The
challenges of parenting are compounded if your child has epilepsy. Not only do
you have the normal concerns about raising a child, but now you have to address
emotional concerns both you and your child are encountering while living and
dealing with epilepsy. It's natural for a child who has a chronic illness or
who is different from other children to feel resentful. Children with an
illness such as epilepsy may develop emotional problems, such as poor
self-esteem or depression. These problems may come from within (anger,
embarrassment, frustration), or from outside (children with epilepsy may be
teased by other children).
Epilepsy
in childhood presents a profound challenge. Children account for a remarkable
proportion of all new cases of epilepsy. Children can have different types of
seizures at different ages. Epilepsy is likely to occur in a developing brain
in a child as young as 1 day old all the way up until 18 years old. The impact
that seizures may have on the developing brain are very different than that of
an adult brain that's already been formed.
Some
children develop epilepsy as a result of their brain being injured in some way.
This could be due to a severe head injury; difficulties at birth; or an
infection that affects the brain such as meningitis. There are a few children
who are born with genetic defects and have a number of conditions, such as
mental retardation, associated with epilepsy. The most common type of seizure in
children is the febrile seizure, which occurs when an infection associated with
a high fever develops.
Prof. Dr.
Shankar Prasad Saha says “Having epilepsy can affect a child in different ways,
depending on his or her age and type of seizures the child has. Diagnosis will
not affect the day-to-day lives of children, but, in some, it may be a
frightening or difficult experience, and they may feel embarrassed, isolated or
different in front of their peers. Behavioural changes and problems can happen
for all children regardless of having epilepsy and, for many, may just be a
part of growing up.”
Epilepsy
is a major health problem in developing countries, including India. Of the 3·5
million people who develop epilepsy annually, 40% are younger than 15 years, and
more than 80% live in developing countries. Epilepsy is the most common
neurological condition where there is an abnormality of electrical activity of
the brain cells, resulting in episodic abnormal behaviour in an individual. This condition requires recognition,
investigation and management.
Prof. Dr.
Shankar Prasad Saha remarks “Seizures may change over time, either in type or
frequency. Some children outgrow their epilepsy by their mid-to-late teens. The
risk of having another seizures ranges from 20–80%. Most recurrence happens
within the 6 months of the first seizure. The risk of another seizure depends
on the cause. If the seizure is provoked by fever, for instance, then the
chance of further seizures is low except in the setting of fever.”
“Epileptic
seizures can interfere with a child’s ability to learn and develop in a number
of areas. The school should be notified that your child has epilepsy. If your
child needs medication administered during school hours, a permission slip and
instructions may be necessary. .” adds Prof. Dr. Shankar Prasad Saha
Prof. Dr.
Shankar Prasad Saha confirms “Teachers play a vital role in the physical,
emotional and academic well-being of students with epilepsy. A teacher who
reacts to seizures calmly and supportively will help others learn to do the
same. In some cases, teachers are the first to notice and recognize the
symptoms of seizures in a student. Teachers who understand, encourage and
inspire students with epilepsy facilitate learning, independence and self-esteem.
“
If your
child has epilepsy, you and your child’s teacher must impart the following
information about what is to be done when the child suffers an epileptic
attack.
§ Stay with the child.
Let the seizure take its course.
§ Speak calmly and
explain to others what is happening.
§ Put something soft
under his or her head to protect it.
§ Move dangerous
objects out of the way.
§ DO NOT restrain the
child.
§ Check the time to
see how long the seizure lasts.
§ If the seizure
activity lasts more than 5 minutes, call for paramedics.
§ Don’t put anything
in the child’s mouth.
§ Gently guide the
child away from danger or block access to hazards.
§ After the seizure,
talk reassuringly to the child.
§ After the child has
stopped shaking, ease him or her gently into the recovery position.
§ Stay with the child
until complete awareness returns.
Though the condition requires long term treatment it may or may
not continue for life long. The criteria
for stopping or reducing the medication depends on the patient’s condition. It
depends on the type of epilepsy, the age of onset of symptoms, extent and
duration of control over the epileptic attacks when under treatment. Doctor may
stop the medication if the patient remains seizure-free for a period of 2—5
years. This decision is made after analysing different aspects of the
situation. However, there are chances that the seizure may occur again after
stopping treatment and the treatment might have to be started again.
The burden of epilepsy could be reduced in India by alleviating
poverty and by reducing the preventable causes, viz. perinatal insults,
parasitic diseases, and head injuries. Empowering primary healthcare workers to
diagnose and start treatment might significantly reduce the treatment gap and
the disparities between rural and urban areas.
Children with
epilepsy can live a happy and successful life. With the advent of newer
medicines, availability of medical care and increased awareness of the
condition, it has become possible for a person with epilepsy to lead a good
life. There are many famous poets, writers and sportsmen with epilepsy who have
excelled in their respective fields. Positive approach towards the problems in
life is a key for success and contentment. Our negative outlook towards the
disease should be challenged and this will certainly help people lead a normal
and happy life.
References:
Ann Indian Acad
Neurol. 2014 Mar; 17(Suppl 1): S3–S11.
General Myths
and Facts about epilepsy in the society
1.
Myth:
Epilepsy is the result of possession by evil spirits. The treatment is to
exorcise such spirits through faith healers or alternative therapies.
Reality:
Epilepsy is a neurological disorder that is treated with medication. The
patients should be taken to a qualified doctor.
2.
Myth:
An epileptic attack can be stopped by making the patient smell an onion or
branding the skin with a hot needle or iron rod.
Reality: Such methods only cause more
injury and do not help the patient.
3.
Myth:
If you touch an epileptic patient during a seizure, the disorder will pass to
you.
Reality: Epilepsy is
not contagious and does not spread by touch.
4.
Myth:
Epilepsy brings stigma to the family, so the patient should be hidden.
Reality: Epilepsy is
a treatable disease just like diabetes or hypertension. There is no reason to
hide an epileptic patient. Ensure that they get timely treatment and that they
take their medication regularly.
5.
Myth:
Epilepsy is a form of madness and the patient needs to be admitted in an
asylum.
Reality: Epilepsy is
the disorder of brain function. So it should be treated by a neurologist.
6.
Myth:
People with epilepsy cannot marry nor have children.
Reality: As long as
the patient takes his/her medication and does not hide the condition, there is
no reason why he/she cannot marry or have children.
7.
Myth:
Children who have seizures should not be sent to school.
Reality: Most children
who have epilepsy are intelligent. In some cases, there may be some co-existent
retardation but that is due to an abnormality in the brain. Again, as long as
the child takes the medication regularly, he/she can go to school.
8.
Myth:
Wearing a metal ring, talisman or offering animal sacrifices will prevent
seizures.
Reality: Nothing can
prevent seizures except antiepileptic medication.
Despite
various efforts across the world to create awareness about epilepsy, a lot of
misinformation still persists. This prevents patients from seeking proper
medical treatment. We need more awareness programs that will reiterate that
epilepsy is a disease like any other and that people with epilepsy are no
different from others.
Prof. Dr. Shankar Prasad Saha - HOD, Neuro Medicine (NRC Medical
College & Hospital) 1. HOD, Neuro Medicine (NRC Medical College &
Hospital) of NRS Medical Collage &
Hospital, JMD Diagnostic Centre (Phoolbagan)
Media Contact:
Rajiv Lodha (9831362041/9831326900)
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