Seizures
and Your Child
Dealing with epilepsy.
PARENTGUIDE News September 2006
About 300,000 American children under the age of 14 have epilepsy.
It affects children at different ages, and in different ways. For some,
it will be a temporary problem, easily controlled with medication, outgrown
after a few years. For others, it may be a lifelong challenge affecting
many areas of life. Medical treatment of childhood epilepsy is getting
better and research towards a cure continues.
Some Facts About Epilepsy
•It may be time-limited or long-term.
•Early recognition and treatment are keys to the best possible outcome.
•It may be associated with serious, difficult-to-treat syndromes,
including infantile spasms, Lennox-Gastaut syndrome, genetically related
conditions and developmental disorders.
•Social impact in childhood is often severe, producing isolation
and loss of self-esteem.
Causes of Childhood Epilepsy
Epilepsy is a disorder of the brain. A child’s brain contains billions
of nerve cells. They communicate with each other through tiny electrical
charges that fire on and off in random fashion. When some or all of these
cells suddenly begin to fire together, a wave of electrical energy sweeps
through the brain, causing a seizure.
Seizures interfere with the child’s normal brain functions.They
produce sudden changes in consciousness, movement or sensation.
Some people use the term “seizure disorder” instead of “epilepsy”
to describe this condition. Both mean the same thing— an underlying
tendency to experience seizures.
Having a single seizure does not mean a child has epilepsy. Epilepsy is
the name for seizures that happen more than once without a known treatable
cause, such as fever or low-blood sugar.
Often Starts in Childhood
While epilepsy can begin at any time of life, 50 percent of all cases
begin before the age of 25. Many start in early childhood. One reason
is that immature brains are more susceptible to seizures.
Possible Causes
Pinpointing the cause of epilepsy is difficult at any age. In seven out
of every ten cases, there is no known cause and those having seizures
are labeled as having idiopathic epilepsy. “Idiopathic” is
a Latin word meaning “of unknown cause.”
There are many possible causes in children. These include problems with
brain development before birth; lack of oxygen during or following birth;
a head injury that leaves scaring on the brain; unusual structures in
the brain; tumors; a prolonged seizure with fever, or the after-effects
of severe brain infections such as meningitis or encephalitis. When a
cause can be identified, these children are labeled as having symptomatic
epilepsy. The seizures are believed to be a symptom of the underlying
brain injury.
Genetic Factors
Epilepsy is a common disorder, and frequently within an extended family
more than one person may have seizures.
In most cases, a specific pattern of epilepsy within the family cannot
be determined. However, there does appear to be a slightly increased risk
of epilepsy in close relatives of individuals with seizures compared to
the risk in the general population.
Sometimes there’s a family history of seizures, including febrile
(fever-caused) seizures, epilepsy or seizures in childhood that later
went into remission.
Absence and juvenile myoclonic epilepsy are two types of epilepsy that
tend to run in families and are thought to have a genetic basis.
A great deal of research is ongoing to find the genetic roots of some
forms of epilepsy or the inherited conditions that have seizures as a
primary symptom.
Informing Relatives
Informed, understanding relatives are a wonderful source of strength when
a child has epilepsy. But some may have beliefs about this condition that
hail from an earlier time. They may think it is somehow linked to mental
illness (it isn’t), or someone’s fault (wrong), or is related
to mental retardation (usually not), or is even a sign of spiritual possession
(an old myth that still lingers). Helping family members understand the
true nature of epilepsy as a medical condition affecting brain function
will set these fears at rest.
Dealing With Risk
A seizure that ends normally after a minute or two is usually not hazardous
to a child who has epilepsy.
However, risks increase when the seizure happens near water, at heights,
near traffic or in any setting in which sudden loss of awareness could
be dangerous.
Parents naturally want to protect a child who has this extra level of
risk on top of all the other risks that accompany a normal childhood.
However, excessive concern about risk may isolate children with epilepsy
from others and reduce social interaction.
Sports
Unless your child’s doctor recommends otherwise, sports activities
and other exercise are as beneficial to a child with epilepsy as they
are to any other child.
In general, school sports activities and gym should be open to all children,
including children with seizures. Safety measures such as harnesses, shock
absorbing mats and adult supervision should reduce risks.
Coaches and other officials should be aware that the child has seizures,
and how the parents want them to be managed.
Wearing safety helmets when riding a bicycle, or for sports where head
injury is possible, should reduce risk.
Seizures and School
Having seizures at school can be socially damaging to a child and frightening
to others. However, it doesn’t have to be.
A well-informed, confident teacher and a supportive school nurse and school
administration can make all the difference in the world.
Take time to meet with your child’s teacher before the beginning
of each school year to discuss how epilepsy affects your child, what type
of seizures he or she has, and how you would like the teacher to handle
the seizures when they occur.
As seizures are a common problem, many teachers will have had other students
with epilepsy. If your child’s teacher is unfamiliar with seizures
and needs information, contact your local Epilepsy Foundation affiliate.
Videos, pamphlets and first aid presentations available from the Epilepsy
Foundation have a basic message: that students with seizures belong in
school and are in no way a threat to other children.
Treatment for Children
Childhood epilepsy is usually treated with seizure-preventing medicines
called antiepileptic or anticonvulsant drugs. If the drugs don’t
work, or the child has a lot of side effects, surgery or the ketogenic
diet may be tried. If surgery is not an option, or the diet does not work,
a new form of therapy called vagus nerve stimulation (VNS) may be tried.
Finding the Right Drug
The search for the best medication for any individual child may take a
long time. Children, like adults, respond to medications in different
ways. Several drugs and different combinations of drugs may have to be
tried in an effort to get the seizures under control.
The goal of treatment is to achieve the greatest level of control and
the lowest level of side effects, at the lowest possible dose.
The Epilepsy Foundation, a national nonprofit with affiliated organizations
throughout the United States, has led the fight against epilepsy since
1968. The Foundation’s goals are to ensure that people with seizures
are able to participate in all life experiences; and to prevent, control
and cure epilepsy through research, education, advocacy and services,
so not another moment is lost to seizures. For additional information,
please visit www.epilepsyfoundation.org.
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