Seizures inflict people of all ages, even children.
Depending on what causes them, seizures can be managed well at home or may require constant medical supervisions.
We had a chat with Nazatul Amira Hamzah, a qualified pharmacist with 10 years of experience in pharmacy practice to learn more about seizure disorders in children.
Q1: What is a seizure?
A seizure is a sudden, uncontrollable change in muscle tone or movements, behaviours, sensations, or states of awareness caused by abnormal electrical activity in the brain. Epilepsy is characterised by recurrent seizures.
Q2: What are the common types of seizure disorders in children?
There are two major types of seizure: focal (partial) seizure and generalised seizure.
Focal seizures happen when abnormal electrical activity occurs in one or more areas on one side of the brain.
Before a focal seizure, your child might experience an aura, which is a sign that an episode is about to happen.
Common auras include feelings like déjà vu, a sense of impending doom, fear, or euphoria (an intense feeling of happiness or excitement).
Your child may also have visual changes, hearing abnormalities, or a change in their sense of smell.
A generalised seizure affects both sides of the brain, causing your child to pass out. They will also feel worn out following an episode.
Q3: What causes seizure disorders in children?
Possible factors contributing to seizures include:
- Genetics (family history of seizure disorders)
- Injuries of the brain
- Infections of the brain like meningitis or encephalitis
- Brain tumour
- Metabolic disorders (a group of conditions that affect one’s metabolism, such as diabetes, obesity, heart disease, and stroke)
- Medicines or illegal drugs
Q4: How do I spot seizure symptoms in my child?
Seizure symptoms vary depending on their type.
Watch out for these common symptoms in children:
- Staring spells: The child stops what they are doing, stares off into thin air, or has a look of absentmindedness
- Uncontrolled jerking movements of the arms and legs
- Muscle stiffness, twitching, or limpness
- Altered or loss of consciousness
- Sudden falls
- Periods of rapid eye blinking or chewing
- Unusual behaviors like gagging, lip-smacking, running, screaming, crying, or laughing
- Difficulty breathing
- Uncontrolled peeing or pooping
Q5: What should I do when my child has a seizure?
Here are the steps to follow immediately when your child experiences a seizure:
- Stay calm.
- Move your child onto a flat surface, such as the floor or ground.
- Remove any nearby objects.
- Lay your child on his or her side to prevent choking on saliva.
- If your child vomits, gently clean their lips with your finger.
- Loosen any clothing around the head or neck.
- Check if your child is breathing normally.
- Don’t try to stop your child from shaking; this will not stop the seizure and may make your child more uncomfortable.
- Don’t put anything in your child’s mouth.
- Don’t force your child’s teeth apart, as doing so could cause injuries or block the airway.
- Don’t give your child anything to eat or drink. Don’t give any medicine, pills, or liquids by mouth until your child is completely awake and alert.
- Record how long the seizure lasts.
- Your child may feel sleepy or take some time to return to normal following the episode. Stay with them until they are awake and alert. After the seizure, allow them to rest.
Q6: When should I call emergency services for assistance?
Get immediate medical attention if your child:
- Has a seizure that lasts more than 5 minutes
- Has repeated episodes
- Struggles to breathe
- Has a bluish color on the lips, tongue, or face
- Has a seizure while in water
- Remains unconscious for more than a few minutes after a seizure
- Falls or hits their head before or during a seizure
Q7: How can medication help with seizure disorders, and does my child need to take them lifelong?
Seizures are mainly treated with anti-seizure medicines based on the type of seizure, age of the child, side effects, cost, and ease of use.
Anti-seizure drugs lower the frequency and severity of seizures by regulating the electrical activity in the brain.
However, their use must be closely monitored and adjusted by a healthcare professional.
Commonly prescribed anti-seizure medicines include phenytoin, carbamazepine, lamotrigine, clobazam, clonazepam, levetiracetam, sodium valproate, and topiramate.
Your child may not necessarily need long-term medication.
If your child has not experienced any episodes in the previous 1 to 2 years, your child’s doctor may decide to take them off medication.
Q8: What are other treatment options available for children with seizure disorders?
If medicine isn’t effective enough to keep your child’s seizures under control or causes side effects, your child’s healthcare provider may suggest alternative treatments, such as:
- Ketogenic diet: Ketogenic diet is a strict diet consisting of very high fat, very low carbohydrates, and including enough protein for growth. This dietary therapy, which must be carefully managed by a dietitian and paediatrician, may help some children to be seizure-free by altering brain metabolism.
- Vagus nerve stimulator (VNS): This treatment involves delivering short pulses of energy to the brain via the vagus nerve, a major nerve in the neck. It is an alternative for children aged 12 and up with partial seizures that are not effectively managed by medication. Voice changes, throat soreness, and hoarseness are possible adverse effects.
- Surgery: During the procedure, the brain areas where seizures originate are disconnected or removed. This may significantly reduce or eliminate seizures in children whose seizures do not respond to medications.
Q9: What are the potential side effects of anti-seizure medications for children?
Anti-seizure medications can result in the following side effects:
- Gastrointestinal issues such as nausea, vomiting, and abdominal pain
- Dizziness
- Sleepiness
- Irritability
- Anxiety
- Trembling
- Poor concentration
- Double vision
These side effects may be temporary at the start of treatment or when your child is given too much.
If they occur, report them to your child’s doctor immediately.
Q10: How do I help my child cope with their seizure disorders?
Parents are crucial in ensuring optimal management of their children’s seizures and proper care of other aspects of their wellbeing.
To support your child’s health, consider the following important measures:
- Ensure your child adheres to their treatment plan. Establish a routine and use reminders (such as apps or pill organisers). Know the dose, time, and side effects of all medicines.
- Track and monitor your child’s seizures. Keep a detailed seizure diary that includes the date, time, kind of seizure, duration, triggers, and any other useful information. This information will help them prescribe or adjust medications.
- Consult your child’s doctor or pharmacist before giving them other medicines or health supplements, as some of them may make anti-seizure medicines less effective or have a greater risk of side effects.
- Help your child avoid anything that could cause a seizure. Make sure your child receives adequate sleep, as a lack of sleep may trigger seizures.
- Create a safe environment at home. Keep floors free of obstructions, install safety gates on staircases, stay away from sharp furniture edges, and supervise bathing.
- Observe your child’s participation in physical activities. Check with your healthcare provider about the types of activities that are unsuitable for your child. Make sure your child wears a helmet during sports such as skating, hockey, and bike riding.
- Inform your child’s teachers and school staff about the seizure disorder. Provide information about the type of seizures, how they appear, triggers, what to do during a seizure, emergency contact information, and any necessary accommodations.
- Support your child’s emotional needs. Encourage open communication and continuous reassurance. It’s also a good idea to refer your child to support groups or counseling and connect them with other children who have similar issues.
Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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