A lot of people ask me about seizures and I found this info to be helpful. I want to write about things Hannah deals with to help them understand more about her. This is the first one.
joan
Info taken from
http://kidshealth.org/parent/medical/brain/epilepsy.html#
Seizures and Epilepsy
If you have a child with epilepsy, you're not alone — 2.5 million Americans have this disorder.
Anyone can get epilepsy at any age, but the majority of new diagnoses
are in kids. About two-thirds of all kids with epilepsy outgrow the
seizures that accompany it by the time they're teens.
About Epilepsy
Epilepsy is a disease of the central nervous system in which electrical signals of the
brain to misfire. These disruptions cause temporary communication problems between nerve cells, leading to
seizures.
A seizure can be thought of as an "electrical storm" that causes the
brain to do things that the person having the seizure doesn't intend.
Having a single or sometimes even several seizures is not necessarily
considered epilepsy. Kids with epilepsy are prone to having multiple
seizures over a fairly long period of time (months to years).
Epilepsy:
- is not the only cause of childhood seizures
- is not a mental illness
- does not necessarily affect intelligence
- is not contagious
- does not typically worsen over time
Causes of Epilepsy
In less than half the cases of epilepsy, there is a specific identifiable brain problem that causes the seizures. These include:
- infectious illness (such as meningitis or encephalitis)
- brain malformation during pregnancy
- trauma to the brain (including lack of oxygen) due to an accident before, during, or after birth or later in childhood
- underlying metabolic disorders (chemical imbalances in the brain)
- brain tumors
- blood vessel malformation
- strokes
- chromosome disorders
In kids, more than half of epilepsy cases are
idiopathic
(meaning there's no other identifiable cause or visible problem in the
brain). In most of these, there's a family history of epilepsy or the
condition is believed to be genetic (kids with a parent or other close
family member with epilepsy are more likely to have it, too).
Researchers are working to determine what specific genetic factors are
responsible for these forms of epilepsy.
Understanding Seizures
Seizures vary in severity, frequency, duration (from a few seconds to
several minutes), and in their appearance. There are many different
kinds of seizures, and what occurs during one depends on where in the
brain the electrical signals are disrupted.
The two main categories of seizures are
generalized seizures, which affect the whole brain all at once, and
partial seizures,
in which only part of the brain is mostly affected. Some people with
epilepsy experience both kinds. Also, the electrical problem in a
partial seizure can spread to cause a generalized seizure.
Seizures can be scary — a child may lose consciousness or jerk or
thrash violently and may appear to stop breathing or have difficulty
breathing. Milder seizures may leave a child momentarily confused or
unaware of his or her surroundings. Some seizures are so brief and minor
that only careful observation or an experienced eye will detect them — a
child may simply blink or stare into space for a moment before resuming
normal activity. Even in those cases, it is usually obvious to parents
that a child is having episodes of concern.
After seizures that last more than 30 seconds, most kids are
exhausted, tired, sleepy, disoriented, confused, or even combative and
agitated for minutes to hours. This is known as the
postictal phase.
During a seizure, it's very important to stay calm and keep your child safe. Be sure to:
- Lay your child down away from furniture, stairs, radiators, or other hard or sharp objects.
- Put something soft under his or her head.
- Turn your child on his or her right side so fluid in the mouth can come out.
- Never stick anything in your child's mouth or try to restrain him or her.
Do your best to note how often the seizures take place, what happens
during them, and how long they last and report this to your doctor. Once
a seizure is over, watch your child for signs of confusion or the
postictal phase. He or she may want to sleep and you should allow that.
Do not give extra medication unless the doctor has prescribed it.
Kids who experience partial seizures may be frightened or confused
during or after the seizure. Offer plenty of comfort and reassure your
child that you're there and everything is OK.
Most seizures are not life threatening, but if one lasts longer than 5
minutes or your child seems to have trouble breathing afterward, call
911 for immediate medical attention.
Diagnosis
Talk to your doctor if your child has seizures, staring spells,
confusion spells, shaking spells, or unexplained deterioration in
behavior or school performance. The doctor can refer you to a pediatric
neurologist, who will take a patient medical history and examine your
child, looking for findings that suggest problems with the brain or with
the rest of the neurological system.
If the doctor suspects epilepsy, tests will be ordered, which may include:
- an electroencephalogram (EEG),
which measures electrical activity of the brain via harmless sensors
secured to the scalp while the child lays on a bed. Usually the doctor
will ask that a child be sleep-deprived (put to bed late and awakened
early) before this painless test, which typically takes about 1 hour.
- a magnetic resonance imaging (MRI) test or a computerized tomography
(CAT) scan of the brain, both of which look at images of the brain
Treating Epilepsy
Your doctor will use the test and exam results to determine the best
form of treatment. Medication to prevent seizures is usually the first
type of treatment prescribed for epilepsy management. Most kids are
successfully treated with one medication — and if the first doesn't
work, the doctor will usually try a second or even a third before
resorting to combinations of medications.
No medication for epilepsy is perfect and side effects are possible.
The most common include tiredness, decreased alertness, and mood or
behavioral concerns, so parents should watch for these and discuss
concerns with the doctor.
Nowadays, many choices are available and most kids treated with
antiseizure medications do not experience worrisome side effects.
Nevertheless, discuss any concerns you have with the doctor so that dose
adjustments or appropriate changes can be made if appropriate.
Rarely, blood tests might be needed to monitor a medication's level in the bloodstream or to watch for side effects.
If your child still has seizures after the second or third medication
tried, it's less likely that subsequent medications will be fully
effective. In this case, more complicated treatments may be recommended
or tried. These include:
- combinations of medications
- a special ketogenic diet (a high-fat, low-carbohydrate, low-protein diet that's often difficult to follow)
- implantation of a vagal nerve stimulator (an electrical pacemaker-like device placed in the chest and neck)
- surgery to remove the affected part of the brain, if possible. In
the right situation, epilepsy surgery can be very effective or may even
cure a child of seizures, but overall it is done in less than 10% of
seizure patients, and only after an extensive screening and evaluation
process.
Even people who respond successfully to medication sometimes have
seizures (called "breakthrough seizures"). These don't mean the
medication needs to be changed, although you should let the doctor know
if they occur.
Living With Epilepsy
To help prevent seizures, make sure your child:
- takes medication(s) as prescribed
- avoids triggers (such as fever and overtiredness)
- sees the neurologist as recommended — about one to four times a year — even if responding well to medication
Keeping your child well fed, well rested, and reducing unnecessary
stress are all key factors that can help manage epilepsy. Common-sense
precautions to take (based on how controlled the epilepsy is) include:
- Younger kids should always be supervised in the bathtub (a
responsible adult should always be within arm's reach) and older kids
should take showers with the bathroom door unlocked — and only when
there is someone else in the house. (It's also wise to lower the
temperature of hot water so a child cannot be accidentally scalded
during a seizure.)
- Swimming or biking alone are not good ideas for kids with epilepsy
(although they can certainly enjoy these activities with other people). A
responsible adult within arm's reach is recommended during swimming for
kids with epilepsy. A helmet is required during bicycling, as it is for
everyone.
With these simple safety precautions, your child should be able to
play, participate in sports or other activities, and generally do what
other kids like to do. State driving laws vary, but teens with epilepsy
will probably be able to drive with some restrictions, as long as the
seizures are controlled.
It's important to make sure that other adults who care for your child
— family members, babysitters, teachers, coaches, etc. — know that your
child has epilepsy, understand the condition, and know what to do in
the event of a seizure.
Offer your child plenty of support, discuss epilepsy openly, and
answer questions honestly. Kids with epilepsy might be embarrassed about
the seizures or worry about having one at school or with friends.
Unfortunately, many kids with epilepsy have other neurological
problems. In particular, learning and behavioral problems are common and
can create more hardship for a child than the epilepsy itself. In some
cases, the medication's side effects can aggravate these problems. Such
difficulties might require the help of other specialists, teachers, and
social workers. Consider having your child talk with a mental health
counselor or psychologist if he or she struggles with these feelings or
problems.
Parents caring for a child with epilepsy also might benefit from
advice from specialists such as psychologists, social workers, or
specialized educators. For those whose kids have more severe epilepsy,
this help is critical. Specialists can help parents plan for the future (
transition services) by identifying social, financial, and other community resources that will improve the child's well-being.
Reviewed by:
Harry S. Abram, MD
Date reviewed: November 2010
Originally reviewed by:
Fran Filloux, MD
