Epilepsy in Infants and Children

 

What is epilepsy?

Epilepsy is a condition of the brain that makes children present with recurrent and unprovoked seizures. Seizures are caused by sudden abnormal activity in the brain. During an actual seizure, the child may temporarily lose awareness of his/her surroundings and may present with abnormal movements or behavior. The majority of seizures last between 30 seconds to 2 minutes and stop on their own. But in rare instances, seizures may last longer and may need to be stopped with a medicine.

What are the types of seizures?

There are 2 different types of epileptic seizures: focal and generalized.

  • Focal seizures occur when the abnormal brain activity is generated on one side of the brain.
  • Generalized seizures occur when the abnormal brain activity is generated by both sides of the brain.

What causes epilepsy?

There are many different causes of epilepsy including:

  • Head injury
  • Injury to the brain from complications related to birth
  • Brain tumors
  • Genetic defects
  • Stroke
  • For most children, the cause of the epilepsy is not known.

What are the symptoms?

A seizure can affect all of your child’s body, or only part of their body. The main symptoms of a seizure include:

  • Staring
  • Muscle spasms, twitching, jerking movement or stiffening of the body:
    • on one side of the body in focal seizures
    • on both sides of the body in generalized seizures
  • Not responding to noise or words for a short period of time
  • Drooling
  • Lip smacking
  • Fast eye blinking
  • Grunting sounds
  • Loss of bowel and bladder control
  • Feeling sleepy and confused after waking up from a seizure

Children with epilepsy are more likely to have seizures when they have a fever, are ill, or not sleeping enough at night.

How is it diagnosed?

The doctor will do a physical exam of your child and will ask you to describe :

  • How the seizure looked
  • How long it lasted
  • How often your child has seizures.

The doctor will order tests to help find the cause of your child’s seizure. Some of the tests the doctor may order are:

  • Blood tests
  • Imaging tests (CT, MRI)
  • A test to record the electrical activity in your child’s brain (EEG)

How is it treated?

Treatment will depend on the cause of the epilepsy. Sometimes, no treatment is required. Other times, medicine may be given to help prevent having a seizure in the future. Most children with epilepsy have to continue taking medicines for at least a period of 2 years without any further seizure recurrence. Depending on the cause of the epilepsy, some children may need to be on medicine for a longer period of time.
In some children, when the epilepsy is not controlled with medicines, other options including surgery or a special diet may be recommended by the doctor.

How is it prevented?

Prevention of a seizure will depend on the cause. Medicine can help, but some children may still have seizures. If the doctor gives your child medicine, it is important that you give your child the medicine as instructed. It is also important to ensure that your child is getting enough sleep every night as lack of sleep can trigger seizures even if your child is taking their medicines.
If your child has a seizure, there are things you can do to keep your child safe. The main goal is to protect your child from injury.

When your child has a seizure:

  • Stay calm
  • Lower your child to the ground to prevent a fall
  • Remove any furniture or sharp objects from the area
  • Protect your child’s head
  • Loosen tight clothing, and clothing around their neck
  • Turn your child on their side. If your child vomits, turning them on their side will help keep the airway clear
  • Stay with your child until the seizure stops
  • Do not hold your child down. (Holding them down will not stop the seizure)
  • Do not put anything in your child’s mouth during a seizure

Call Emergency Services (999) if:

  • The seizure lasts more than 5 minutes
  • The seizure causes any problems with breathing or your child’s color changes
  • Your child chokes on secretions (blood, vomit, etc.)
  • Your child injured their head during the seizure
  • Your child has 2 seizures in a row, without much time between them
  • Your child has a seizure and does not wake up after the seizure stops
  • Your child has a seizure and is very confused after
  • Your child has a headache, a stiff neck or a rash after the seizure