Seizures are common in childhood and adolescence. They happen for a variety of reasons. A seizure may occur as the result of a high fever or of an illness that affects the brain. A single seizure is not epilepsy. Approximately one in ten Canadians will experience at least one seizure during a lifetime. Many do not have epilepsy. In those children who have a single seizure, only a small percentage have a second one. Epilepsy is a condition that is defined by multiple seizures.
Epilepsy that begins in childhood is often outgrown. Children with ongoing seizures requiring medical treatment frequently respond to medications, and lead active, productive lives.
Cases of intractable or medication resistant epilepsy, however, present a real challenge to the child, the family and the clinician. In some of these cases, seizures may be associated with motor problems or developmental delay.
Each family member may respond differently to having a child in the family with seizures. Some of the usual feelings may be confusion, guilt, fear, loss, inadequacy, anxiety, disbelief, shock, shame and embarrassment. Having a family member with seizures can be overwhelming. Appointments with physicians, diagnostic tests, medications and their side effects, unfamiliar medical terms and the unpredictability of seizures may often cause stress. Each family member, depending on their previous experience with seizures, may cope differently with their feelings. Sometimes these feelings can become problematic, interfering with relationships and day-to-day life. Should this occur, parents may want to consider talking with a professional epilepsy counselor. It is usual to seek counselling should you want help to work through feelings about your child's epilepsy.
When a child has epilepsy, it is normal for parents to be worried about their child having a seizure. Sometimes, in an effort to be a good parent or to be loving and helpful, parents try to do too much for their child. They may find it difficult to allow their child the increased independence that is so important for development. Children with epilepsy can usually participate in the same activities as their peers, although there may be some extra steps to ensure safety that need to be taken.
Seizure Medications and Children
Early recognition of seizures, followed by consistent, regular treatment with seizure medications, offers the best chance of a normal childhood, and a positive future, for the child with epilepsy.
Regular check-ups are important, even when children are seizure-free, because the original dose of seizure medication may become ineffective as children grow taller and increase in body weight.
Should a previously seizure-free child begin to have seizures again, it does not mean that the condition is getting worse, nor that the medication is no longer appropriate. Usually, a change in dosage will take care of the problem.
The bodies of children and adults process medications differently, so it often takes a proportionally larger dose of seizure medication to control seizures in the average child than in the average adult.
At the onset of puberty, body chemistry changes over from that of childhood to adulthood, often in a matter of just months. Unless medication levels are tested, and dosages adjusted accordingly, the recently-matured adolescent may suddenly be taking more medication than his or her body can handle. He, or she, may become drowsy and find it difficult to do school work. Over-medication can be easily avoided by periodic check-ups and medication level tests as youths on seizure medications approach sexual maturity.
Depending on their social maturity, children should be encouraged to be responsible for taking their own medicine, as early as possible. In most cases, this will give them a greater sense of responsibility, and of being in control of their condition.
If medication is given in liquid suspension form, as in a syrup, the bottle must be shaken well before measuring out the dosage. Otherwise, the active medication may sink to the bottom of the suspension, making the first doses out of the bottle too weak while the last ones will be too strong.
In some children, phenobarbital may have the effect of producing hyperactive, irritable behaviour. In others, performance ability may be impaired. If these problems arise at home or at school, a different medication might be prescribed, after discussion with the treating physician.
Sometimes, the widely-used medication phenytoin (Dilantin) can cause problems of gum overgrowth, ranging from slight to severe. This may often be prevented by brushing very carefully, as well as by regular use of dental floss and frequent professional cleaning. If gum growth becomes a severe problem, the tissue can be surgically removed.
Brothers and Sisters: When there is a child with seizures in the family, there are certain things that have to happen around the management of the seizure disorder. For example, there are doctor's appointments to attend and medications to be given. Another interruption to daily life is the caring involved when a child has a seizure. As well, parents may be called into the school to pick up the child because of a seizure. In this way, family routines are disrupted, outings are sometimes cancelled or postponed, as are plans for special one-to-one time with siblings. Seizures, by nature, are unpredictable. As a result, siblings can sometimes feel that they are not receiving the same amount of attention.
When planning family outings, it may be helpful to create a back-up plan(should a seizure occur) that considers the following.
- How can brothers and sisters help during and after a seizure?
- Can your child resume activity after the seizure?
- If not, who will tend to the child after the seizure, while other family members continue with their trip to park, birthday party, picnic, or camping?
- Under what conditions would it be necessary to cancel or end an outing prematurely?