Childhood epilepsy: What parents need to know

As per a recent research paper published in The BMJ, epilepsy contributes to a significant disease burden in children and adolescents worldwide. “The incidence of childhood epilepsy is three-fold higher in low- and middle-income countries compared to high-income countries,” notes the paper.

Epilepsy is a serious neurological disorder characterised by recurrent seizures, thereby severely impacting a person’s quality of life. And when it is diagnosed in a child, the problem increases manifold, especially for parents as it comes with a range of complexities and uncertainties. Experts emphasise that parents learn about the different types of childhood epilepsy to be able to provide the best possible care for their child. “While many children with epilepsy outgrow the condition as they age, some continue to experience seizures into adulthood. One of the most challenging aspects of childhood epilepsy is the unpredictability of seizures, which can disrupt daily activities and lead to social stigmatisation. The management of childhood epilepsy often involves a complex regimen of medications and lifestyle modifications which can be burdensome for both the child and their family,” says Dr Priyanka Tater, neurologist, Zynova Shalby Hospital.

A seizure may produce varied symptoms depending on the part of the brain affected. Based on the symptoms, seizures are of several types.

Absence seizure: This is when the child stares off into blank space and becomes unresponsive, says Tater. “Sometimes the eyes may flicker during this episode. In Myoclonus, there are sudden jerks, usually of the upper part of the body. If the child is holding a toothbrush or a toy, it may fall from the child’s hand.”

Focal seizure: It is an electrical storm in a small part of the brain, Tater says. “In this case, the child has sensations or movements only in one body part. For example, only the right hand may twist or shake. Generalised convulsion is when an electrical storm takes over the entire brain. The whole body starts to shake violently. This kind of seizure is also known as a generalized tonic-clonic (GTC) seizure.

Atonic seizure: These are seen when there is a sudden loss of body power. This can cause a sudden fall called a “Drop Attack”. To categorise the seizures, doctors may need MRI, EEG, and sometimes video-EEG monitoring. “The management of seizures often involves the prescription of antiepileptic drugs. Determining the appropriate medication and dosage may require careful oversight by experts. In instances where medications are not effective, some children may undergo surgical interventions,” she explains.

Given that there are more than 30 medications to treat seizures, it is essential that one is able to identify the exact type of seizure a child develops. Precise diagnosis is crucial here, say doctors. They explain how 80 per cent of children become completely seizure-free with properly chosen medications. But, about 20 per cent of children don’t stop having seizures, even with many medications. Steroids may reduce EEG abnormalities, improve thinking, and stop seizures. One can also opt for Removal Epilepsy surgery which means if the electrical storm comes from a small brain part, we remove that small part. Then there’s the calming down of abnormal brain activity via the Vagus Nerve Stimulation (VNS), a small device, about the size of a matchbox kept below the chest.