Have you ever been worried when your child suddenly convulses or loses consciousness? Or does your child stare at you for a moment, unresponsive to your words? It's normal for a parent to feel very scared when they see things like this. Today we are going to talk about epilepsy, or as some call it, a condition that can occur in children. Don't worry, if we are properly informed about this, we can cope with this situation well.
What is epilepsy simply?
Okay, let's first look at what epilepsy is. Simply put, epilepsy is
a condition caused by a temporary electrical disturbance in a child's brain. Our brain cells communicate with each other through small electrical messages. Imagine, suddenly, there is a small problem in this electrical message system, and a lot of electrical messages are being sent out irregularly. That's when
a 'seizure' occurs. Perhaps you have seen someone who has a fit lose consciousness and convulse. However, not all seizures are the same. Some children have a fit when you wait, or they may feel some confusion.
The important thing is that not every time a child has a seizure, it is due to epilepsy . For a doctor to conclude that the child has epilepsy , the child must have had more than one seizure, without any other underlying medical condition. Sometimes doctors call this 'pediatric epilepsy' or ' seizure disorder '.
What are the types of epilepsy in children?
There are different types of epilepsy that children can develop. Let's look at some of the most common types:
- Absence epilepsy: In this, the child suddenly stares at you for a while, seemingly oblivious to the surroundings. When you speak, the child does not respond. It is like watching a movie and then suddenly 'pauses' it. The child returns to normal within a few seconds.
- Rolandic epilepsy (self-limited epilepsy with centrotemporal spikes): This type occurs in about 15% of children with epilepsy. The seizures often occur when going to sleep or waking up in the morning. There may be uncontrollable jerking movements on one side of the body, especially the face and arm. Speech may also be slurred.
- Juvenile myoclonic epilepsy: This is most common during puberty. The arms and legs jerk suddenly, as if they have been electrocuted. This can happen especially when you wake up in the morning.
- Infantile spasms (West syndrome): This is a milder form of epilepsy that affects infants. It occurs when they are going to sleep or waking up. Suddenly, the child's body bends forward, jerks, and the arms and legs stretch out. This fit lasts only a few seconds, but can occur several times in a row, with a short break in between.
- Lennox-Gastaut syndrome (LGS): This is also a more severe type. In this, the child's muscles may suddenly tighten and then relax again. Sometimes they may lose consciousness, become confused, and not respond to speech.
How common is epilepsy among children?
There are over 3 million people with epilepsy in the United States alone, 450,000 of whom are children under the age of 17. So this is not an uncommon disease.
What are the first signs of epilepsy in a child?
The main symptom of epilepsy is a seizure. Before a seizure occurs, you may experience early signs such as:
- Feeling like you are losing awareness of your surroundings.
- Feeling confused.
- You just stare (blank stare).
- Changes in hearing, vision , taste, or smell.
- Feeling uncomfortable, like a stomachache or a change in body temperature.
However, sometimes a fit can come on suddenly without any prior signs.
What are the symptoms a child experiences when having a seizure?
Symptoms that occur during a seizure usually last only a few minutes. The most common symptoms include:
- Loss of consciousness or falling unconscious.
- Uncontrolled muscle twitching, twitching, or continuous movement of a part of the body in the same way.
- Inability to speak, lip smacking, or chewing movements.
- Heart palpitations .
- Rapid breathing .
The nature of a fit can vary from person to person. It doesn't always involve a convulsion. However, many people experience the same or similar symptoms with each fit.
It can be harder to recognize a fit in a young baby than in a slightly older one. Therefore, it is very important for you, the caregiver, to pay close attention to any unusual behavior, how long it has been going on, and to report it to your child's doctor.
After the fit is over, the child
feels tired and confused.You may feel it. You may even lose memory of what happened.
A headache is also common after a fit.
At what age do epilepsy symptoms usually begin?
This varies depending on the type of epilepsy the child has. Some symptoms start in infancy, while others may begin in school-age or adolescence.
What causes epilepsy in children?
As we mentioned earlier, epilepsy is caused by an uncontrolled disorder in the electrical activity of a child's brain. Think about it, electricity travels between brain cells. That's how cells communicate with each other. Sometimes, this electricity becomes irregular, temporarily changing the messages sent between cells. That irregularity is what causes the temporary symptoms of a fit. Once the brain is able to send the right messages again, those symptoms disappear. There are several factors that can contribute to the development of epilepsy:
- Head injury or brain damage.
- Birth injuries.
- An infection (e.g., brain infections such as meningitis or encephalitis).
- An abnormality that occurs during brain development while the baby is in the womb.
- Genetic tendency.
Sometimes, there may be no clear cause for epilepsy. It could also be just a coincidence. This is something that is being researched further.
Who is at higher risk of developing epilepsy?
Your child may be at slightly higher risk of developing epilepsy if they have or have had any of the following:
- Having a family member (biological relative) with epilepsy (genetic predisposition).
- If you have previously suffered a severe head injury.
- If you have had a previous brain infection.
- If you have other nervous system diseases or problems.
What are the complications that can occur due to epilepsy?
Epilepsy can affect a child's
physical and mental health . Common complications include:
- Physical injuries (such as falling during a fit).
- Fear of having another fit.
- Sleep problems.
- Low self-esteem.
- Difficulty concentrating.
- Depression and Anxiety.
During a fit, especially if the child loses consciousness and falls, there is a high risk of injury. If you see signs of a fit,
get the child to a safe place immediately. Lay them down on the floor and
protect them from hard surfaces, sharp objects, heavy objects, or anything that could fall on them. Until the fit is over
Place something soft, such as a blanket or shirt, under the child's head. Hold the child and do not try to stop the convulsions. The fit usually ends in a few minutes. If the fit lasts more than five minutes, ask your doctor what to do. Is epilepsy dangerous for children?
Some types of epilepsy are more severe, and their symptoms can even be life-threatening. Serious complications can include:- Intellectual disability.
- Status epilepticus: This is a condition where seizures occur continuously, or when one seizure occurs without enough time to recover. This is a very dangerous, life-threatening emergency.
- Brain damage or death.
Doctors can treat your child and help control symptoms to prevent these potentially life-threatening complications. As research continues, new treatments may reduce your child's risk. How do you accurately diagnose epilepsy?
A doctor will examine the child and perform certain tests to determine if they have epilepsy. These tests may include:- Physical exam: In this, the doctor obtains information about the child's general health, symptoms, and family medical history.
- Neurological exam: This checks how the child's brain and nervous system are working.
- Blood tests: Blood tests can be done to see if there is another underlying cause for the symptoms.
- Imaging tests: For example, tests such as MRI (Magnetic Resonance Imaging) can provide more information about the functioning of the child's brain.
- Electroencephalogram (EEG): This is a painless test that measures the electrical activity of the child's brain. It is done by attaching small sensors to the head.
These tests can help the doctor understand what is causing the child's seizures and whether there are other medical conditions. It may take some time to reach a definitive conclusion that epilepsy is the cause, and it doesn't happen overnight. What are the treatments for epilepsy?
The following can be used as treatments for childhood epilepsy:- Antiseizure medication: These medications only control the symptoms of epilepsy and reduce the frequency of seizures, they do not cure the cause of epilepsy. These medications help to prevent the irregular electrical activity in the brain, but they only work as long as the medication is in the bloodstream. Therefore, it is extremely important to give your child the medication exactly as prescribed, and on time.
- Surgery:If medication is not effective, doctors may recommend specialized brain surgery to target the cause of the epilepsy.
- Implanted medical devices: When medications are not effective, high-tech medical devices are used to control epilepsy symptoms. The most common devices are the Vagus nerve stimulator or the Deep brain stimulator. These stimulators send electrical currents to specific parts of the brain, regulating the way brain cells function.
- Ketogenic diet: The ketogenic diet may be helpful for some children with difficult-to-control epilepsy. This is a high-fat, low-carbohydrate eating plan. It is best done under the supervision of a medical team.
A treatment that works for one child may not work for another. Therefore, the medical team may have to try several different treatments until they find the one that works best for the child. What should I know as a parent when giving my child epilepsy medication?
If your child is taking medication for epilepsy, you can work with the doctor to make sure they are taking the medication correctly. Be especially careful about these things:- Know exactly when to give the medication (how many times a day, whether to give it with food, etc.).
- Find out what to do if you forget to give your child medicine .
- Find out if blood tests are required for certain medications.
- Be aware of the possible side effects of medications and what to do if they occur.
- Ask your doctor what to do if your child has a fever or is sick . Sometimes a fever can cause a fit.
- Inform the school that your child is taking medication for epilepsy and, if necessary, make arrangements to administer the medication at school.
- Make sure you have a seizure rescue plan in place if you have a seizure at school.
Are there any side effects of the treatment?
Possible side effects vary from one medication to another. However, some antiseizure medications can cause things like:- Drowsiness.
- Changes in the child's liver function or bone marrow function.
- Skin rashes.
- Stomach ache.
- Changes in appetite.
Ask your doctor about the possible side effects of the medicine your child is taking. These side effects may decrease over time as your child's body adjusts to the medicine. If your child has side effects, talk to your medical team to make sure the medicine is right for them.Can childhood epilepsy be prevented?
There is no way to prevent all causes of epilepsy. However, you can help your child reduce their risk of developing epilepsy by preventing head injuries . For example, by having your child wear protective gear when playing. If you are pregnant, you can try to prevent birth injuries by getting the necessary medical care before your baby is born. However, no matter how careful you are, head injuries can still happen. What is the outlook for a child with epilepsy?
The prognosis will vary depending on the type of epilepsy your child has and the frequency of seizures, so talk to your child's doctor about this. Early diagnosis and treatment are key to achieving the best outcomes. Rarely, some seizures can be life-threatening and can even lead to unexpected death. Does childhood epilepsy go away as we grow older?
More than 60% of children outgrow their epilepsy before reaching adulthood. Others may have to live with and manage the condition for the rest of their lives. Some types of epilepsy are more likely to outgrow their epilepsy than others. Can a child with epilepsy live a normal life?
Many children with epilepsy can live normal, unaffected lives like other children their age. About 70% of children diagnosed with epilepsy do not have any significant changes in their development or daily activities. The only difference may be that they need to take medication regularly. However, it is common for children diagnosed with epilepsy to feel frustrated, embarrassed, and isolated . This is because they may feel that their condition makes them look bad to others. Epilepsy can cause low self-esteem, depression, and anxiety . Therefore, many children find great relief from talking to a mental health counselor about their child's mental well-being. Also, the love and support they receive from their parents, caregivers, and medical team are very important in coping with the complications of this condition. Will the Keto diet help my child with epilepsy?
Some children have found that making dietary changes to control their epilepsy symptoms can help. The ketogenic diet (or Keto diet) is a high-fat, low-carbohydrate diet. Your doctor may recommend this eating plan for your child. It is thought to change the way your child's brain uses and uses energy. Your doctor will tell you if you need to make any changes to your child's diet. How do I keep my child with epilepsy safe?
As a caregiver for a child with epilepsy, it's normal to worry about your child's safety if they suddenly have a seizure. There are many things you can do to protect your child that are also helpful for children without epilepsy. If your child's seizures are well-controlled, most activities are safe for your child. However, your doctor will tell you if certain sports or activities are safe for your child. Keep these things in mind when caring for your child:- Wear safety gear when playing and sporting activities. For example, wear a helmet when riding a bike.
- Make sure there is someone watching over the child while they are playing, exercising, or engaging in other activities. Caregivers should be aware of the child's medical condition and know what to do if they have a fit.
- If your young child has a seizure, ask your doctor before letting them drive. Driving recommendations vary by country/state.
- Do not let your child sleep on the top bunk of a bunk bed. Be aware of other risks associated with heights (e.g., rock climbing, tree climbing).
Things to be especially careful about when working with water, such as when bathing (Water safety tips)
If you are caring for a child with epilepsy, remember these safety tips regarding water:- Leave the bathroom doors unlocked. Make it clear to the rest of the family that your child needs privacy in the bathroom.
- Supervise your child whenever he or she is near water, whether at home or outdoors. This includes things like the bathtub or a backyard swimming pool.
- Do not send a child with epilepsy to bathe or swim alone.
- Check if the bathtub drain is working properly.
- Keep the water level in the tub low.
- Keep the water temperature low (to prevent skin burns).
- For older children , install a shower or tub seat. It's best if the seat has a safety strap.
- Keep all electrical appliances away from the sink or bathtub.
If your child has a seizure while swimming , take them out of the water as soon as possible and check for breathing and a pulse. If something seems wrong, call a doctor or emergency services immediately. At what time do you need to see a doctor?
See a doctor if your child has any of the following:- If the frequency of the fit increases.
- If the medication that prevents the fit causes side effects.
- If you are experiencing symptoms such as depression or anxiety.
- If you are late in reaching developmental milestones appropriate for your age.
To an Emergency Treatment Unit (ETU)When do you want to go?
If your child experiences any of these symptoms, call 911 (or your local emergency number) or take them to an emergency room immediately:- If you have a fit for the first time in your life.
- If you get injured during a fit.
- If the fit lasts more than five minutes.
- If another fit comes before the first one is healed.
- If you remain unconscious for more than 10-15 minutes after the seizure stops.
- If it takes more than 30 minutes to recover from a fit.
Status epilepticus is a dangerous condition. It means that a child has a seizure for a long time, or when they go from one seizure to another without having time to recover properly. This is a life-threatening emergency, so immediate medical attention is needed. For persistent seizures, special "rescue medications" can be given by caregivers, such as parents or teachers (either rectally or as a nasal spray). Ask your doctor if it is appropriate for your child to have these types of rescue medications on hand. What are the important questions to ask the doctor?
- What type of epilepsy does my child have?
- What signs should I look out for?
- What are the side effects of the treatment?
- Does my child need surgery?
- What should I do if I have a fit?
- How do I inform the school about my child's condition?
- Can my child play sports?
Final Take-Home Message
Caring for a child is challenging enough, but caring for a child with epilepsy can be even more challenging. It's normal to feel frustrated, confused, and anxious about what your child is going through. Don't be afraid. Your child's doctors will work together to help you understand the condition and guide you on how to help your child as they grow. Contact your medical team if you have any questions about your child's diagnosis, or if you notice any side effects, new symptoms, or worsening symptoms.
Research continues to help children with epilepsy live happy, fulfilling childhoods without major disruption to their daily lives. You are not alone, get the help you need.
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