Epilepsy in Children: Things Parents Should Know – News18

Last Updated:January 30, 2025, 10:43 IST

As a parent, staying informed about your child’s epilepsy is key to ensuring their safety.

Is your child behaving unusually: experiencing unexplained staring spells or full body shaking? Are you worried whether your child has epilepsy? If your child has epilepsy, are you afraid to send him/ her to school, to play or do sports?

Epileptic seizures in children can be a deeply distressing experience for parents- associated with significant fear and uncertainty. A better understanding of epilepsy: its causes, treatment options and emergency response is not only crucial to ensure your child’s safety but also overall family well-being in context of epilepsy. Dr Pradnya Gadgil, Senior Consultant Pediatric Neurology Narayana Health SRCC Children’s Hospital shares all you need to know:

Understanding Seizures

A seizure occurs when there is abnormal electrical activity in the brain, leading to changes in movement, attention or awareness.

The look of epileptic seizures can vary hugely. Infants may exhibit subtle symptoms like startle like jerks without a trigger. Other subtle seizures are staring episodes, lip smacking with a confused look. Sometimes children may be unconscious and/or have no memory of the event whilst in some seizures they are aware of the symptoms and can even describe them well later. The full body convulsions are more obvious – the visuals of violent jerking movements with eyes rolled up, frothing at mouth, jaw clenched etc can be very distressing to the eye witnesses.

What is epilepsy?

A tendency to experience seizures repeatedly and out of the blue ie without a ‘new’ brain problem- is termed as epilepsy. Epilepsy is a medium to long term brain disorder.

However, sometimes seizures are triggered by factors destabilizing the brain ie fever, low blood sugar, infection or bleeding in the brain, etc. These seizures are not diagnosed as epilepsy. They subside as the underlying factor is resolved. It is important to note the difference between these seizures and epilepsy.

What causes epilepsy?

There are 2 broad causes of epilepsy: structural problems in the brain or a genetically determined tendency.

1. Structural problems maybe inherent – ie parts of the brain not being formed as expected- ie malformations. Scars in the brain secondary to damage caused by various reasons- a difficult birth, low sugar in first few days of life, brain infections etc can also cause epilepsy. In fact in India, brain scars are the commonest structural causes of epilepsy.
2. Genetic causes are common and do not necessarily run in families. Genetic epilepsies are very variable- can be simple and easily manageable or difficult to control.Patient characteristics and various tests help the neurologist to unearth the cause of epilepsy.The cause of the epilepsy largely determines the possibility of associated problems with learning etc, treatment plans and the eventual outcomes.

Treatment Options

Children diagnosed with epilepsy have access to various treatment options.

1. Medications:The foremost treatment option is antiseizure medications (ASMs). There are 20+ antiseizure medications (ASMs) available in India- in syrups/ tablet forms. Modern medicine has ensured that these ASMs are generally very well tolerated ie have a low chance of permanent and serious side effects whilst being quite effective. In fact, worldwide, 60-70% epilepsies are well controlled with 1 or 2 ASMs. The limitation of ASMs is that they only control the epilepsy- do not cure it.
2. Epilepsy surgery:Among the treatment options for epilepsy, epilepsy surgery is the most attractive option as some epilepsy surgeries cure the child of his/her epilepsy. If the epilepsy does not come under control with 2 appropriate ASMs, the child undergoes detailed brain tests to understand eligibility for epilepsy surgery. There are many types of epilepsy surgeries. Resective or disconnective brain surgeries can cure children of epilepsy. Other disconnective surgeries and neuromodulation procedures are disease modifying.Epilepsy surgery is a functional neurosurgery and one of the safest subtypes within neurosurgery.

   At SRCC children’s hospital we perform all types of epilepsy surgeries in children after a thorough vetting process regarding their eligibility for the same.

3. Other options:Ketogenic diet of various types, medications which serve as precision medicine etc are other treatment options in select patients with cerin types of epilepsies.

Key Considerations for Parents

1. Regular medicationsTypically, antiseizure medications are to be taken twice daily for a few years. It is crucial to not only take ASMs daily but also to take them on time. Missing a dose could sometimes lead to breakthrough seizures. This can sound daunting at first, but it is admirable to see how most families manage compliance with regular medications exceedingly well. Some families set alarms whilst others use smart phone apps as medication reminders.
2. Diet for Children with EpilepsyMisunderstandings regarding diet in epilepsy are abundant! Contrary to popular belief, dietary changes do not typically play a major role in managing epilepsy.
3. Special considerations:Ketogenic diet is a medical diet that is very low in carbohydrate content and high in fat and proteins. This is prescribed as one of the treatment options if epilepsy is not being well controlled by appropriate anti seizure medications.Vitamins and Minerals – Some epilepsies – especially ones starting early in life maybe vitamin responsive or rarely secondary to low calcium. The respective vitamin supplements are cornerstone in treating this select subset of epilepsies.
4. VaccinationsVaccinations are generally safe for children with epilepsy. It is wise to discuss concerns with your paediatrician to ensure your child receives appropriate immunisations without compromising their condition.
5. Combining Allopathy and Ayurvedic RemediesSome parents explore Ayurvedic and other alternative treatments alongside allopathic medicine. It is vital to consult healthcare professionals to avoid potential interactions or adverse effects.
6. Managing Other IllnessesDuring illnesses like fever or infections, children with epilepsy may have an increased risk of seizures. Ensure adequate hydration, monitor fever, and follow your doctor’s advice for managing sickness.
7. Responding to an Active SeizureStay Calm: Keep your child safe by clearing the area of sharp objects.Positioning: Place the child on their left side to prevent choking.Do Not Restrain: Avoid holding the child down or putting anything in their mouth.Time the Seizure: Seek urgent help and use emergency nasal sprays (as prescribed) if convulsive seizure lasts longer than five minutes.

Is Epilepsy Curable?

2 types of epilepsies can be cured:

i) Surgically remediable epilepsy- by means of epilepsy surgery

ii) Some types of childhood genetic epilepsies are self limiting- need support while they run their clinical course

While other types of epilepsy is not always curable- it is often well manageable in a overwhelming majority of patients.

Duration of Medication

The duration of treatment is determined by the cause of the epilepsy. The duration varies from 3-4 years or much longer time ie well into adulthood. Rraely some epilepsies may not be offered active treatment. Always consult your doctor before making any changes to medication.

Daily activities

Children with epilepsy have a wide range of functionality. In majority well controlled childhood epilepsies, children can attend school and perform extracurricular activities like their peers. Certain activities may need special considerations – eg swimming, cooking with gas, adventure sports, etc. especially in poorly controlled epilepsies. It is prudent to discuss the need for specific safety precautions in daily activities with your paediatric neurologist.

As a parent, staying informed about your child’s epilepsy is key to ensuring their safety. Misinformation can adversely affect quality of life of the child and the family dealing with epilepsy. Understanding epilepsy and its cause, and knowing how to respond in an emergency can feel very empowering. Regular daily ASMs are the cornerstone of treatment of epilepsy.

Regular consultations with pediatric neurologists to plan appropriate treatments and to review progress go a long way in providing optimal care for your child’s epilepsy.