FAQ

The brain is made up of billions of nerve cells or neurons that communicate through electrical and chemical signals. When there is a sudden excessive electrical discharge (short-circuit), this causes change in behaviour or function which results in an epileptic seizure.

Epilepsy is a condition with 2 or more unprovoked seizures. Often, ‘provoked’ seizures occur due to fever or low blood glucose or head injury.

Epilepsy is primarily a clinical diagnosis. lnvestigations are performed to support the diagnosis of epilepsy.

EEG is performed to record the electrical activity within the brain. This can help us determine whether abnormal electrical activity is arising from one particular focus in the brain, or all over the brain. Specific EEG patterns can help us decide the exact type of epilepsy, and help in management.  In some cases, a video-EEG is done where simultaneously video recording of the seizure is done along with simultaneous EEG recording. More importantly, a normal EEG does not rule out epilepsy and an EEG cannot be used in isolation to diagnose epilepsy.

MRI Brain is done to find out if there is any structural problem in the brain, particularly if the seizure description and EEG are suggestive of an abnormal focus in one part of the brain.

Further investigations like blood tests and genetic tests are done in some cases to determine the exact cause of the epilepsy.

Absolutely not. A regular EEG report can show epileptic currents, sporadically. This is often misdiagnosed as epilepsy in the child.

Anti-epileptic medicines are the mainstay of treatment. There are several medicines avialable and the choice depends on the age, type of epilepsy and after discussing the possible side effects.

Children with epilepsies may have associated problems like learning difficulties, behavioural problems, sleep disorders, or physical problems like those in children with cerebral palsy. Simultaneous assessment and management of these problems help in holistic management of the child.

1. Seek treatment from the right professional – this is very important. Children are not young adults and have specific needs, particularly in neurological disorders. So you must seek advice from a qualified pediatric neurologist.
2. Be regular in giving medicines – this step sounding very simple, actually is one of the most important things to do. Missed doses of medicine, particularly during festivals or while travelling can result in breakthrough seizures.
3. Seek care for intercurrent illnesses with fever at the earliest.
4. Ensure that the child has a balanced lifestyle. Ensure regular and adequate sleep and right nutrition.
5. Be aware of dangers- for instance possibility of seizure while swimming. Unsupervised swimming in a child with epilepsy can be dangerous! Similarly, always ensure the child wears a helmet while driving a cycle. Ensure that someone accompanies the teenager whilst crossing the roads.
6. Discuss medicine related side effects with your doctor.
7. Parents, teachers and other care-givers should be aware of what first aid to provide when there is a seizure.
8. Do not stop medicines without doctor’s advice.
9. Maintain a seizure diary and try to video-record the seizures if possible.

1. Try not to panic.
2. Do not try to insert any object in the child’s mouth.
3. Place the child safely in recovery position as the seizure comes to an end.
4. If the seizure lasts for more than 3 minutes, put midazolam nasal spray in the child’s nostrils as per the dose mentioned by the doctor.
5. Make arrangements to take the child to the nearest pediatric hospital.

In some cases, if the child has a structural lesion seen on the MRI scan, and if we can prove by investigations like video-EEG that the lesion is triggering the seizures – then removing the lesion by surgery would be an option. Children need neuropsychology assessments in most cases to ensure that the part of the brain to be removed is not contributing to any important function. In the rightly selected cases, this can lead to freedom from epilepsy, and also from taking life-long medications.

It is important to remember that there will always be an option to treat the child’s epilepsy. In some cases, a specialised type of diet called the ‘ketogenic diet’ could be a useful option. This is a highly restrictive diet with increased fat content and low carbohydrate content, which leads to a state of starvation, which produces ‘ketones’. These ketones are thought to exert an anti-epileptic property. The benefits, risks and monitoring during the diet needs to be discussed with your pediatric neurologist before embarking on it.

Yes. In some cases, the epilepsy can recur even after surgery. If there are no resective options, then other options like vagus nerve stimulation or corpus callosotomy will be discussed after re-evaluation.

It is never the aim of the clinician to use medications to reduce quality of life of the child, whilst controlling the epilepsy. However, all medications can lead to some side effects in some children. Regularly attending follow up and discussing these are important.

Yes. Hormones have been shown to either worsen or improve seizure episodes. This is very specfic to the nature/type of epileptic convulsions. This can be predetermined to a certain degree during the initial diagnosis of the seizure type

No. However, a good balanced diet and adequate intake of calcium is essential in children taking anti-epileptic medications. Some medications can affect bone health, so checking for vitamin D and calcium periodically, and correcting these with the right supplements is important.

There isn’t enough evidence in the form of clinical trials, to support the efficacy of these alternate modes of therapy.

There could be several causes:

1. The medication given may not be the right one for the epilepsy.
2. The medication may not be titrated upto maximal doses.
3. The add-on medications may be interfering with the prior medications.
4. Certain epilepsies, particularly genetic ones, tend to be difficult to completely control, but we always attempt to improve them.