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Epilepsy in Babies and Children

Epilepsy is a neurological condition, which affects the nervous system. Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures that were not caused by some known medical condition. - Carol Camfield, M.D. / Robert S. Fisher, M.D., Ph.D., https://www.epilepsy.com/101/ep101_epilepsy

What is a Seizure?
Your brain is made up of millions of nerve cells called neurons, and these cells communicate with one another through tiny electrical impulses. A seizure occurs when a large number of the cells send out an electrical charge at the same time. This abnormal and intense wave of electricity overwhelms the brain and results in a seizure, which can cause muscle spasms, a loss of consciousness, strange behavior, or other symptoms.

What May Cause a Seizure?
Anyone can have a seizure under certain circumstances. For instance, a fever, lack of oxygen, head trauma, or illness could bring on a seizure. People are diagnosed with epilepsy when they have seizures that occur more than once without such a specific cause. In most cases -- about seven out of 10 -- the cause of the seizures can't be identified.  The problem may be with an uncontrolled firing of neurons in the brain that trigger a seizure.

Possible Causes of Epilepsy in Babies (This information specifically relates to babies who are up to one month old.)
There are many causes of seizures in babies. In around seven to eight out of 10 babies with seizures, a cause will be found. These are the most common ones.

  • Being born more than two or three months early. If your baby is born so early, they are at risk of having bleeding inside their brain.
  • Being born on time but suffering a lack of oxygen to the brain.
  • Having low levels of glucose, calcium or sodium in the blood.
  • Having an infection such as meningitis or encephalitis.
  • Being born with an abnormal brain. This is called cerebral dysplasia or dysgenesis.
  • Inheriting a medical condition, such as benign neonatal convulsions.

Diagnosis of Epilepsy
Epilepsy can begin at any age.  Diagnosing a seizure can be tricky. Seizures are over so quickly that your doctor probably will never see your child having one.  Your description of the seizure is therefore critical to help your doctor with the diagnosis.  You may want to keep a video camera handy so that you can record your child having a seizure.

In babies, seizures may not be obvious to an onlooker. Their seizures may show as changes in breathing patterns, or movements of their eyelids or lips. They may have bicycling movements of their legs, brief jerks or episodes of stiffening of their body and limbs. As their brain matures, older children have seizures that are sometimes more easily recognised.

Some kinds of seizures, such as absence seizures, are especially difficult to catch because they may be mistaken for daydreaming.  They come at inappropriate times, such as when your child is in the middle of speaking or doing something, and suddenly stops.

Epilepsy may be diagnosed using the following methods:

  • Electroencephalogram (EEG) - Tells doctors about the electrical activity in the brain.
  • Computed tomography (CT scan) - This type of X-ray shows the structure of the brain and may help to identify an abnormality that could cause epilepsy.
  • Magnetic resonance imaging (MRI scan) - Uses radio waves and a magnetic field, rather than X-rays, to show if there’s a structural cause for someone’s epilepsy. Not all children with epilepsy will need a CT or MRI scan.

Are Seizures Painful?
Although they may look painful, seizures don't really cause pain. But they may be frightening for children and the people around them, and they may endanger a child depending on their situation.

Although the majority of seizures aren't dangerous and don't require immediate medical attention, one kind does. Status epilepticus is a life-threatening condition in which a person has a prolonged seizure or one seizure after another without regaining consciousness in between them. Status epilepticus is more common among people with epilepsy, but about one-third of the people who develop the condition have never had a seizure before. The risks of status epilepticus increase the longer the seizure goes on, which is why you should always get emergency medical help if a seizure lasts more than five minutes.

How is Epilepsy Treated?
Most children with epilepsy are prescribed epilepsy medicines.  It may take a while to find the right dose of the right medicine for your child. But once it is found, they have a very good chance of being seizure free.  Once their seizures are controlled, they will still usually need to take epilepsy medicine for a while. Sometimes, they may need to take it for many years.It is adviseable to be aware of any potential side effects of the prescribed medication and what you can do to relieve these.  You will probably also want to ask the doctor what to do if your child is ill or has a fever bearing in mind this sometimes brings on seizures.    It is also recommended that you always carry a detailed list of your child's medications.

If your child is old enough, they might be able to recognise things that make their seizures more likely. These are called triggers. Tiredness, lack of sleep and stress are some of the more common triggers in children. A very small number of children with epilepsy have their seizures triggered by flashing or flickering lights. This is photosensitive epilepsy.

Supporting Your Child with Epilepsy
It's natural for a child who has a chronic illness or who is different from other children to feel resentful. Children with a condition such as epilepsy may develop emotional problems, such as poor self-esteem or depression. These problems may come from within (anger, embarrassment, frustration), or from outside (children with epilepsy may be teased by other children).

As a parent, you can help your child deal with these feelings in the following ways:

  • Make sure your child understands as much about his or her condition as possible.
  • Try to get your child to be positive about his or her condition and focus on things he or she can do.
  • Help your child accept being a “different normal”  and accept that their will be some risk in activities

It is important to ensure your other children understand about their sibling's condition, as well as the extended family.

What Else Can You Do to Protect Your Child?

  • Keep an eye on your child while he/she is in the bath
  • Make sure the bathroom door opens outward rather than inward, so that it can still be opened in case your child falls. Take the locks off the bathroom door.
  • Check the bathtub drain to make sure it's working properly.
  • Keep the water in the bath at low levels.
  • Keep the water temperature low to prevent scalding.
  • Keep all electrical appliances away from the sink or bath
  • Don't let a child with epilepsy swim alone.
  • Make sure all adults, including the lifeguards and swimming instructors, know that your child has epilepsy.
  • If your child has a seizure while swimming, get him or her out of the water as soon as possible. If anything seems wrong, contact the doctor right away.

Learning and Education
Most children and young people with epilepsy go to mainstream schools and colleges. It is important that school staff know about your child’s epilepsy and how it might affect them at school.  Sometimes, arrangements will need to be made for him or her to take medicine at school .

Courtesy of:

Support in Zimbabwe:
The Epilepsy Support Foundation is a registered Welfare Organization (No. 1190/1990) established on the 17th of April 1990 and is a member of the International Bureau for Epilepsy. It was set up to promote and support people with epilepsy. There are regional branches and support groups in Harare, Gwanda, Buhera, Gutu and Bulawayo.  The purpose of the foundation is to supply free medical support services in the form of early detection, diagnosis, counseling, treatment and rehabilitation.