Epilepsy in children

Epilepsy is a brain condition that causes repeated seizures.

Seizures in epilepsy are caused by uncontrolled electrical and chemical signals in the brain. There are different types of seizures — the type of seizure depends on the part of the brain that is involved.

Not all children who have a seizure have epilepsy. About 1 in 20 children has had a seizure by the time they are 15 years old. But only about 1 in 200 children has epilepsy.

There are different types of epilepsy that can affect children.

Symptoms vary depending on the type of epilepsy and the type of seizures involved. Some children have a strange sensation before having a seizure.

Symptoms of seizures can include having episodes of:

• muscle stiffening or limpness
• jerking movements
• unusual movements, sensations or behaviours (such as chewing and swallowing, picking at clothing or seeming afraid)
• falling over suddenly
• staring blankly, stopping activities and not responding to you for up to 30 seconds

With some types of seizures, children can lose consciousness for a few minutes. They may:

• have shallow or noisy breathing
• wet or soil themself

Your child may be sleepy or confused after having a seizure.

If your child has a seizure, stay as calm as possible. Don't restrain them, but gently keep them out of danger by:

• removing any objects they could hurt themselves on
• loosening tight clothing
• placing something soft under their head
• rolling them onto their side when the seizure is over
• if they're in water, keeping their face above the water

Don't put anything in their mouth. Talk to them and reassure them. It's also helpful to time how long the seizure goes for.

You should call triple zero (000) for an ambulance if:

• this is your child's first seizure
• your child has diabetes
• the seizure lasts more than 5 minutes
• they are still unconscious after the seizure
• the seizure happened in the bath or a swimming pool
• they quicky have another seizure, or they have multiple seizures
• your child has been hurt

If you already know that your child has epilepsy, you probably don't need to call an ambulance every time a seizure happens. But always call an ambulance if you are worried or unsure about what to do.

You can talk with your doctor about developing an Action Plan. This will include instructions on what to do if they have a seizure and may involve giving emergency medicine.

Make sure that any adult looking after your child knows what to do if they have a seizure. These people may include:

• grandparents
• other family members, such as aunts or uncles
• child care workers
• teachers

For many children, there is no obvious cause of epilepsy. In some children with epilepsy, genetics play a part.

Other children may have epilepsy because of:

• problems with the structure of their brain
• damage caused by an infection or scarring from a bad brain injury
• brain damage due to lack of oxygen

Febrile seizures (seizures that can happen when young children have a fever) are not the same as epilepsy. Less than 1 in 20 children who has had a febrile seizure goes on to develop epilepsy.

Epilepsy in children is usually diagnosed by a:

• paediatrician (doctor who specialises in children's health)
• paediatric neurologist (a doctor who specialises in children's brain conditions)

Your doctor will ask you about your child's symptoms, general health and development. They may also ask if any of your family members have a history of seizures or epilepsy.

Your doctor will ask you to describe the seizure(s) and share any videos of them. They will also examine your child.

Some of the tests they may recommend to help diagnose epilepsy are:

• an electroencephalogram (EEG) — a painless recording of the electrical brainwave activity in your child's brain
• a brain scan (such as a CT scan or an MRI scan)
• blood tests
• urine tests
• genetic tests

Sometimes, video EEG monitoring is recommended. This usually involves a short stay in hospital so the seizures can be recorded with an EEG and video.

Treatment will depend on the type of seizures and epilepsy your child has. Some children do not need any treatment.

Children with recurrent seizures may be treated with medicines called anti-seizure medicines. These medicines are given to help prevent seizures.

Only stop giving your child medicine for epilepsy if your doctor tells you to.

Other children may need more intensive therapy, such as:

• Ketogenic diet — a special diet that should only be given under medical supervision.
• Epilepsy surgery — to remove or disconnect brain tissue that is causing seizures.
• Vagus nerve stimulation therapy — where a device is implanted under the skin to stimulate the brain via a nerve in their neck.

If your child's seizures start happening more often, let your doctor know.

Alternative therapies shouldn't be used to replace mainstream therapies. If you're considering using them, talk to your doctor before you start.

Some types of childhood epilepsy get better as your child gets older.

Most kids with epilepsy can still do most things. But it's important to put some safety measures in place to avoid injuries or accidents. These include:

• Not letting your child swim or bathe alone.
• Ensuring they wear a helmet and are accompanied by an adult when riding a bike or scooter.
• When showering, making sure that your child turns on the cold water first to avoid burns.

Some children with epilepsy have developmental or behavioural problems. If your child is having problems at home or school, talk to your doctor.

Epilepsy Action Australia offers support and information and has a National Epilepsy Line — call 1300 37 45 37.

Epilepsy Australia is a national partnership of epilepsy organisations.

The Epilepsy Foundation provides support and education to people and families living with epilepsy. You can phone the National Epilepsy Support Service on 1300 761 487.