When someone has recurrent convulsions over a prolonged period of time – months and years, for example – the condition is called epilepsy.
What is epilepsy?
Epilepsy is a general name for a range of conditions that have no obvious external cause, but are characterised by recurrent attacks (two or more) of abnormal electrical activity in the brain.
The nerve cells of the brain erratically release electrical discharges that are uncontrolled and cause odd sensations and abnormal movement or behaviour. These are called convulsions or seizures.
We don’t know what causes epilepsy. Around 60% of children who suffer from epilepsy are otherwise perfectly healthy.
Certain factors can make a child more likely to have seizures. These include certain structural changes in the brain seen in disorders such as cerebral palsy or hydrocephalus. In these cases, epilepsy is a sign of a neurological disorder.
Some seizures are caused by fever. These seizures are called febrile convulsions
, and they’re not considered a type of epilepsy. Only 3% of children with febrile conditions will later develop epilepsy.
Epilepsy is characterised by many different types of seizures, some more dramatic than others. The type of seizure depends on where the abnormal electrical discharge in the brain comes from.
Generalised seizures of the tonic-clonic type (formerly known as grand mal seizures) occur without warning. They affect the whole brain, causing your child to lose consciousness and fall down. Your child’s body stiffens and her arms and legs jerk rhythmically. She might drool and wet herself.
In contrast, other generalised seizures might only appear as a brief ‘absence’ from activities, in which your child stares into space and has an altered conscious state for about 30 seconds.
Partial or focal (localised) seizures start in only one part of the brain. Your child’s awareness might or might not be affected. There might be localised muscle twitching, sensory disturbances (including numbness and abnormal smells, sounds, tastes and vision), a temporary inability to talk, and abnormal behaviour (including automatic movements, such as picking at clothing or lip smacking).
When to see your doctor
You should visit your doctor if:
- your child has recurrent seizures
- your child has a seizure that lasts more than five minutes
- you’re not sure whether your child has had a seizure
- your child starts having seizures more often than is usual for him.
If your child is suspected of having epilepsy, your GP will usually refer your child to a paediatrician or neurologist for further investigation. Blood tests and an EEG are routinely performed, and a CT or MRI scan of the brain might help rule out any underlying structural abnormality.
Your doctor will consider the age of onset, seizure type and EEG results when classifying your child’s epilepsy into an epilepsy syndrome. This classification provides valuable information for treatment options and prognosis.
The aim of treatment is to allow your child to carry on an otherwise perfectly normal life.
Anticonvulsant medication can help most children, but it does have side effects. Discuss this carefully with your doctor, who will provide you with information about the drugs, as well as regularly monitoring their level in your child’s blood. If medication doesn't work, there are other therapies, including a ketogenic diet or surgical options, which your doctor will explain to you.
The outlook varies from person to person and is difficult to predict. Contacting an epilepsy support group might help you feel less fearful about your child’s condition.
Discuss any doubts that you might have with your doctor. Perhaps the most important thing of all is that your child understands the nature of his problem. Try to encourage him to be self-confident so he can live a full and productive life.
Anyone involved in your child’s daily care, including teachers, should be informed that your child has epilepsy. They need to understand what this means, as well as how to handle a seizure if it happens. Encourage your child to wear a talisman (wrist bracelet or pendant) that lets people know she has epilepsy.
Regular meals, adequate sleep and exercise are an important part of an overall approach to preventing seizures. Avoid any known trigger factors for your child as much as possible, such as flashing lights, tiredness, hunger or watching television. Supervise your child when she’s swimming or bathing, and try to avoid activities such as climbing trees.