‘Do seizures happen in children?’ This is the commonest response we get when we talk about seizures. It is important to know that seizures indeed occur in children – in fact as commonly as up to 5 kids out of a 100 will experience a seizure.
What is epilepsy?
A tendency to have seizures again and again is called epilepsy.
This is a brain disease where a ‘short circuit’ happens in the electrical networks of the brain which manifests as a seizure. Epilepsy is called “apasmar” in Marathi and “mirgi” in hindi. It also known as ‘Khench”, “Daura”, “fit”, “akadi” etc.
How to identify a seizure?
Seizures in children are of different types.
1. They can be very obvious where the child is having jerking of all 4 limbs/ going stiff/ uprolling of eyes and frothing at mouth.
2. Often in children they can be quite subtle wherein the child just goes blank and looks ‘absent’ or just has a single jerk and falls down.
3. In babies they can be even more subtle and can look as if the baby is startling (dachakna or chamkana or dar gaya).
Often children cannot explain what is happening to them. The subtle seizures are often missed or mistaken to be naughty behavior. In our society it is also unfortunately commonly thought as ‘boori nazaar’ or a curse and families are misled to do pooja/black magic/voodoo rather than meeting a doctor.
What causes epilepsy?
There are many conditions which can cause epilepsy. Brain injury because of any reason eg after brain infection, head injury (severe), cerebral palsy, syndromes such as down’s (Mongolian child) can be associated with epilepsy. Another common cause of epilepsy is genetic- this is seen especially in children who have seizures but no developmental or academic concerns.
What about seizures with fever?
Often seizures which occur with fever in children less than 5 years age are confused with epilepsy. Majority children actually grow out of these- ie it’s an age limited condition like childhood asthma (baldama) and do not need anti-epileptic medications.
Can epilepsy be cured?
Seizures in children can be very scary to look at- parents naturally get very worried. There is good news- 60-70% of children with epilepsy can be fully treated with medications. These children can usually lead a normal life- attend school, participate in extra curricular activities, etc. The newer medicines have minimal side-effects and can be easily used even in babies. The usual concerns about getting addicted to medicines or the medicines affecting cognitive development have largely been overcome. It is important to note that as epilepsy is a chronic condition medicines need to taken for a few years.
Does epilepsy affect learning?
The cause of the epilepsy is what dictates whether learning is affected. Epilepsy by itself usually does not affect cognition. Majority of lids with genetic epilepsies do nlt have major learning issues. However as t is a common association it is always important to continually assess and review development in younger kids and academic performance in school going kids.
What about patients who do not improve with medicines?
A section of patients in whom medicines do not control the epilepsy can be offered epilepsy surgery. In well chosen cases the patient can be rendered disease free after epilepsy surgery. We routinely perform surgeries on all age groups- ranging from children as young as 8 months to adult patients. If epilepsy is not surgically remediable we can offer palliative surgery and ketogenic diet.
An epilepsy surgery program needs lot of infrastructure as well as skilled doctors (neurologists and neurosurgeons) to be well implemented. Hence it is typically done in tertiary care neurology centres such as Kokilaben Dhirubhai Ambani Hospital, Andheri, Mumbai.
The major challenge in epilepsy is actually not medical. It is the social stigma/taboo that is associated with this condition. This needs to be urgently addressed by the medical community and the society so patients with epilepsy can hope to lead fulfilling lives.
