Epilepsy living in children

Overview

Epilepsy is a condition where a person has repeated seizures. A seizure is a sudden burst of electrical activity in the brain that can affect how a person moves, feels, or behaves. It is not a mental illness and it is not contagious.

Yes, epilepsy is relatively common. It affects about 1 in 200 children worldwide.

Epilepsy can affect children of any age, race, or background. It often starts in early childhood or adolescence.

Symptoms

Common symptoms

• Seizures that cause shaking or jerking movements (convulsions)
• Staring spells or blanking out
• Temporary confusion or difficulty speaking
• Unusual sensations like tingling or smells

Symptoms in children

• Brief staring episodes (absence seizures)
• Sudden falls (atonic seizures)
• Jerking movements on one side of the body
• Seizures triggered by fevers (febrile seizures, which are not always epilepsy)

Symptoms in older adults

• In older adults, epilepsy may present with confusion, memory problems, or subtle seizures that are mistaken for aging. This article focuses on children.

Causes

Main causes

• Head injury or brain trauma
• Brain infection like meningitis
• Genetic conditions
• Brain structural problems present at birth
• Metabolic imbalances
• In many cases, the cause is unknown (idiopathic epilepsy)

Risk factors

• Family history of epilepsy
• Complicated birth or lack of oxygen during birth
• Brain infections in early childhood
• Developmental disorders like autism or cerebral palsy

When to see a doctor

See a doctor urgently if:

• If a child has a first seizure without a clear trigger (like fever)
• If seizures become more frequent or severe
• If the child has trouble breathing or gets injured during a seizure
• If a seizure lasts more than 5 minutes

Book a routine appointment if:

• If a child has been diagnosed with epilepsy but seizures are not well controlled
• For regular check-ups to monitor medication and side effects
• If you notice any changes in behaviour, mood, or school performance
• Before making any changes to medication

Diagnosis

Diagnosis is based on a detailed history of the child's seizures, a physical exam, and tests. The doctor will ask about what happens before, during, and after the seizures.

Tests that may be done

• Electroencephalogram (EEG) – records brain's electrical activity
• Brain imaging like MRI or CT scan to look for structural issues
• Blood tests to rule out other causes
• Sometimes a video EEG to capture seizures

What to expect at your appointment

The doctor will explain the diagnosis and discuss treatment options. Most children will need to take medication to prevent seizures. It may take time to find the right medicine and dose.

Treatment

Treatment aims to control seizures and allow the child to live a full life. The most common treatment is daily medication (antiepileptic drugs). Other options include dietary therapy and, in some cases, surgery.

Self-care at home

• Keep a seizure diary to track triggers and patterns
• Ensure the child takes medication exactly as prescribed
• Teach the child and family about seizure first aid
• Make the home environment safe to prevent injury during seizures

Medical treatments

Doctors usually start with a single medication to prevent seizures. The type of medicine depends on the child's age, seizure type, and overall health. If one medicine doesn't work, another may be tried or combined. Some children may benefit from a ketogenic diet (high fat, low carb) which is supervised by a dietitian. In severe cases, surgery to remove the part of the brain causing seizures may be an option.

When is surgery considered?

Surgery may be considered when seizures are not controlled by medication and the seizure focus (the area of the brain causing seizures) can be safely removed. This is only possible after thorough evaluation by a specialist team.

Living with this condition

Most children with epilepsy can go to school, play sports, and have normal friendships. They may need extra support at school, such as a care plan for seizures. It is important to tell teachers and caregivers about the condition and what to do if a seizure happens.

Lifestyle tips

• Get enough sleep – lack of sleep can trigger seizures
• Always take medication on time
• Avoid known triggers like flashing lights if photosensitive
• Wear a medical alert bracelet or have an emergency card
• Supervise activities like swimming or bathing

Diet and exercise

A balanced diet is important for overall health. Exercise is encouraged, but certain sports may require supervision. Swimming should always be with a buddy. The ketogenic diet is a specific medical therapy, not a general diet.

Mental health and emotional wellbeing

Epilepsy can affect a child's emotional well-being. They may feel anxious, frustrated, or embarrassed. It is important to talk openly about feelings and seek support if needed. If you or your child are having thoughts of self-harm, call your local crisis line or emergency services immediately.

Prevention

Epilepsy itself cannot always be prevented, but many seizures can be controlled with treatment. Avoiding head injuries (by using seat belts and helmets) can reduce the risk of epilepsy from brain trauma.

Complications

If left untreated

• Repeated seizures without treatment can lead to injury or accidents
• Status epilepticus (prolonged seizure) can be life-threatening
• Developmental delays or learning difficulties in some cases
• Social isolation or emotional problems

Long-term outlook

With proper treatment, most children with epilepsy live full, healthy lives. Many children outgrow epilepsy as they enter their teenage or adult years. Even if seizures continue, they can usually be well controlled. It is important to work closely with your healthcare team to manage the condition.

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