Epilepsy in Young: Early Treatment Found Essential
Some children may become suddenly unresponsive once in while, staring blankly. Then, they may begin chewing and repeating odd, mechanical motions. Some may try to take off their clothes or run and flail at restraint. Others simply may suffer sudden falls for no apparent reason.
Such confusing behavior may last for just moments and go unnoticed, or result in ridicule from other children and punishment from adults, who misinterpret it as a discipline problem.
Sharp-eyed day-care providers, teachers and parents should suspect epilepsy, an unfortunately common neurological disorder that often responds well to early treatment. It need not limit the child’s activities or education.
This disorder is produced by brief changes in the brain’s electrical system due to a sudden increase in the amount of energy passing between cells in one small area of the brain.
Recently reported studies have shown that many in the early stages of epilepsy can discontinue all medication entirely once they have been treated and free of seizures for at least two years. Left untreated, they risk developing a more severe disorder in the future.
Dr. E. H. Reynolds of Kings College Hospital and Medical School in London reports that unless a person’s seizures are controlled within the first two years of onset, they may not ever be controlled. The reasons for this pattern, observed in a 10-year study, are not understood.
‘Early Treatment Important’
“Early treatment is very important,” Reynolds said, adding that the interplay between natural remission and the medication is unclear. “But there seems to be little doubt that drugs play a major role in the high remission rates,” he concludes.
In a few pediatric cases where standard treatment fails, a high-fat, high-calorie diet helps.
“Many times, a teacher is the first person to pick up on subtle symptoms of epilepsy,” said Epilepsy Foundation of America spokeswoman Nancy Hembree.
The Landover, Md.-based EFA recently produced a poster and revised pamphlet to help teachers and others who work with the public know the best responses to a seizure as well as how to recognize a potential problem.
Contrary to the stereotype, epilepsy does not always involve a “fit,” a term which wrongly suggests mental derangement.
There are more than 20 different types of seizures, ranging in severity as well as frequency, and an estimated one person in 100 has recurring ones. About 750,000 of the more than 2 million people with epilepsy are children and teen-agers, Hembree said.
A Grand Mal seizure, also known as the generalized tonic-clonic type, is the most severe and involves massive body convulsions, loss of consciousness, and sometimes loss of bladder or bowel control. When consciousness returns, the person can feel confused and sleepy, and will not have any memory of the seizure.
Not All Convulsive
Not all seizures are convulsive, but in all cases, what you should not do is as important as what you should do.
- Do not put anything in the child’s mouth and do not try to hold the tongue; it is physically impossible for the child to swallow it.
- Do not try to give liquids or medicines during or just after the seizure.
- Very important: Do not restrain the child’s movements. Rather, guide the child away from hard, sharp or hot objects. Put something soft under his or her head. Turn the child on one side to keep airway clear.
In a Petit Mal seizure, a blank stare comes over the child’s face for a few seconds. It may be accompanied by rapid blinking, upward rolling of the eyes, chewing movements. The child may drop what he or she was holding and be out of touch, unresponsive, although the child appears to respond to his or her name.
Partial seizures can include involuntary jerking of fingers or toes, sometimes spreading up the body. Other types may cause the child to suddenly collapse or fall. In children between 3 months and 3 years of age, seizures may be characterized by sudden jerking movements, with the head dropping or the body pulling into a kind of fetal position.
In all cases, observe the child carefully, making sure he or she cannot be hurt by surroundings. And it is important always to speak calmly and reassuringly. Comfort the child afterwards. If the child has not been diagnosed with epilepsy, medical evaluation is necessary.