About Epilepsy

According to the Epilepsy Society, epilepsy affects at least 300,000 people in the UK - 60,000 of these people are children under the age of 16. Epilepsy affects 1 in every 100 children.
It is the most common serious neurological condition in the world and can affect anyone at any time in their life - it has no respect for age, sex, race or social class.
Seizures tend to develop in childhood or by late adolescence, but the likelihood of developing epilepsy rises again after the age of 65.
One in twenty people will have a single seizure sometime in their life.

Types of Epilepsy
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Types of Epilepsy

Seizures, their types and how to recognise them

There are around 40 different types of seizure, which are divided into two main areas. The first being generalised, where the whole brain is affected and consciousness is lost, and partial (or focal), where only part of the brain is affected.

Tonic-Clonic

Tonic-clonic ('Grand mal') is the most recognised form of convulsive seizure. Tonic-clonic seizures are where the child may go rigid and fall down, sometimes with an involuntary high cry or shriek. This is caused by air being forced out of the lungs and through the larynx in spasms as the muscles relax and tighten rhythmically, causing the child to jerk in convulsions. This can be very upsetting to watch, as the person may breathe with difficulty due to the fact that the respiratory muscles are also involved in the stiffening process. The child may turn blue in the face, foam at the mouth, bite the inside of the cheek or tongue, grunt or be incontinent. Surprisingly, the child affected is unaware of what is happening, though they may feel tired, confused or have a headache when they come round. There is also a possibility that they may have injured themselves when falling, and will more than likely need to rest in order to recover fully.

Tonic

The child's muscles stiffen and he or she may fall to the ground, though there is no jerking. They may injure themselves when they fall to the ground, but generally recovery is quick.

Atonic (or drop attacks)

Due to a sudden loss of muscle tone, the child may fall suddenly to the ground. Again, there is a risk of injury but generally recovery is rapid.

Absence Seizures

Absence seizures ('petit mal') are common in children and may often be mistaken for daydreaming. During an absence seizure the child experiences a brief interruption of consciousness and becomes unresponsive. They may appear 'blank' or 'staring' usually without any other features, except for a fluttering of the eyelids. These seizures often last for only a couple of seconds and due to their subtle nature may even go unnoticed.

Myoclonic Seizures

Myoclonic seizures involve sudden muscle jerks - for example, the head may suddenly nod, or there may be abrupt jerking of the arms and/or legs.

If myoclonic seizures take place in young children they are normally called infantile spasms or salaam attacks. This form of seizure involves the child's whole body as they are thrown forward with their arms up. These often happen within a short time of waking, either on their own or accompanied by other forms of generalised seizures.

Nocturnal Seizures

Some children have seizures only when asleep, which often happens at night. These seizures could also happen during the day if the child was to fall asleep.

Partial/Focal Seizures

Partial (or focal) seizures are restricted to a certain part of the brain, and consciousness may well be affected, but it is not lost. A child's experiences during a seizure will depend on which area of the brain is being affected by seizure activity.

Simple Partial Seizures

Simple partial seizures affect a small area of the brain and the child stays awake throughout. The seizure may be restricted to either rhythmical twitching of one limb or part of a limb, or to unusual tastes or sensations such as pins and needles in a specific part of the body. Simple partial seizures often mark the start of some other form of seizure. They can spread across the whole brain developing into other sorts of seizure and because of this they may be referred to as a 'warning' or 'aura'.

Complex Partial Seizures

These are seizures which affect consciousness. When a larger area of the brain is involved the child may experience some strange sensations depending on which of the brain's four lobes is affected. A complex partial seizure can spread quickly or slowly, and it may cut the child off from the outside world altogether. They will have limited or no memory of the seizure having happened.

In temporal lobe seizures, the child may have incredibly powerful emotional experiences, such as fear or terror. Another feeling is of intense déjà vu (the feeling that this has all happened before), or conversely, jamais vu, when familiar surroundings and objects appear strange. Children affected may see scenes from their past unfolding before their eyes, have other hallucinations, or forget where they are and what they are doing. They may also smell strong aromas or they may speak unintelligibly or even be unable to speak at all. All these feelings are incredibly intense, much more so than the feelings we experience in our everyday lives.

In frontal lobe seizures, there may be twitching or jerking of the arms or legs, or involuntary eye movements. Partial lobe seizures, may cause tingling or pins and needles in some part of the body, for example down one side of the body.

With occipital lobe seizures, the child may see flashing lights for a few seconds.

A complex partial seizure may also involve automatic behaviour (also known as an automatism) in which the children affected wander around, sometimes continuing with actions they were involved in prior to the seizure starting. They may look purposeful but in fact they have no awareness of their actions, and once the seizure is over, they have no memory of it. Their actions are usually simple and stereotyped (such as smacking their lips or pulling at their clothes). Sometimes the nature of their actions might be more complicated, for example undressing and putting themselves to bed.

Secondary Generalised Seizures

This is when the seizure spreads over both halves of the brain resulting in the child losing consciousness evolving into a generalised tonic-clonic seizure. This may happen very quickly, or more slowly. If it is slow, the child may have a 'warning' or 'aura'.

Status Epilepticus

Status epilepticus is classed as a medical emergency. It is when one seizure occurs after another with no recovery period in between. If a child's seizure lasts longer than is normal for them (or for longer than 5 minutes if the normal length of time is not known) an ambulance should be called. A status seizure is potentially an extremely dangerous condition, as the child risks severe brain damage or even death from oxygen shortage to the brain.

Non-Epileptic Convulsions/Febrile Convulsions

Non-epileptic convulsions can occur in babies and young children when their bodies are unable to cope with a sudden high temperature. A tendency to febrile convulsions often runs in families, and the child commonly grows out of it by around age four to five.

SUDEP (Sudden and Unexpected Death in Epilepsy Patients)

Sadly, we have first hand experience of this condition. This can happen as a result of primary or secondary cardiac arrhythmia or can be due to primary respiratory dysfunction. You may wish to consider using a night-time breathing monitor for your child.

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