Epilepsy is a neurological condition where an individual has recurrent seizures. A seizure is defined as an abnormal, disorderly discharging of the brain's nerve cells, resulting in a temporary disturbance of motor, sensory or mental function. There are various causes of childhood epilepsy like developmental, inborn errors of metabolism, genetic causes, fever, meningoencephalitis, vascular conditions, etc.
How early does it start
Seizures can start at neonatal age. Hypoglycemic seizures can happen in the first few days of life, whereas febrile seizures are common at the age of 1–5 years. Juvenile absence and myoclonic epilepsy are more common in adolescents.
Category of children in whom epilepsy is more common
Children with cerebral palsy, autism, developmental delay, family history of epilepsy, etc., have higher chances of epilepsy attacks.
Indication that point to onset of epilepsy
• Febrile seizures during early childhood
• Mental retardation
• Cerebral palsy
• Developmental delay
• Focal neurological deficits like hemiparesis are risk for future epilepsy
Epilepsy in children is diagnosed mainly on clinical history reports from the parents with detailed eyewitness accounts of seizures. Further classification of epilepsy is made on brain imaging (CT/MRI), EEG, metabolic profile, genetic tests, etc.
Epilepsy is mainly treated with medications to control the seizures. Sometimes, non-AED medications like steroids are also used to control certain specific seizures. If the epilepsy is refractory to medications, procedures like vagal nerve stimulation, epilepsy surgeries like resection of epileptic focus, or palliative procedures like callosotomy are done. A ketogenic diet is used to treat certain types of childhood epilepsy.
Lifestyle changes required
Compliance with medications is the primary responsibility of the parents along with ensuring that the child sleeps well, eats well, is not exposed to excessive TV, video games, etc. Children should avoid the prone sleeping posture at night and should get enough exercise and outdoor activity.
Children who suffer from epilepsy can find it difficult to lead a normal like other children. Know all about epilpsy in children, especially in toddler by going through this ClipBook.
Do children outgrow epilepsy?
In some cases, seizures are few and children go into remission in a few years. Certain types of epilepsy, however, require lifelong medication. Hence, a clear classification of epilepsy into primary or secondary is important.
Precautions to take when traveling with epileptic children
Carry appropriate medications. Make sure kids get adequate sleep.
Does yoga or meditation help children with epilepsy?
Yes, it should help.
Branches of medicine involved in treating children with epilepsy
Paediatricians, neurologists, paediatric neurologists – all these specialisations must work together to treat a child with epilepsy.
Reaction of epilepsy medications with those used for other diseases
Anti-epileptic medications, especially the older generation ones, do have interaction with the other medications like antibiotics, anti-TB medications etc. Dose adjustments are required to prevent complications.
The author is a Consultant Neurologist at Columbia Asia Referral Hospital, Bengaluru.