seizures that start in the brain without acute provocation. The brain is made up of millions of nerve cells that use electrical signals to control the body’s functions, senses and thoughts. If electric signals are disrupted, the person may have an epileptic seizure (sometimes called a ‘fit’ or ‘attack’).
Below are some of the common questions that arise about childhood epileptic seizures:
Are all Seizures Epileptic?
No. Not all seizures are epileptic. Other conditions that can look like epilepsy include fainting (syncope) due to a drop in blood pressure, and febrile seizures due to a sudden rise in body temperature when a young child is ill. These are not epileptic seizures because they are not caused by disrupted brain activity.
What Are Types of Seizures?
There are two main types of seizure: focal seizures and generalized seizures. Focal seizures affect only one side of the brain and generalized seizures affect both sides of the brain.
Generally, adults and children have the same types of seizure, although some may be more common in childhood than adulthood. For example, absence seizures which can be very brief and are often mistaken for 'daydreaming' or not paying attention.
During seizures following things may be noted:
- Jerking of the body
- Stiffening of the body
- Repetitive movements
- Staring spells
- Strange taste in the mouth
- Strange smell
- Rising feeling in the stomach
- Fall or drops
In some types of seizure, a child may be aware of what is happening. In other types, a child will be unconscious and have no memory of the seizure afterwards.
Some children may have seizures when they are sleeping (sometimes called 'asleep' or 'nocturnal' seizures). Seizures during sleep can affect sleep patterns and may leave a child feeling tired and confused the next day.
Why Does My Child Have Epilepsy?
Some children develop epilepsy as a result of their brain being injured in some way. This could be due to a severe head injury, difficulties at birth, or an infection which affects the brain such as meningitis. Epilepsy with a known structural cause like this is called structural epilepsy.
For some children, their epilepsy has a genetic cause. This may be inherited from one or both parents or it may be a change that happened in the child's genes (before they were born). Epilepsy with a likely genetic cause is called as genetic epilepsy.
Sometimes no cause is found then this is called as unknown epilepsy. Everyone has a level of resistance to seizures called a seizure threshold. This is included in the genes passed from parent to child. A child with a low seizure threshold may start having seizures for no obvious reason. However, having a low seizure threshold doesn't always mean that seizures will start.
Other children in the family may have a similar seizure threshold but may not develop epilepsy.
How Is Epilepsy Diagnosed?
Epilepsy is a clinical diagnosis. A diagnosis of epilepsy may be considered if your child has had more than one seizure. You and your child (if they can) may be asked to describe in detail what happened before, during and after the seizure. Having a video recording of the seizure can help us understand what is happening.
A few tests can be suggested to help with the diagnosis. The tests alone cannot confirm or rule out epilepsy, but they can give extra information to help find out why your child is having seizures. Those tests include electroencephalogram (EEG) and brain imaging like MRI. An EEG test is painless, and it records the electrical activity of the brain.
What Is a Childhood Epilepsy Syndrome?
If your child is diagnosed with a childhood epilepsy syndrome this means their seizures have specific characteristics. These can include the type of seizure or seizures they have, the age when the seizures started and the specific results of EEG and the child’s neuro-developmental profile.
Syndromes follow a particular pattern, which means that the child neurologist may be able to predict how your child's condition will progress. Syndromes can vary greatly. Some are called 'benign' which means they will have a good outcome and usually go away once the child reaches a certain age. Other syndromes are severe and difficult to treat. Some may include other disabilities and may affect a child's development.
Treatment for Children
Anti-epileptic Drugs (AED’s)
Most people with epilepsy take anti-epileptic drugs to control their seizures. The child neurologist can discuss with you whether AEDs are the best option for your child. Although AEDs aim to stop seizures from happening, they do not stop seizures while they are happening, and they do not cure epilepsy.
Most children stop having seizures once they are on AEDs that suit them. Like all drugs, AEDs can cause side effects for some children. Some side effects go away as the body gets used to the medication, or if the dose is adjusted. If you are concerned about your child taking AEDs you can talk to the doctor. Changing or stopping your child's medication without first talking to the doctor can cause seizures to start again or make seizures worse.
Although AEDs work well for many children, this doesn’t happen for every child. If AEDs don’t help your child, the child neurologist may consider other ways to treat their epilepsy.
For some children who still have seizures even though they have tried AEDs, the ketogenic diet may help to reduce the number or severity of their seizures. The diet is a medical treatment, often started alongside AEDs and is supervised by trained child neurologist and dietitians.
This involves removing or separating a part of the brain to stop or reduce the number of seizures a child has. It may be possible for some children to have surgery depending on the type of epilepsy they have and where in the brain their seizures start.
Will Epilepsy Affect My Child's Life?
As a parent, you may not be able to predict how epilepsy will affect your child’s life. However, helping your child to manage their seizures and be open about their feelings can make a positive difference.
What Are the Triggers for Seizures?
There can be triggers such as stress, excitement, boredom, missed medication or lack of sleep. Keeping a diary of their seizures can help to see if there are any patterns to when seizures happen. If you can recognize triggers, avoiding them as far as possible may help to reduce the number of seizures your child has. Getting enough sleep, and well-balanced meals, will help keep your child healthy and may help to reduce their seizures.
What to Do with Immunization (Vaccination) of My Child?
Some parents are nervous about immunization, whether or not their child has epilepsy. It is recommended that every child is immunized against infectious diseases. This includes children who have epilepsy. If you are concerned about immunizations, a doctor can give you more information.
Will Epilepsy Affect My Child’s Behaviour?
It depends on every child. For some children, having epilepsy and taking AEDs will not affect their behaviour. However, some people may notice a change in their child’s mood or behaviour such as becoming irritable or withdrawn. Some children may be responding to how they feel about having epilepsy and how it affects them.
They may also want to be treated the same as their siblings or friends and to feel that having epilepsy isn’t holding them back. Encouraging your child to talk about epilepsy may help them feel better. Behaviour changes and problems can happen for all children regardless of having epilepsy and for many, may just be part of growing up. In a few children, irritable or hyperactive behaviour may be a side effect of AEDs.
If you have concerns about changes in your child’s behaviour, you may want to talk to the doctor
What Can I Do for The Leisure Activities of My Child?
Most children with epilepsy can take part in the same activities as other children. Simple measures can help make activities such as swimming and cycling safer. For example, making sure there is someone with your child who knows how to help if a seizure happens.
Can Epilepsy Change as Children Get Older?
Seizures may change over time, either in type or frequency. Some children outgrow their epilepsy by their mid to late teens. This is called 'spontaneous remission'. If they are taking AEDs and have been seizure-free for over two years, child neurologist may suggest slowly stopping medication.
How Might My Child Feel?
Having epilepsy can affect a child in different ways. Depending on their age and the type of seizures your child has, the impact may vary.
For some children having a diagnosis of epilepsy will not affect their day-to-day lives. For others it may be frightening or difficult to understand. They may feel embarrassed, isolated or different in front of their peers. Encouraging your child to talk about their concerns may help them to feel more positive.
Most children with epilepsy will have the same hopes and dreams as other children and seizures may not necessarily prevent them from reaching their goals.
Your Feelings as A Parent
If your child is diagnosed with epilepsy you may have mixed emotions - for your child and for yourself. It can take time to come to terms with a diagnosis and how it may affect family life. You may feel worried or relieved. How you feel about the diagnosis may also change over time.
Surya group of hospitals are a pioneer in modern healthcare services for women and children since 1985. We offer cutting-edge facilities along with a staff that’s highly acclaimed in their field. To book an appointment and know more about childhood epilepsy, call our helpline on 022-61538989.
Dr. Torne has completed her Fellowship in Paediatric Neurology and Epilepsy from Maharashtra University Health Sciences at Lokmanya Tilak Municipal Hospital and Lokmanya Tilak Municipal Medical College, Mumbai. She has presented many national and international papers in Cambridge, Birmingham, Italy, France and Hungary and served as a Chief Guest in World Congress of Anatomist held in Gadag Institute of Medical Sciences in Karnataka.