Childhood Epilepsy Overview
Epilepsy is a neurological condition (affecting the brain and nervous system) where a child has a tendency to have seizures that start in the brain. The brain is made up of millions of nerve cells that use electrical signals to control the body’s functions, senses and thoughts. If the signals are disrupted, the person may have an epileptic seizure (sometimes called a ‘fit’ or ‘attack’).
Not all seizures are epileptic. Other conditions that can look like epilepsy include fainting (syncope) due to a drop in blood pressure, and febrile convulsions due to a sudden rise in body temperature when a young child is ill. These are not epileptic seizures because they are not caused by disrupted brain activity.
Epilepsy is disorders characterized by recurrent unprovoked seizures due to abnormal & excessive electrical activity in the brain. Every episodic disorder is not a seizure and every seizure is not epilepsy. Diagnosis of epilepsy is often made by experienced Pediatric Neurologist like Dr. Krupa Torne thorough clinical evaluation supported by EEG & sometimes MRI.
Epilepsy leads to tremendous anxiety in the parents and witnessing the event leads to fear and panic. Appropriate diagnosis & treatment, most children can be cured. The first step is correct diagnosis to be followed by starting the right medications.
What happens during a seizure?
There are many different types of child epileptic seizures. The type of epileptic seizure a child has depends on which area of their brain is affected. There are two main types of seizure: focal seizures (sometimes called partial seizures) and generalised seizures. Focal seizures affect only one side of the brain and generalised seizures affect both sides of the brain. Generally, adults and children have the same types of seizure, although some may be more common in childhood than adulthood. For example, absence seizures which can be very brief and are often mistaken for ‘daydreaming’ or not paying attention.
Different seizures include:
- Jerking of the body (convulsions).
- Repetitive movements.
- Unusual sensations such as a strange taste in the mouth or a strange smell, or a rising feeling in the stomach.
- In some types of seizure, a child may be aware of what is happening. In other types, a child will be unconscious and have no memory of the seizure afterwards.
- Some children may have seizures when they are sleeping (sometimes called ‘asleep’ or ‘nocturnal’ seizures). Seizures during sleep can affect sleep patterns and may leave a child feeling tired and confused the next day.
Why does my child have epilepsy?
Some children develop epilepsy as a result of their brain being injured in some way. This could be due to a severe head injury, difficulties at birth, or an infection which affects the brain such as meningitis. Epilepsy with a known structural cause like this is sometimes called symptomatic epilepsy. Some researchers now believe that the chance of developing epilepsy is probably always genetic to some extent, in that anyone who starts having seizures has always had some level of genetic tendency to do so. This level can range from high to low and anywhere in between. Even if seizures start after a brain injury or other structural change, this may be due to both the structural change and the person’s genetic tendency to have seizures combined. This makes sense if we consider that many people might have a similar brain injury but not all of them develop epilepsy afterwards.
How is epilepsy diagnosed?
A diagnosis of epilepsy may be needed by Dr. Krupa Torne if your child has had more than one seizure. More are the chances that you will rush to your general practitioner who will further guide you to the best paediatrician (a doctor who specialises in treating children). Wouldn’t it be great if you have the direct number of the best Pediatric Neurologist in Mumbai, Dr. Krupa Torne who will diagnosis and treat your child without wasting much of the precious time, in all such cases. She may ask you to describe in detail what happened before, during and after the seizure. Having a video recording of the seizure can help the Dr. Krupa understand what is happening. She may also suggest a few tests to help with the diagnosis. The tests alone cannot confirm or rule out epilepsy, but they can give extra information to help find out why your child is having seizures.
Treatment for children in Epilepsy
In 90% of the cases, your General Practitioner will guide you Paediatric Neurologist (a children’s doctor who specialises in the brain and nervous system). An epilepsy specialist nurse may also be involved in their care. Anti-epileptic drugs Most people with epilepsy take anti-epileptic drugs (AEDs) to control their seizures. Dr. Krupa Torne may discuss with you whether AEDs are the best option for your child. Although AEDs aim to stop seizures from happening, they do not stop seizures while they are happening, and they do not cure epilepsy. Most children stop having seizures once they are on an AED that suits them. Like all drugs, AEDs can cause side effects for some children. Some side effects go away as the body gets used to the medication, or if the dose is adjusted. If you are concerned about your child taking AEDs you can talk to Dr. Krupa Torne. However changing or stopping your child’s medication without first talking to her can cause seizures to start again or make seizures worse. Although AEDs work well for many children, this doesn’t happen for every child. If AEDs don’t help your child, she may consider other ways to treat their epilepsy. Ketogenic diet For some children who still have seizures even though they have tried AEDs, the Ketogenic diet may help to reduce the number or severity of their seizures. The diet is a medical treatment, often started alongside AEDs and is personally supervised by Dr. Krupa Torne Epilepsy surgery It may be possible for some children to have epilepsy surgery depending on the type of epilepsy they have and where in the brain their seizures start. Epilepsy surgery involves removing a part of the brain to stop or reduce the number of seizures a child has.