Children With Disabilities: What You Need to Know About Epilepsy & Seizures
When a doctor diagnoses a child with epilepsy, it is a frightening experience for the both the parents and the child. Part of this fear lies in not fully understanding epilepsy, seizures, or the affect that it will have on the child's life and the family as a whole. A part of coping with epilepsy is researching to learn as much about the condition as possible. This includes learning about the causes of epilepsy, the different types of epilepsy, and how to take the necessary precautions to avoid injury and lessen the number of potential seizures.
What is Epilepsy?
Epilepsy is a neurological disorder of the brain that can affect both children and adults. It is also known as a seizure disorder because reoccurring seizures are its defining and most recognizable characteristic. This condition is considered chronic because of its long-lasting and recurrent nature. Epilepsy occurs more frequently than one might imagine, with nearly 500 new diagnoses being made daily and up to 150,000 people diagnosed yearly in the United States alone. Of these new cases, 30 percent are children. It is estimated that there are some three million people diagnosed in the United States, with 300,000 of that number under the age of 15 years.
- Citizens United for Research in Epilepsy (CURE): What is Epilepsy
- University of Illinois Extension: Youth With Special Needs
- National Institute of Neurological Disorders and Stroke: What is Epilepsy?
What are Seizures?
A seizure is an incident that occurs as a result of an electrical discharge in, or decreased blood flow to, parts of the brain. When this discharge occurs, it disrupts the routine and normal functions of the brain. This may result in a loss of consciousness, convulsions or other involuntary movements. When seizures occur frequently, they are seen as an indication of possible epilepsy.
There are several different types of seizures that fall under one of two categories - generalized or partial. They can also be either convulsive or non-convulsive. A generalized seizure is one in which there is an electrical discharge in both sides, or halves, of the brain. One type of convulsive seizure is known as a tonic-clonic or grand mal seizure. It is characterized by an initial stiffening of the body, followed by jerking and shaking, an expulsion of vocal noises, and even incontinence. A person suffering from this type of seizure may also be at risk of biting his tongue or even dislocating bones. Another generalized convulsive seizure is known as a myoclonic seizure, in which the arms and legs experience repetitive jerking movements. Absence, or petit mal, seizures occur in children as young as four years old and as old as 12. This type of seizure is characterized by staring while maintaining normal posture. It lasts for approximately 30 seconds and the child does not remember the episode happening. This is also a type of generalized seizure that is non-convulsive.
Partial seizures, also known as focal seizures, occur when there is an electrical discharge in one half of the brain. These types of seizures may be divided into two sub-types called simple or complex partial. A simple partial seizure is one that shows symptoms that correlates with the location of the abnormal activity in the brain. It may affect muscle movement, smell or taste, vision, or even emotions. Complex partial seizures last between 30 seconds and two minutes and typically begin within the temporal lobe of the brain. This is a non-convulsive seizure in which the child may stare or make movements that serve no real purpose, such as rubbing hands together or walking in circles. Children who experience this type of event are not aware of what they are doing and will not have any memory of it occurring.
- The New York times Health Guide: Seizures
- University of Maryland Medical Center: Seizure Disorders
- Ohio State Medical University: Epilepsy and Seizures
Causes of Epilepsy:
When a parent discovers that his child has epilepsy, it isn't uncommon to search for the cause of the condition. This can be easy to ascertain in some cases, while in other cases it may be difficult or impossible to determine and the cause may remain unknown. Common causes of epilepsy in children include head injuries, an infection in the brain, or abnormal development of the brain. Children with brain tumors may also develop epilepsy.
- Stanford School of Medicine: What Causes Epilepsy
- NYU Langone Medical Center: Epilepsy and Children/Causes
- Cedars-Sinai: Epilepsy Causes and Risk Factors
Causes of Seizures:
There are numerous potential causes of seizures. Many of these causes are the same as what causes epilepsy. This may include head injury, infections, and the brain receiving insufficient levels of oxygen. Other conditions that may result in a child having a seizure include congenital abnormalities, illness, high fever, medications, or trauma at birth.
- Pediatric Clinics of North America: Seizures in Children (.pdf)
- Chicago Medical Center: Epilepsy and Seizures
- University of Rochester Medical Center: Seizures and Epilepsy in Children
Characteristics of Epilepsy:
It may be easy to assume that everyone who has a seizure is also epileptic. Epilepsy and seizures are not, however, necessarily the same thing. What makes seizures potentially different from epilepsy is the number of times that they occur. A doctor may diagnose a child with epilepsy when he has more than one, or repeated seizures. This suggests that the condition is chronic. When a child only has a single seizure and no history of them, it may be a result of other conditions, such as a high fever or injury. Common symptoms associated with epilepsy include staring, convulsions, or displaying behavior that seems random or involuntary. Some epileptic children may experience what is called an aura before having a seizure. This aura may be manifest as a complaint of an unusual odor or changes in mood.
Certain types of epilepsy are more common in children than in adults. This includes absence epilepsy, juvenile myoclonic epilepsy, and benign rolandic epilepsy. As the name suggests, absence epilepsy is associated with absence seizures. In the teenage years, a child may develop juvenile myoclonic epilepsy, which is associated with myoclonic seizures that may eventually evolve into tonic-clonic seizures. Benign rolandic epilepsy occurs most often in children between the ages of four and 10. A child with this type of epilepsy may experience tonic-clonic seizures or facial twitching that occurs at night, along with difficulty speaking.
- Mayo Clinic: Epilepsy Symptoms
- Rush University Medical Center: Epilepsy
- Cleveland Clinic: Epilepsy Symptoms
Diagnosing a Child with Epilepsy
Whenever a child has a seizure for the first time, he should be taken to the emergency department at the nearest medical facility. As much information about the surrounding conditions should be taken to the appointment in order to help the doctor accurately make a diagnosis. Emergency help should also be sought when a child's seizure lasts longer than two minutes. To help assess whether the child has epilepsy, the doctor will run a series of tests after obtaining a medical history from the family. These tests will include blood work, an electroencephalogram (EEG), and magnetic resonance imaging (MRI). The EEG is meant to measures the amount of electrical activity that goes on inside of the brain. The MRI takes an image of the brain and can reveal if there are any scars or other abnormalities that may be causing the seizures. The results of these tests, along with an assessment of the symptoms will help the doctor to make a diagnosis.
- University of Washington: Epilepsy - Diagnosis
- Medline Plus: Epilepsy
- Dartmouth Medical School: Epilepsy and Seizure Disorder Resource Guide for Parents PDF
What Precautions Should I Take?
When a child is diagnosed with epilepsy, the parents or legal guardians must make certain adjustments to provide a safe environment for their charge. These precautions will help to reduce the chances of injury in the event of a sudden seizure. In the home, examine all of the furniture and remove any item that has the potential to shatter, such as tables with glass tops. Use padding on sharp edges to avoid unnecessary injury, should the child fall and bump his head. Put all sharp instruments and objects away or out of reach. Make the bathroom safe by placing non-skid mats in the tub and padding the fixtures. Older children should be encouraged to take showers and replace any potentially breakable shower doors with plastic or other shatterproof materials. To avoid the risk of drowning, smaller children should never be left alone while in the bathtub. In homes with a fireplace, never leave children unattended when it is in use, and remove all fireplace implements to a safe location. Keep stairs blocked off as much as possible to prevent children from falling down. Children with controlled epilepsy may still ride a bicycle, however they should wear protective gear at all times and never bike alone. In addition to having a safe home and play environment, the child should also be given a medical alert bracelet. Wearing a medical bracelet will help to inform others of his condition, in the event that there is an epileptic episode around people who are unfamiliar with his condition.
- Canadian Epilepsy Alliance: A Guide for Parents - Epilepsy (.pdf)
- Columbia Comprehensive Epilepsy Center: Seizure Precautions
- WebMD: Epilepsy and Home Safety
What to do if a Child is Having a Seizure:
It is important for parents and guardians to know how to react when a child is having a seizure. Although there may be a sense of helplessness until it stops, it is necessary to understand what should and should not be done during an actual episode. The first step is to mitigate the risk of injury by moving any objects that can be knocked over or that may have sharp edges. If the child is standing, help him to lie down if possible, placing a pillow or other soft item beneath the head. Once the child is lying down, remove his glasses, loosen any snug or overly tight clothing, and turn him to his side to prevent choking from saliva. Step away at this time and do not attempt to hold him down, as this may also cause injury. Whenever possible, time the length of the seizure. This is important for several reasons. If the child has never had a seizure, the doctor will need to know how long the episode lasted. Knowing the duration of the seizure is also a way of knowing when to call emergency services, which should be done if it lasts for longer than two to five minutes.