Epilepsy is a type of brain disorder which leads to a sudden change in how the brain works. It can cause people to have repeated (several or many) seizures called epileptic fits (convulsions), for short periods of time. The seizures happen because there is an uncontrollable electrical discharge from the nerve cells in the brain. This may create a short term disturbance in the way the brain works and cause odd sensations and abnormal movement or behaviour.
Epiliptic seizures are not usually dangerous. But, a person can be at risk if they are in a dangerous environment (eg swimming in a pool or beach, driving a car), or if they become unconscious. Injuries can happen at school, at work, at home or other places.
One child in every 20 will have a seizure during their childhood, often with a high temperature (febrile convulsion). This is not epilepsy. Most children who have febrile convulsions do not go on to have epilepsy. Only about one in 200 children have epilepsy.
Children with epilepsy can usually lead a normal and active life but will need to take be careful with certain activities.
It is important to know what to do and how to help your child if they have a seizure.
Signs and symptoms
The symptoms of the seizure depend on what parts of the brain are affected. What happens during a seizure lets doctors know what parts of the brain are involved.
Signs and symptoms may include:
- Sensory disturbances - is when you/your child experiences tingling, numbness, changes to what you/your child sees, hears or smells, or unusual feelings that may be hard to describe.
- Abnormal body movements - limp, stiff or jerking movements that may come with loss of consciousness and shallow or jerky breathing
- Abnormal behaviour - is when you/your child may be confused or have automatic movements such as picking at clothing, chewing and swallowing or appearing afraid
- All of the above
Types of seizures
There are many different types of seizures and they can be generally classified into two groups:
Focal seizures
Focal seizures happen when the seizure activity begins in only one part of the brain. It usually affects one side of the body and you/your child may or may not lose consciousness.
These include:
- Simple partial seizures
- Complex partial seizures
Generalised seizures
Generalised seizures happen when the seizure activity begins all over the brain. The person's conscious state is always affected.
These include:
- Tonic-clonic seizures, sometimes called 'grand mal' or major seizures.
- Absence seizures, sometimes called 'petit mal' or starring seizures.
- Myoclonic, atonic and tonic seizures.
Diagnosis of epilepsy
It is important that your/your child's epilepsy is correctly diagnosed and treated by a children's doctor (paediatrician) or a doctor who specialises in childhood disorders of the brain (paediatric neurologist). To diagnose epilepsy the doctor will need a very detailed description of your child's seizures, medical history, development, learning and behaviour. A home video recording of your child's seizures is very helpful if they happen often or are predictable.
Tests
Special test are needed in some children with epilepsy. Your child's doctor will talk to you about the following tests if they are needed.
- Blood tests:to check your child's sugar, calcium, magnesium and salt levels.
- EEG:is a recording of brainwave activity. (More information on EEG factsheet).
- CT or MRI:gives us pictures of the brain. (More information on MRI or CT factsheets).
- Video EEG monitoring:detailed EEG done in hospital. (More information on Video EEG monitoring factsheet).
What causes epilepsy in children?
Many different disorders of the brain may be associated with epilepsy.
For some patients the epileptic disorder is congenital, that is, the child is born with the predisposition to have epilepsy. In other patients, the epileptic disorder is acquired, as a result of brain damage that occurred after birth.
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The congenital epilepsies could be the result of the child having a gene that is responsible for the epileptic disorder; these are the genetic types of epilepsy. Alternatively, congenital epilepsy may be the result of factors that interfere with the development of the brain during gestation, resulting in brain malformations.
In acquired epileptic disorders, the damage might occur at the time of birth, for example the case of newborns that have oxygen deprivation during labor and delivery; or intracranial bleeding, as seen in some children born prematurely. Also, the brain damage may occur any time after birth. For example, epilepsy could be a complication of infections in the brain (meningitis, encephalitis), head injuries with brain damage, brain tumors, or intracranial bleeding.
Are seizures bad for children?
Presently there is no indication that short-lasting seizures will result in any brain damage. However, prolonged seizures, especially generalized tonic-clonic seizures, in some cases could result in brain damage, but this is very unusual.
Although brain damage is not likely, children can be injured at the time of the seizures. For example, in the atonic seizures there is a sudden loss of muscle power and, if this happens when the patient is standing, it is followed by a fall that might result in injuries to the face and/or mouth. Similar types of physical injuries can happen with other seizures.
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