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Epilepsy and Children a Guide for Parents

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Epilepsy and Children a Guide for Parents Epilepsy and Children A Guide for Parents www.facebook.com/epilepsy.ie @epilepsyireland www.epilepsy.ie Email: [email protected] Epilepsy Ireland was established in 1966 in order Contents to help and support people with epilepsy, their families and friends. We also aim to improve public understanding of epilepsy and eliminate Introduction 2 prejudice and misunderstanding about it. We work to encourage and assist research into the Describing Childhood Epilepsy 3 causes and treatment of epilepsy and to promote How Does the Brain Work? 4 an awareness of the need for education and rehabilitation. How is Epilepsy Diagnosed? 5 Treatment of Epilepsy in Children 7 The content of this booklet has been developed by Grainne Griffin, Advanced Nurse Practitioner in Classification of Seizures 10 Children’s Epilepsy and Maria Keegan, Paediatric First Aid for Seizures 13 Neurology Clinical Nurse Specialist, from Children’s Health Ireland at Crumlin, and Ann Connolly, What to Do When Your Child Has a Seizure 14 Advanced Nurse Practitioner in Children’s Epilepsy from Children’s Health Ireland at Tallaght. What Parents Need to Know 15 Keeping a Seizure Diary 16 Epilepsy Ireland How to Help Your Child Live with Epilepsy 18 249 Crumlin Road, Dublin 12 Epilepsy and Leisure 20 Tel: 01 455 7500 Email: [email protected] Useful Resources 21 Web: www.epilepsy.ie Facebook: www.facebook.com/epilepsy.ie Twitter: @epilepsyireland Charity Number: 6170 CRA Number: 20010553 Date of Print: November 2019 1 Introduction Describing Childhood Epilepsy There are approximately 1 in 200 children with epilepsy in Ireland. Many What is epilepsy? people with epilepsy have their first seizure in childhood or adolescence. Epilepsy is one of the most common neurological conditions. Children However, most children with epilepsy enjoy a full and active life and only with epilepsy have a tendency to have recurring seizures without any some continue to have epilepsy into adulthood. obvious cause. Epilepsy is a complex condition but research and knowledge of the area is growing and there are also many new treatments available. What is a seizure? Just like a computer, the brain can suddenly malfunction. When it does, This booklet is designed for parents but may also be useful for people who an epileptic seizure often results. A seizure occurs when there is a sudden want to learn more about epilepsy in children. burst of intense abnormal electrical activity within the brain. This causes a temporary disruption to the way the brain normally works. Symptoms experienced during a seizure depend on the part of the brain that is affected. What causes epileptic seizures? Epilepsy may begin at any age and for many children the cause is unknown. This can be confusing and difficult for parents to understand. When a cause is identified, it is usually one of the following: previous severe head trauma, brain injury at birth or previous infection of the brain e.g. meningitis or encephalitis. In rare cases, it can be linked to problems with metabolism or genetic disorders, brain tumours, brain malformations, stroke and degenerative nervous system diseases. The size of your brain has The average brain cell can have nothing to do with how between 1,000 and 10,000 clever you are. connections with other brain cells. The brain is like a computer for the body. It controls every single action of your body. It works 24 hours a day, 7 days a week. 2 3 How Does the Brain Work? How is Epilepsy Diagnosed? When your child has a suspected seizure, it is essential that the doctor determines that they are definitely having epileptic seizures. To establish this the doctor will: Parietal lobe + Take a detailed medical history. This will include details relating to FRONTAL lobe pregnancy, birth history, early development, general health and family medical history + Take a detailed history of the events experienced to date including what happens before, during and after each event occipital lobe + Perform a medical examination + If the doctor thinks your child may have epilepsy, further investigations may be requested, which may include an EEG, CT or MRI scan. temporal lobe cerebellum In some children their epilepsy can ‘go away’ Lobe of the brain What it controls & affects as they grow up whilst in others it continues Temporal Lobe Memory and emotions into adult life. Reading and writing Non verbal processing Language, speech, visual & auditory skills Frontal Lobe Planning and organisation Judgement and problem solving Making decisions Occipital Lobe Visual perception and attention Reading and writing Parietal Lobe Hand-eye co-ordination Spatial and direction awareness Body awareness and touch 4 5 Investigations Treatment of Epilepsy in Children Epilepsy is difficult to diagnose and while medical history, examinations and The best treatment for epilepsy begins with you and your child (if old enough) investigations are very important, the diagnosis can only be confirmed by a getting to know more about epilepsy. The main source of information about doctor who has all the information. your child’s condition is your doctor or nurse specialist. Don’t be afraid to ask questions. Your child’s type of epilepsy, the likely prognosis (outcome) and The EEG (Electroencephalogram) the treatment plan should be discussed with you at clinic. It is important to An EEG is a test that can help diagnose epilepsy. Small discs are applied to the realise, however, that it is often not possible to be certain about the prognosis child’s scalp. These discs are attached to small electrodes which record the for epilepsy and part of the coming to terms with it may be learning to live with electrical activity of the brain. This information transmits to a computer which this uncertainty. There can be a lot of information to take in at first, therefore it produces a printed record of brain wave activity. The procedure is painless and is worth asking what support is available so that you can access it at a later date. lasts approximately one to two hours. Children can sleep during the test. Sleep Epilepsy Ireland provides support for parents and carers and has a range of makes the recording more informative. Sometimes a child has a seizure during leaflets and information on epilepsy. the test which helps detect abnormal brain waves. However, the brain of people with epilepsy can show abnormal activity, even when no seizure occurs. Medication Anti-epileptic drugs (AEDs) are the most common way to treat epilepsy. These CT (Computerised Tomogram) medications don’t cure epilepsy but are designed to treat and stop seizures A small number of children may require either a CT or MRI scan. Both occurring. procedures identify brain abnormalities but will not tell if your child has epilepsy. A CT scan is an X-ray that provides a computer reconstruction of the Choosing medication brain. It gives valuable information about the structure of the brain. The scan There are many AEDs to choose from. The drug which the doctor chooses will usually takes about 40 minutes. depend on the type of epilepsy that your child has. It is important to note that certain groups of drugs are more effective with particular types of epilepsy. The MRI (Magnetic Resonance Imaging) doctor will choose the one that’s most appropriate for your child. MRI scanning does not involve X-rays. It uses the body’s own magnetism to Once a drug is chosen it is usually started at a low dose and gradually increased generate detailed images of the brain. over a period of weeks to months. This minimises the risk of side effects. Images from an MRI scan are often more detailed than those from a CT scan, However, some children are more sensitive to drugs than others and it may but only a small percentage of children require MRI scanning. The procedure be necessary to go slower than recommended. Where possible one drug takes about one hour. (monotherapy) will be used to treat seizures; however, when seizures prove Results/Reports difficult to control more than one drug (polytherapy) may be necessary. All tests are studied and reports are sent to your child’s doctor or discussed in the clinic. 6 7 AEDs are available in tablet, liquid or granule form. Tablets come in various Duration of treatment dosages and some are available in slow-release form which permits a more Most children with epilepsy must take anti-epileptic medication until they are at convenient dosage regime. Granules may suit infants and young children. least two years seizure-free. At the end of that period, depending on the type of Granules are easily administered, they can be sprinkled on food or directly into epilepsy, the doctor may consider reducing treatment gradually. the mouth. Missed dose of medication Medication side effects Occasionally a dose of medication may be forgotten. If this happens, give Any type of medication can have side effects. These side effects can range from your child the missed dose as soon as you remember. If it is close to the time mild to severe. Often side effects are short lived. Once the body adjusts to the the next dose is due just give the next dose early. Never give a double dose new drug they often lessen or disappear completely. of medication. If you are concerned about side effects you should discuss them with your Note: Once AED treatment has begun, switching between different brands child’s doctor or nurse specialist. It may be possible to adjust the dosage and if or generic versions of the AED should be avoided, unless advised by an this isn’t an option, another drug may be used. Never stop or change the dose epilepsy specialist.
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