234 chapter 29
MORE ABOUT Seizures (EPILEPSY)
Mental ability. Some children with epilepsy are intelligent. Others are mentally slow.
Occasionally, seizures that are very frequent and severe can injure the brain and cause or
increase mental slowness. Treatment to control seizures is important.
Types of seizures. Seizures may appear very differently in different children. Some may
have severe, ‘big’ or ‘major’ seizures with strong, uncontrollable movements and loss
of consciousness. Others may have smaller or ‘minor’ seizures. These can be ‘brief
spells’ with strange movements of some part of the body. They can be sudden unusual
behavior such as lip-sucking or pulling at clothes. Or they can be brief ‘absences’ in
which the child suddenly stops and stares—perhaps with blinking or fast movement of
the eyelids.
Some children will have both minor and ‘big’ seizures or they may first have minor
ones and later develop big ones.
Warning signs or ‘aura’. Depending on the kind of seizures, the child (and parents)
may be able to sense when a seizure is about to begin. Some children experience
a ‘warning’ in which they may see flashes of light or colors. Or they may suddenly
cry out. In one kind of seizure, the ‘warning’ may be fear or imagined sights, sounds,
smells, or tastes. In some kinds of seizures there is no ‘warning’. The child’s body
may suddenly jerk or be thrown violently. These children may need to continuously
wear some kind of safety hat or other head protection.
Timing of seizures. Seizures may happen weeks or months apart, or very often.
Minor seizures or ‘absences’ may come in groups—often in the early morning and
late afternoon.
Seizures are usually short. Minor seizures may last only a few seconds. Big seizures
seldom last more than 10 or 15 minutes. Rarely, however, a child may enter into a long
‘epileptic state’ which may last hours. This is a medical emergency.
Some kinds of seizures may appear at any age. Others begin in early childhood and
usually disappear or change to other patterns as the child grows older.
Many persons have epilepsy all their life. However, some children stop having
seizures after a few months or years.
Usually there is no need to know the exact kind of seizures a child has. However,
some kinds of seizures require different medicines. The chart on p. 240 and 241
describes the main types of seizures, when they begin, and their treatment.
WHEN ARE SPECIAL MEDICAL STUDIES NEEDED?
In some poor countries, doctors sometimes prescribe medication for seizures without
properly checking for signs of causes that may need attention. However, more and more
doctors regularly order expensive testing such as an ‘EEG’ (electroencephalogram). Even
if these services are ‘free’, they are often only available in a distant city, which causes
the family much time and expense. Such tests do not usually help much in deciding
treatment—unless a brain tumor is suspected. And even if it is a tumor, the possibilities
of surgery or successful treatment may be very small, and the costs are often much too
high.
Usually EEGs and other costly testing are not helpful.
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