National Epilepsy Day 2022: Expert Tips To Manage This Condition In Children

Seizures and epilepsy in children are one of the most common neurological disorders and affect almost 4 to 5% of children. Around 60% of epilepsy starts in childhood. Seizures occurring with fever in a child who is otherwise developmentally normal are usually febrile seizures and are often benign and have a good outcome. These should not be treated like epilepsy.

Usually, the impression in peoples' mind is that a seizure involves strong jerking of the limbs with stiffening and up rolling of eyeballs. While this is true for some types of seizures, it is not necessarily true in all cases. Children often have different types of seizures which can be overlooked by parents if they are not aware of these. These include sudden jerking of the whole or parts of the body as if the child has become afraid of some thing - these jerks can occur either as single jerks or as repeated jerks i.e., clusters particularly when the child wakes up from sleep. If, the parents notice any such jerks, they should report them to the pediatric neurologist as they may reflect a certain type of seizures known as Infantile Spasms.

Similarly, children may have very brief staring spells with or without blinking of eyes. These are often mistaken - both parents and school teachers as daydreaming or it is thought that the child is not paying attention. These may represent what are known as absence seizures. Also, some children may become suddenly loose and fall down without any apparent reason. These may represent atonic seizures. Hence parents should report any such abnormal moment to the doctor who will then guide them to the appropriate pediatric neurologist.

At the same time, all abnormal moments that are seen in children are not necessarily seizures or epilepsy. Many non-epileptic events can look like seizures and sometimes these children are started unnecessarily on anti-seizure medication. Some of the common non-epileptic events in children include breath holding spells wherein the child cries, holds breath and becomes blue and may become stiff. Similarly, children can have fainting episodes which can be mistaken for seizures. There are a number of events that mimic seizures, and a good pediatric neurologist will be able to differentiate these from true seizures.

Epilepsy in children can be caused by several factors including problems during delivery, infections of the central nervous system, head injury, and of course they could be genetic. Your doctor will help find the cause of seizures by conducting some tests

If your child has been diagnosed as epilepsy, the paediatric neurologist would prescribe some anti-seizure medication's that need to be taken regularly as advised. These medications should not be stopped abruptly even if the seizures have stopped. The treating doctor should be consulted before changing their dose or stopping them. In case your child develops a seizure, the important thing is to remain calm and keep the child in a place where there is no danger of falling, loosen any tight clothes, turn the child on the left side, and let the seizures stop. Do not try to put anything in the mouth of the child or make him/her smell pungent things; also, do not lift the child and start patting. If the seizure does not stop in a minute or two, then use the medication to be sprayed into the nose of the child to stop the seizure that your paediatric neurologist has prescribed.

There is no stigma in having epilepsy. With proper management, most children with epilepsy can live normal lives.

(Prof Dr. Pratibha Singhi, Head Department of Neurology, Amrita Hospital Faridabad)

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