About epilepsy

Epilepsy is the name for a range of brain conditions. Children with these brain conditions have or are at risk of having repeated seizures without a reason.

Seizures happen when electrical activity in the brain is disturbed. This leads to changes in children’s awareness, thinking, behaviour, body movements or senses.

If a child has one seizure, it doesn’t always mean they have epilepsy. Most children who have a single seizure don’t have any more. Epilepsy isn’t usually diagnosed until after 2 or more seizures.

Epilepsy causes, risk factors and triggers

Several conditions are associated with epilepsy. These include:

• genetic conditions
• developmental and behavioural conditions like intellectual disability and autism
• disorders linked with large structural changes in the brain like cerebral palsy or hydrocephalus
• cortical dysplasia
• acquired brain injury, brain infection, tumour or stroke.

Epilepsy is more likely in children whose immediate family members also have epilepsy.

Triggers like sleep deprivation, fever and illness can lead to seizures in children with certain kinds of epilepsy. Flickering lights are a very rare trigger.

Febrile seizures are seizures triggered by fever. If your child has a febrile seizure and is otherwise healthy and there’s no family history of epilepsy, your child’s chance of developing epilepsy is only slightly higher than for any other child.

Types of epileptic seizures and their symptoms

There are many different types of seizures. They fall into 2 main groups – focal seizures and generalised seizures.

Focal seizures
Focal seizures start in one part or on one side of the brain. Symptoms of a focal seizure depend on what part of the brain is affected.

Symptoms of focal seizures might include:

• muscle twitching in one part of the body
• changes to smells, sounds, tastes and sight
• numbness
• difficulty talking
• unusual behaviour and movements, like picking at clothing or lip smacking
• head or eye movement to one side only.

A child’s awareness or responsiveness might change if they’re having a focal seizure.

Generalised seizures
Generalised seizures start on both sides of the brain at once. There are several different types of generalised seizures, and they have different symptoms:

• Tonic seizures cause children’s muscles to stiffen. They often happen during sleep.
• Atonic seizures cause muscle weakness. Children’s heads might slump forward, or they might fall to the ground in a ‘drop attack’.
• Clonic seizures cause muscles to repeatedly jerk and relax.
• Myoclonic seizures cause a sudden, very brief muscle jerk.
• Tonic-clonic seizures start with the body stiffening, and then jerking movements develop. The body becomes less stiff as the jerking goes on. Children lose awareness and fall down.
• Absence seizures involve a sudden loss of awareness. Children stare and don’t respond to touch or voice. These seizures last only a few seconds.
• Infantile or epileptic spasms cause both arms to stretch out suddenly and briefly, sometimes with a head nod or eye roll. These seizures happen in clusters. They’re most common in babies 4-9 months old.

What to do if you think your child is having an epileptic seizure

1. Stay calm, make sure your child is in a safe place, and remove any harmful objects so your child doesn’t injure themselves.
2. Watch exactly what happens, especially if it’s your child’s first seizure. This is so you can describe it later. If you have a smartphone or camera, take a video of the seizure.
3. Time the seizure.
4. After the seizure has stopped, put your child in the recovery position on a soft surface. This will keep your child’s airways open.
5. Stay with your child and comfort them until they recover.

Medical help: when to get it for children and teenagers with epileptic seizures

It’s important for your child to see a GP or go to a hospital emergency department if your child:

• hasn’t had a seizure before
• has several or repeated seizures
• starts having seizures more often than usual.

Monitor your child’s breathing. If your child stops breathing, call an ambulance on 000 immediately and start CPR for babies or CPR for children over one year. Also phone 000 and ask for an ambulance if a seizure lasts longer than 5 minutes.

Tests for epilepsy

If your GP thinks your child might have epilepsy, the GP will usually refer your child to a paediatrician or neurologist for further investigation.

The doctor might order blood tests and an EEG. Your doctor might also organise an MRI scan of your child’s brain.

Treatment for epilepsy

Epilepsy treatment aims to let children live an active and independent life.

If your child is diagnosed with epilepsy, your doctor will discuss with you whether your child should take antiseizure medicine.

If your doctor prescribes antiseizure medicine for your child, the doctor will let you know whether there might be some side effects to watch out for. If your child is taking antiseizure medicine, they’ll need to see a doctor regularly.

If medicine doesn’t work, your doctor might talk with you about other treatments, including a ketogenic diet or surgical options.

If your child has severe, prolonged or frequent seizures, your doctor might give you an emergency medication management plan.

An epilepsy support organisation can help you to develop an epilepsy management plan. This can help your child’s carers at child care, school and other settings understand your child’s epilepsy, including what to expect if your child has a seizure, how to manage it and who to call.

Prevention of epileptic seizures

Make sure your child takes their antiseizure medicine regularly.

Your child should avoid anything that might trigger a seizure. For example, if your child’s seizures are triggered by a lack of sleep, it’s important that your child has a regular sleep schedule. If your child’s seizures are triggered by flickering light, ask your doctor how to avoid this.

Your doctor will tell you what safety precautions your child needs to take when they go swimming, have a bath or do activities that involve heights.

Watching your child having a seizure can be very distressing. Talking to other parents can be a great way to get support and feel less fearful about your child’s condition. You can connect with other parents in similar situations by joining a face-to-face or online support group.