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Epilepsy in Children
WHAT YOU NEED TO KNOW:
What is epilepsy?
Epilepsy is a brain disorder that causes seizures. It is also called a seizure disorder. A seizure means an abnormal area in your child's brain sometimes sends bursts of electrical activity. A seizure may start in one part of your child's brain, or both sides may be affected. Depending on the type of seizure, your child may have movements he or she cannot control, lose consciousness, or stare straight ahead. Your child may be confused or tired after the seizure. A seizure may last a few seconds or longer than 5 minutes. A birth defect, tumor, stroke, injury, or infection may cause epilepsy. The cause of your child's epilepsy may not be known. If the seizures are not controlled, epilepsy may become life-threatening.
How is epilepsy diagnosed?
Your child's healthcare provider will ask about your child's health conditions and what medicines he or she takes. Epilepsy is usually diagnosed if your child has at least 2 seizures within 24 hours. It may also be diagnosed if your child has 1 seizure but is likely to have more. Your child's risk is higher with a family history of epilepsy. A brain scan may also show signs of epilepsy that make another seizure likely. Tell the provider how close together the seizures were if your child had more than one. The provider will ask for a detailed description of each seizure. If you did not see the seizure happen, try to bring someone with you who did see it. Your child may also need any of the following:
- An EEG records the electrical activity of your child's brain. It is used to find changes in the normal patterns of his or her brain activity.
- CT or MRI pictures may be used to check for abnormal areas. Your child may be given contrast liquid to help his or her brain show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
- A PET scan is used to see activity in areas of your child's brain. Your child will be given radioactive material that helps healthcare providers see the activity better.
- A SPECT scan uses radioactive material to find where the seizure started in your child's brain. This scan may be done if other scans do not show where the seizure started.
How is epilepsy treated?
The goal of treatment is to try to stop your child's seizures completely. He or she may need any of the following:
- Medicines will help control seizures. Your child may need medicine daily to prevent seizures or during a seizure to stop it. Do not let your child stop taking his or her medicine unless directed by a healthcare provider.
- A ketogenic diet may be needed to control your child's seizures if medicine does not work. The diet may be suggested by your child's healthcare provider and monitored by a dietitian.
- Surgery may help reduce how often your child has seizures if medicine does not help. Ask your child's healthcare provider for more information about surgery for epilepsy.
What else do I need to know about epilepsy?
- Sudden unexplained death in epilepsy (SUDEP) is a rare complication of epilepsy. In 1 year, 1 child in 4,500 children with epilepsy will have this complication. The risk of SUDEP increases if your child has 3 or more generalized tonic-clonic seizures in 1 year. Your child's risk also increases if he or she has nocturnal seizures (seizures during sleep). After a nocturnal seizure, your child's breathing can become shallow.
- Your child's healthcare provider may recommend a change in medicine to decrease the number of seizures. For nocturnal seizures, he or she may recommend that someone sleep near your child. The person must be older than 10 years. The person must also be close enough to know that your child is having a seizure. Your child's healthcare provider may instead recommend a remote listening device (such as a baby monitor) in your child's room. The device will help you hear when your child has a seizure if you are in another room.
What can I do to help prevent my child's seizures?
You may not be able to prevent every seizure. The following can help you and your child manage triggers that may make a seizure start:
- Have your child take his or her medicine every day at the same time. This will also help prevent medicine side effects. Set an alarm to help remind you and your child to take the medicine every day.
- Help your child manage stress. Stress can be a trigger for seizures. Encourage your child to exercise. Exercise can help reduce stress. Talk to your child's healthcare provider about safe exercises for your child. Illness can be a form of stress. Offer your child a variety of healthy foods and give plenty of liquids during an illness. Talk to your healthcare provider about other ways to help your child manage stress.
- Set a regular sleep schedule. A lack of sleep can trigger a seizure. Try to have your child go to sleep and wake up at the same time every day. Keep your child's bedroom quiet and dark. Talk to your child's healthcare provider if he or she is having trouble sleeping.
What can I do to manage my child's epilepsy?
- Keep a seizure diary. This can help you find your child's triggers and avoid them. Write down the dates of the seizures, where your child was, and what he or she was doing. Include how your child felt before and after. Possible triggers include illness, lack of sleep, hormonal changes, lights, or stress.
- Record any auras your child has before a seizure. An aura is a sign that your child is about to have a seizure. Auras happen before certain types of seizures that are in only 1 part of the brain. The aura may happen seconds before a seizure, or up to an hour before. Your child may feel, see, hear, or smell something. Examples include part of your child's body becoming hot. He or she may see a flash of light or hear something. If your child has an aura, include it in the seizure diary.
- Create a care plan. Talk to your child's family, friends, and school officials about the epilepsy. Give them instructions that tell them how they can keep your child safe during a seizure.
- Find support. You may be referred to a psychologist or social worker. Ask your healthcare provider about support groups for parents of a child with epilepsy.
- Ask what safety precautions your child should take. Talk with your adolescent's healthcare provider about driving. Your adolescent may not be able to drive until he or she is seizure-free for a period of time. You will need to check the law where your adolescent lives. Also talk to healthcare providers about swimming and bathing. Your child may drown or develop life-threatening heart or lung damage if a seizure happens in water.
- Have your child carry medical alert identification. Have your child wear medical alert jewelry or carry a card that says he or she has epilepsy. Ask your healthcare provider where to get these items.
How can I protect my child during a seizure?
- Do not panic.
- Note the start time of the seizure. Record how long it lasts.
- Gently guide your child to the floor or a soft surface. Cushion child's head and remove sharp objects from the area around him or her.
- Place your child on his or her side to help prevent him or her from swallowing saliva or vomit.
- Loosen the clothing around your child's head and neck.
- Remove any objects from your child's mouth. Do not put anything in your child's mouth. This may prevent him or her from breathing.
- Perform CPR if your child stops breathing or you cannot feel his or her pulse.
- Let your child sleep or rest after his or her seizure. He or she may be confused for a short time after the seizure. Do not give your child anything to eat or drink until he or she is fully awake.
How can I keep my child safe?
Your child may need to follow these safety measures:
- Your child must take showers instead of baths.
- Your child must wear a helmet when he or she rides a bike, scooter, or skateboard.
- Do not let your child sleep on the top of a bunk bed.
- Do not let your child climb trees or rocks.
- Do not let your child lock his or her bedroom or bathroom door.
- Do not let your child swim without an adult who is informed about his or her condition. Have your child use a flotation device, such as a life jacket.
- Tell your child's teachers and babysitters that he or she has epilepsy. Give them written instructions to follow if he or she has another seizure.
Call your local emergency number (911 in the US) for any of the following:
- Your child's seizure lasts longer than 5 minutes.
- Your child has trouble breathing after a seizure.
- Your child has diabetes and has a seizure.
- Your child has a seizure in water, such as in a swimming pool or bath tub.
When should I call my child's doctor?
- Your child has a second seizure within 24 hours of his or her first.
- Your child is injured during a seizure.
- Your child has a fever.
- Your child is depressed or anxious because he or she has epilepsy.
- Your child's seizures start to happen more often.
- Your child is confused longer than usual after a seizure.
- You have questions or concerns about your child's condition or care.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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