Seizures are commonly known as fits, convulsions, shocks, epilepsy, or episodes. These episodes typically manifest as abnormal movements throughout the body or on one side of the body, unusual spasms in the eyes and face, abnormal sensations, momentary loss of consciousness, peculiar behaviour, vacant stares, or excessive daydreaming. Pediatric epilepsy is often characterized by the abnormal overactivity of neurons in the brain, also known as seizures, contrary to some beliefs that it is caused by possession.
Not all seizures are epilepsy. Epilepsy refers to a condition where two or more seizures occur without any apparent provoking factor. Approximately 4 to 5 out of a thousand people are affected by this condition. In children, epilepsy is often genetically predisposed, but it can also result from damage to the brain during birth or earlier in life, brain infections, structural abnormalities, head injuries, brain tumours, or certain metabolic disorders. Some children with epilepsy may develop discoloration on their skin, such as brown or white spots, or red spots on the face, as a result of the condition.
In such cases, it is advisable to consult a pediatric neurologist. In many cases, the cause of epilepsy is identified through a detailed examination by a doctor. Electroencephalography (EEG) and brain scanning, such as CT head, are commonly performed. MRI of the brain may be conducted in selected children affected by epilepsy. It is not necessary to repeat it for every episode.
Treatment depends on the underlying cause. In cases such as CNS infections, infestations, tumours, and some metabolic causes, treatment is available. Otherwise, medications are prescribed to control seizures, but they cannot cure the disease. Typically, medication is given for the first two years after the initial seizure and then gradually reduced. It is crucial to follow the prescribed treatment plan to prevent the recurrence of seizures.
Establish a fixed time for medication administration and make an effort to take it regularly. In case a dose is missed, take it as soon as possible. If the next dose is due, both the missed dose and the next one can be taken together. Consult the doctor if there is an accidental overdose.
Every medication has some side effects, but they vary depending on the type of medication. The most common side effect is drowsiness, which usually improves over time. Skin issues, ulcers, jaundice, altered mental status, behavioural disturbances, cognitive decline, imbalance, or vomiting should prompt immediate consultation with a healthcare provider.
Approximately 70% of children improve after discontinuing medication, depending on the causes of epilepsy and other brain-related problems. The recurrence of seizures is more likely if there is an underlying neurological abnormality, epilepsy, abnormal EEG, or a family history of epilepsy. Epilepsy recurrence is usually seen within the first six months after stopping medication.
To prevent other forms of seizures, it is advisable to follow some general advice. Children with epilepsy should avoid exposure to unexpected triggers, such as hot baths, sleep deprivation, playing video games, watching TV, fasting, or listening to music. It is essential to regulate the child's sleep and prevent them from experiencing undue stress.
In summary, although epilepsy poses challenges, children with this condition can generally attend school successfully. Parents should communicate the child's condition thoroughly with school staff. Primary interventions should be explained, and emergency contact information should be provided. Some medications may cause drowsiness, which can affect school performance, but this effect often diminishes with time or can be adjusted after consulting the doctor.
Dos and don'ts when a child has a seizure:What Not to Do:
1. Avoid panicking.
2. Do not attempt to cool the child by immersing them in cold or lukewarm water.
3. Refrain from putting anything in the child's mouth.
4. Avoid restraining or controlling the child.
What to Do:
1. Stay calm.
2. Stay with the child.
3. Loosen tight clothing.
4. Keep the child away from potential hazards like sharp furniture.
5. Clear the child's mouth and nose from any fluids.
6. Place something soft under the child's head to prevent head injuries.
7. Note the start and end times of the seizure if possible.
Authored by: Dr. Aditya Gupta, Director – CyberKnife, Artemis Hospital, Gurugram
