Epilepsy Facts and FAQs

Facts about epilepsy

Parent information sheet written by

Dr.BidishaBannerjee MD, DM(Paed Neurology)

* A disease wherein repeated seizures occur without apparent trigger.

* Every seizure is not epilepsy. 4 /1000 people suffer from epilepsy.

* Seizure could come as abnormal jerky movements/ sensations or loss of consciousness.

* In otherwise normal children they are often ‘genetic’ in origin.

* Seizure could also occur due to brain damage around the time of birth or early in life.

* Neurocysticercosis ( parasitic cyst in the brain) is another cause.

* Seizures that occur in under-five children during fever is usually not epilepsy.

* Most need control of fever, first aid for seizure and medicines to prevent seizures during fever.

* For a young child always consult doctor; they may have serious infection requiring treatment.

Common myths

 

Epilepsy occurs due to possession by evil spirit, equated to lunacy, and that it remits if a girl is married off. None of these hold an iota of truth

First-aid:

* Child should be made to lie on his/her side.

* Any sharp/other objects that may hurt should be removed from the vicinity.

* One should not attempt to put anything into mouth or give water.

* Medicines can be given rectally, inside nose with doctor’s advice to stop seizure.

What next?

* Consult a child specialist or neurologist.

* EEG and head scan head are done commonly.

* Medications control the seizures in majority.

* Medicines are not always started at the first seizure but necessary if the child has had more than one seizure.

* It is very important to adhere to the treatment schedule prescribed by the doctor, failing which seizures can comeback.

* In case a dose is missed it may be given as soon as one remembers.

* No restrictions on food other activities are required barring swimming.

* Try to have regular 7-8 hours of sleep.

* Continue to send to school unless uncontrolled and risk of injury.

* Usually treatment is given for 2 years after the last seizure and then gradually withdrawn.

* About 70 % remain well after medicines are stopped; depends on cause of epilepsy and other neurological problems Relapses, If any usually occur in the 1st 6 months of stopping.

What if child’s epilepsy is uncontrolled on medicines.

* You should consult a neurologist to check if the drug and the dose are fine.

* Some newer drugs may be tried for specific seizure types.

Certain special diets like ketogenic/modified Atkins diet, an implantable device (vagal nerve stimulator) and epilepsy surgery are other options.

FAQs on Epilepsy

What is epilepsy?

is a disease in which repeated seizures occur without any apparent trigger. Every seizure is not epilepsy. About 4 in every thousand people suffer from this disease. In a seizure child may have abnormal jerky movements over which he/she has no control, abnormal sensations or perception or may transiently loose consciousness.

What is the cause of epilepsy?

Epilepsies that occur in otherwise normal children are often ‘genetic’ in origin. They could also occur due to brain damage around the time of birth or early in life. It may be due to abnormal structure of the brain or rarely ‘metabolic errors’. Some of the common myths about epilepsy are that it occurs due to possession by evil spirit, equated to lunacy, often projected as criminals and that it remits if a girl is married off. None of these hold an iota of truth and can be counterproductive for the emotional growth of the individual.

How can parents recognize a seizure?

Not all episodic events are seizures and one needs to note the details/video record the event and meet his/her doctor for clarification. A seizure can present in various manner; blank stare and unresponsiveness, repeated abnormal talking/hand or mouth mannerisms of which the child is unaware, jerky movements of arms/legs/whole body, loss of consciousness with jaw clenching, frothing and/or urinary incontinence.

As parents what immediate remedy can be offered at home?

Child should be made to lie on his side. Any sharp/other objects that may hurt should be removed from the vicinity. One should not attempt to put something into mouth or give water. There are medicines that can be given rectally, inside nose with doctor’s advice.

What to do next? Whom to consult and what tests are necessary?

One should consult a pediatric neurologist or pediatrician (child specialist). Tests may be required depending on each case, but they are not required for diagnosis. Electroencephalography (EEG) and head scan head are done commonly but is not required in all. They are not required to be repeated for every episode unless the peculiarity of the patient demands so.

How long is treatment required? Do medications cure this disease?

Medications do not cure the disease but they do control the seizures in majority. Childhood epilepsy has a favorable outlook with about 80% getting well controlled on medicines. Medicines may not always be started at the first seizure but is necessary if the child has had it more than once. Usually they are given for a period of 2 years after the last seizure and then gradually withdrawn. It is very important to adhere to the treatment schedule prescribed by the doctor, failing which seizures can stage a comeback.

What to do if dose/s is missed?

One should try to fix time of the drug and take it as regularly as possible. But in case one dose is missed then it may be given as soon as one remembers or if the time for next dose has come then the due dose may be given, however if more than one dose is missed then consult your doctor.

Do these medicines have side effects?

All medicines have some or other side-effects but they are not seen in all. The common ones are sleepiness which gets better with time. Skin rash, jaundice, imbalance and vomiting should make you to get in touch with your doctor. Newer antiepileptic drugs are better tolerated

After stopping medicines what are the chances that the child will remain well?

Most that is about 70 % remain well after medicines are stopped; this depends a lot on the cause of epilepsy and other neurological problems, if any. Relapses usually occur in the 1st 6 months of stopping

When should one seek referral to a higher centre or a specialist?

If seizures start in the first year of life, occur as repeated jerks in series, multiple types of seizures, uncontrolled on prescribed doses of medicines or if child shows a definite change in intelligence/speech/behavior

What are the options if the child’s epilepsy is uncontrolled on drugs?

One needs to consult a neurologist to check if the drug and the dose are fine. Some newer drugs may be tried for specific seizure types. Certain special diets like modified Atkins / ketogenic diet, an implantable device (vagal nerve stimulator) and epilepsy surgery are other options.