General

Childhood Epilepsy

The disease is quite prevalent in children, and as many as 30% of all epileptics fall into this category.

It needs urgent awareness that, usually, there is an excellent prognosis of epilepsy in children. Hence there should be no unnecessary panic when a child gets an attack although detailed investigations will be required in each and every case. One such case of an Indian female child, aged 7, was discussed by the author with Lord Walton. The child suddenly started getting twitchings on the left side of her face, starting from the angle of the mouth towards the left ear. To begin with, the twitchings were transitory, and she suffered an attack per day for the first two days. On the third day she had three attacks. On the fifth day, the attack lasted for about 2-3 minutes. This female child was labelled as a case of focal epilepsy. The parents of the child were very co-operative; they did not lose much time, and showed the case to the author, and the patient, after necessary investigations, was put on a suitable antiepileptic drug, which continued for about 3 years.

The clinical data, along with the relevant investigation reports were sent to London to the reputed neurologist, Lord Walton, and he, after going through the case, labelled it as a case of ‘benign focal epilepsy of childhood’. Later the case was taken up for personal discussion with Lord Walton during our meeting at General Medical Council, London. The overall opinion was that such cases have a very good prognosis, and if the full course of treatment is carried out uninterruptedly, it is very likely that the child may be free from attacks of epilepsy forever.

This patient had an uneventful course; the parents were highly convinced of the fact that their child would be free from trouble after three years of medication. That is exactly what happened, and now after a lapse of 6 years, the patient, taken off drugs, has had no attacks. Now this 16-year young girl is good in health, studies, as well as in sports. Epilepsie bei Kindern

It is, thus, clear that epilepsy is a curable disease, and the above case should serve to remove misconceptions about it. Therefore, one should not feel perturbed, irrespective of the age of the patient. Every patient is likely to recover, sooner or later. Some patients need drugs in high dosages for a longer period, i.e. beyond 3-5 years. This situation is dependent on the underlying pathology, threshold / resistance and severity of the disease.

A word may also be said about epilepsy in newborns/ infants. In this case, the mother is the true eyewitness, and she should closely watch the child, especially when there is a history of epilepsy in the family. She should keep an acute eye on the movements of the newborn. There may be only unnoticeable signs like eye deviation, movements of swallowing, abnormal movements (smacking) of the lips, etc. There may be transitory generalized convulsions/jerky movement, as in myoclonic epilepsy. Being transitory, initially, these movements may be missed. However, whenever the mother notices any such abnormal movement(s)/convulsions in a child, a pediatrician/neurologist must be consulted for tests/therapy to especially save the brain from injury, and mental retardation at a later stage.

However, the parents should not become panicky at the start, as many of the transitory movements/disorders may look like symptoms of epilepsy, when the child, in fact, may be suffering from other disorders like breath-holding spells, or infantile syncopal (transient unconsciousness) attacks, as a result of a congenital heart disease. Hence the diagnosis of epilepsy in a newborn/ infant must be made keeping all such considerations in view.

 

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