Epilepsy
Epilepsy is a condition that affects the brain. Anyone can have one seizure in their lifetime, which may look like epileptic seizures but they do not start in the brain.
Some seizures are caused by conditions such as low blood sugar (hypoglycaemia) or a change to the way the heart is working. Some very young children have 'febrile convulsions' (jerking movements) when they have a high temperature. These are not the same as epileptic seizures.
When you have more than one seizure, doctors will look into Epilepsy.
What are seizures?
We all have electrical activity in our brain as cells send messages to each other. A seizure is a sudden burst of intense electrical activity, which causes temporary disruption.
There are many different types of seizures so what happens to someone with Epilepsy depends on which part of the brain is affected.
What are the different types of seizures?
There are over 40 different types on seizures. I have listed the most common but if you would like further information, please click here
Simple focal seizures
In simple focal seizures (SFS) a small part of one of the lobes of the brain is affected. The person is conscious (aware and alert) and will usually know that something is happening and will remember the seizure afterwards. Often mistaken for daydreaming.
Complex focal seizures
Complex focal seizures (CFS) affect a bigger part of one hemisphere (side) of the brain than a simple focal seizure. The person’s consciousness is affected, they may be confused and make strange movements (called ‘automatisms’).
Generalised and secondarily generalised seizures
Generalised seizures affect both sides of the brain at once and can happen without warning. The person will be unconscious (except in myoclonic seizures), even if just for a few seconds. Afterwards they will not remember what happened during the seizure.
Sometimes focal seizures spread from one side (hemisphere) to both sides of the brain. This is called a secondarily generalised seizure because it starts as a focal seizure and then becomes generalised. When this happens the person becomes unconscious and will usually have a tonic clonic ('convulsive' or shaking) seizure. If this happens very quickly, they may not be aware that it started as a focal seizure.
Absences (sometimes called petit mal)
Absence seizures, or petit mal seizures, are more common in children than adults and can happen very frequently. During an absence a person becomes unconscious for a short time.
Tonic seizures
In a tonic seizure the person’s muscles suddenly become stiff. If they are standing they often fall, usually backwards, and may injure the back of their head. Tonic seizures tend to be very brief and happen without warning.
Atonic seizures
In an atonic seizure (or 'drop attack') the person’s muscles suddenly relax and they become floppy. If they are standing they often fall, usually forwards, and may injure the front of their head or face.
Myoclonic seizures
Myoclonic means ‘muscle jerk’. Muscle jerks are not always due to epilepsy (for example, some people have them as they fall asleep). Myoclonic seizures are brief but can happen in clusters.
Tonic clonic seizures
At the start of the seizure the person becomes unconscious their body goes stiff and if they are standing up they usually fall backwards. During the seizure they jerk and shake (convulse) as their muscles relax and tighten rhythmically.
Clonic seizures
Clonic seizures are convulsive seizures but the person's body does not go stiff at the start.
What causes Epilepsy?
Typically, the known causes of seizure involve some injury to the brain. Some of the main causes of Epilepsy include:
Low oxygen during birth
Head injuries that occur during birth or from accidents during youth or adulthood
Brain tumors
Genetic conditions that result in brain injury, such as tuberous sclerosis
Infections such as meningitis
Stroke or any other type of damage to the brain
Abnormal levels of substances such as sodium or blood sugar
In up to 70% of all cases of Epilepsy in adults and children, no cause can be discovered.
How is it diagnosed?
Epilepsy is diagnosed by giving a specialist doctor (A neurologist) a detailed description of the seizure activity or/and a video.
Tests are also taken, these can include blood tests, an EEG (recording of the brainwaves) and brain scans.
How is it treated?
The most common treatment is Anti-Epileptic drugs. Unfortunately they cant cure Epilepsy but can can stop or reduce seizures.
Other treatment options are brain surgery, vagus nerve stimulation and a special diet called the Ketongenic diet.
First Aid for seizure's?
Stay calm
Look around - is the person in a dangerous place? If not, don't move them. Move objects like furniture away from them.
Note the time the seizure starts.
Stay with them. If they don't collapse but seem blank or confused, gently guide them away from any danger. Speak quietly and calmly.
Cushion their head with something soft if they have collapsed to the ground.
Don't hold them down.
Don't put anything in their mouth.
Check the time again. If a convulsive (shaking) seizure doesn't stop after 5 minutes, call for an ambulance.
After the seizure has stopped, put them into the recovery position
Check that their breathing is returning to normal. Gently check their mouth to see that nothing is blocking their airway.
Stay with them until they are fully recovered.
If they are injured, their breathing sounds difficult after the seizure has stopped or they have another seizure without recovering fully from the first seizure, call for an ambulance.
What is living with Epilepsy like?
I was born with Epilepsy due to low oxygen at birth - I came out with the umbilical cord wrapped too tight around my neck. My Epilepsy wasn't diagnosed until i was 16, when i had my first Tonic Clonic.
In my early childhood I experienced Focal seizures. My parents used to say that I was "off with the fairies" and that I was a daydreamer. It wasn't until my first EEG which showed up extra electrical activity that it all made sense. By the time I was 17, I was having up to 5 Tonic Clonic seizures a day. I would lose consciousness, followed by my body stiffening and then I would jerk violently. After the seizure I would fall into a deep sleep and wouldn't remember the seizure when waking up.
The most frightening part of having Epilepsy is the unknown of when or where it is going to happen.
Luckily for me when I got pregnant with my first child, my seizures stopped. Whether it was because of my hormones or my medication I will never know. I've been 7 years seizure free now and i'm to scared to reduce my medication in fear of them returning.
Unfortunately Epilepsy is still a huge part of my life as my second born son has it. He was born with meningitis and has had 5 bouts of it in his 3 year life. Each time having breathing difficulties, with the worst at 6 weeks old.
When we met with my son's neurologist, we discussed everything in great detail about his meningitis, how many times and for how long he had stopped breathing. We showed her a video of what his most typical one looks like.
She started my son on a low dose of medication and sent us off for further testings.
He has had 2 EEG's but each time it didn't show up any results. With many types of Epilepsy, you only have unusual electrical activity in your brain when you are having a seizure. The rest of the time your brain activity is normal. So, if your EEG test doesn’t show any unusual activity, it means that there isn't any Epileptic activity in your brain at the time the test is being done.
This doesn’t rule out the possibility that you have Epileptic activity in your brain at other times. A clear EEG test does not definitely mean that you don’t have Epilepsy but it makes it very hard to diagnose what's going on.
My son went down hill quite rapidly after taking his new medication. His seizures were worse than ever and he had the most awful diarrhoea. After a trip to A&E the doctors witnessed his seizures and had to give him emergency medication to bring him out of a seizure that had lasted longer than 5 minutes.
They took a sample of his diarrhoea and it turns out he was allergic to the first medication.
His Neurologist came down to visit us in the ward and we finally got the official diagnosis of Epilepsy - secondary generalised seizures and they changed his medication.
Our journey is ongoing, he is on the maximum dosage for this weight and for now his seizures are uncontrolled.
On a good day, he can have up to 10 Focal seizures a day - he stares off in the middle of an activity and doesn't respond until he is back with us, he lip smacks, twitches.
On a bad day, he can have 1 or 2 Tonic clonic seizures, which mostly happen during the night or early in the morning. Its scary hearing the thrashing on the monitor and running into him.
I can only pray that one day the seizure monsters will stop, just like they did with me.
For more information on Epilepsy or to donate please click below links.
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