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What is epilepsy?
Epilepsy is the name for a range of brain conditions where a child has or is at risk of having repeated and unpredictable seizures because of abnormal electrical activity in the brain. This abnormal activity can change a child's awareness, behaviour, body movements or senses.
If a child has one seizure, it doesn't always mean she has epilepsy. Most children who have a single seizure don't go on to have any more. Epilepsy isn't usually diagnosed until after two or more seizures.Febrile convulsions are seizures caused by fever. If your child has a febrile convulsion and is otherwise healthy and you have no family history of seizures, he's no more likely to develop epilepsy than any other child.
What causes epilepsy?
There are some things that make a child more likely to have epileptic seizures. These include:
- genetic abnormalities or a history of epilepsy in immediate family members
- structural changes in the brain linked with disorders like cerebral palsy or hydrocephalus
- developmental and behavioural conditions like intellectual disability and autism spectrum disorder
- brain injury caused by injury, tumours or strokes
- febrile convulsions that last longer than 10 minutes or happen many times.
Seizures in children at risk of epilepsy might be triggered by flashing lights or by looking at patterns on a TV or cinema screen.
In about half of all children with epilepsy, we don't know what causes the condition.
Symptoms of epilepsy
Children with epilepsy might have many different types of seizures, some more dramatic than others. The type of seizure depends on where the abnormal electrical activity in the brain comes from. There are two main groups of seizures - focal seizures and generalised seizures.
Focal seizures start in only one part of the brain. Symptoms of a focal seizure depend on what part of the brain is affected.
Symptoms of focal seizures might include:
- muscle twitching in one part of the body
- changes to smells, sounds, tastes and sight
- difficulty talking
- abnormal behaviour and movements like picking at clothing or lip smacking.
A child's awareness or responsiveness might change if she's having a focal seizure.
Generalised seizures involve the whole brain. There are six different types of generalised seizures, and they have different symptoms.
Tonic seizures cause a child's muscles to stiffen. They often happen during sleep.
Children with atonic seizures lose control of their muscles so their heads might slump forward or they might fall to the ground.
In children with clonic seizures, muscles repeatedly and rhythmically jerk and move around.
In children with myoclonic seizures, muscles jerk suddenly and very briefly.
Tonic-clonic seizures are the most dramatic. They cause children to lose consciousness (black out) and fall down. The child's body stiffens (like a tonic seizure) and his arms and legs jerk around (like a clonic seizure). He might drool and wet himself.
Children with absence seizures might look like they're staring into space and seem unaware of what's going on around them.
Management of epileptic seizures
If you think your child is having a seizure and has lost consciousness, it's important that you stay calm and remove any harmful objects so she doesn't injure herself.
Place your child on a soft surface, lying in the recovery position on his side. Stay with him and give him reassurance.
If it's your child's first seizure, watch exactly what happens, so you can describe it later. If you have a smartphone or camera, take a video of the seizure.
Time the seizure.
Once the seizure has stopped, place your child on a soft surface, lying in the recovery position on her side to keep her airway open.
When to see your doctor about epileptic seizures
It's important for your child to see a GP or go to a hospital emergency department if:
- it's your child's first seizure
- your child has several or repeated seizures
- you're not sure whether your child has had a seizure
- your child starts having seizures more often than is usual for him.
Tests for epilepsy
If your GP thinks your child might have epilepsy, the GP will usually refer your child to a paediatrician or paediatric neurologist for further investigation.
The doctor will order blood tests and an EEG. Your doctor might also organise a CT scan or MRI scan of the brain.
Treatment for epilepsy
If your child is diagnosed with epilepsy, your doctor will tell you whether your child needs medication.
If your doctor prescribes anticonvulsant medication for your child, the aim is to let your child have a normal life. But this medication might have some side effects. If your child is taking anticonvulsant medication, she'll need to see a doctor regularly.
If medication doesn't work, your doctor might talk with you about other therapies, including a ketogenic diet or surgical options.
Your doctor might develop an emergency management action plan with you if your child has severe or frequent seizures.You should tell everyone involved in your child's daily care - for example, child care staff and teachers - that your child has epilepsy. They need to understand what this means, as well as how to handle a seizure if it happens. Encourage your child to wear a wrist bracelet or pendant that lets people know he has epilepsy.
Prevention of epileptic seizures
Regular meals, adequate sleep and exercise might help to reduce the risk of seizures.
Your child should avoid things that she knows trigger her seizures, like flashing lights, overtiredness, hunger or television.
Always supervise your child when he's swimming, bathing or doing activities that involve heights.Watching your child having a seizure can be very distressing. Contacting an epilepsy support group might help you feel less fearful about your child's condition.