Epilepsy

People with epilepsy tend to have recurrent seizures or fits. Having one seizure doesn’t mean a child has epilepsy.

The condition is more common than many people realise. Around one child in every 200 has epilepsy, and while some will grow out of it, others won’t.

Seizures are caused by a sudden burst of electrical activity in the brain. This means there is a temporary disruption in the way that messages are passed between brain cells.

The brain is responsible for all the body’s functions, so what happens during a seizure will depend on exactly where in the brain the seizure begins, and how widely and quickly it spreads. For this reason there are lots of different types of seizures.

The most common type of seizure is known as a ‘tonic-clonic’ seizure. There are other types too though including, in children, ‘absence’ seizures.

Sometimes there is a clear reason for epilepsy developing. This can include a severe blow to the head, an infection of the brain such as meningitis, or brain damage due to lack of oxygen during a difficult birth. But for most people with the condition, there isn’t a clear cause.

• A tonic-clonic seizure happens in two stages. First, the body’s muscles contract and a person becomes stiff. They might cry out, and breathing can become irregular.
• The second, clonic, stage happens when the limbs jerk. This is caused by the muscles contracting and relaxing in quick succession.
• It isn’t possible to stop the seizure. During the second phase, a person might bite their tongue and the inside of their cheeks.
• After a minute or so, the muscles relax and the person goes limp. They are unconscious and will slowly regain consciousness. Afterwards, they may seem groggy or confused, and may not be able to remember anything at first.
• They can be left with a headache and aching limbs that can last for hours or even days.
• An absence seizure involves a child stopping their normal activity, and apparently staring into space as though they are daydreaming for 10 to 15 seconds. They don’t appear to see or hear anything, and afterwards a child has no memory of the seizure.
• Other seizure types may involve a change in behaviour and confusion over one or two minutes.

• If a child experiences a tonic-clonic seizure, don’t try to stop it. Instead, move any furniture out of the way, try to loosen any tight clothing around the neck and stay with the child until the seizure has finished. As soon as uncontrolled movements finish, lay the child on their side in the recovery position.
• If a child has another type of seizure, sit them down quietly and stay with them until they are fully recovered and alert. Reassure the child calmly.

Having a seizure doesn’t itself cause any harm. It won’t cause any sort of brain damage or internal damage.

However, a person might injure themselves during a tonic-clonic seizure, for example by biting their tongue or the inside of their cheek by accident, or because of things they might bump into or hurt themselves on in their immediate environment.

• Doctors will probably suggest a number of tests to exclude other possible causes – for instance, a blood sugar test to rule out low blood sugar levels.
• An electroencephalogram (EEG) is a way of measuring the electrical activity in the brain and is usually carried out to identify the type of epilepsy.
• The child may also need a brain scan to detect whether a structural brain abnormality may be the cause.

Modern anti-epileptic medication can be very effective. The trick is finding the right type, or combination of medication, that most benefits the child.Some of the more recent types of medication which has attracted significant media attention are cannabis-based medicinal products (CBMP).

In very rare cases when medication does not control a child’s seizures, and scans indicate a structural brain abnormality is the cause, surgery may be suggested to correct the problem.

If the child has never had a seizure before, call a doctor at once. If the child remains unconscious for longer than ten minutes, whether this attack is the first or not, call an ambulance and get the child to the nearest Accident and Emergency department.

The vast majority of children with epilepsy can lead full and active lives.

It is estimated that around three quarters of children with epilepsy will be controlled on medication or grow out of it. The chances of this happening will depend on the type of epilepsy a child has.

Most children, even those who don’t outgrow epilepsy, don’t have any other medical problems. They can go to mainstream schools and participate in most sports.

The child’s doctor will advise you if there are any precautions that the child should take, and whether any activities need to be avoided.