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من طرف Mansour Nasraween السبت أغسطس 09, 2008 6:54 pmEpilepsy
If your child has epilepsy, he or she is not alone — 2.5 million Americans have this disorder.
Anyone can get epilepsy at any age, but the majority of new diagnoses are in kids. About two-thirds of all kids with epilepsy outgrow the seizures that accompany it by the time they're teens.
Epilepsy is a nervous system condition that causes electrical signals in the brain to misfire. These disruptions cause temporary communication problems between nerve cells, leading to seizures. One seizure is not considered epilepsy — kids with epilepsy have multiple seizures over a period of time.
Epilepsy:
• is not the only cause of childhood seizures
• is not a mental illness
• does not usually affect intelligence
• is not contagious
• does not typically worsen over time
Causes of Epilepsy
In about half the cases of epilepsy, there is an identifiable cause. These include:
• infectious illness (such as meningitis or encephalitis)
• brain malformation during pregnancy
• trauma to the brain (including lack of oxygen) during birth or an accident
• underlying metabolic disorders
• brain tumors
• blood vessel malformation
• strokes
• chromosome disorders
The other half of epilepsy cases are idiopathic (the cause is unknown). In some of these, there may be a family history of epilepsy — a child who has a parent or other close family member with the condition is more likely to have it too. Researchers are working to determine what specific genetic factors are responsible.
Understanding Seizures
Seizures vary in severity, frequency, and duration (they typically last from a few seconds to several minutes). There are many different kinds of seizures, and what occurs during one depends on where in the brain the electrical signals are disrupted.
The two main categories of seizures are generalized seizures, which involve the whole brain, and partial seizures, which involve only part of the brain. Some people with epilepsy experience both kinds.
Seizures can be scary — a child may lose consciousness or jerk or thrash violently. Milder seizures may leave a child confused or unaware of his or her surroundings. Some seizures are so small that only an experienced eye could detect them — a child may simply blink or stare into space for a moment before resuming normal activity.
During a seizure, it's very important to stay calm and keep your child safe. Be sure to:
• Lay your child down away from furniture, stairs, or radiators.
• Put something soft under his or her head.
• Turn your child on his or her side so fluid in the mouth can come out.
• Never stick anything in your child's mouth or try to restrain him or her.
Do your best to note how often the seizures take place, what happens during them, and how long they last and report this to your doctor. Once a seizure is over, watch your child for signs of confusion. He or she may want to sleep and you should allow that. Do not give extra medication unless the doctor has prescribed it.
Kids who suffer from partial seizures may be frightened or confused by what has happened. Offer plenty of comfort and reassure your child that you're there and everything is OK.
Most seizures are not life-threatening, but if one lasts longer than 5 minutes or your child seems to have trouble breathing afterward, call 911 for immediate medical attention.
Diagnosis
Talk to your doctor if your child has seizures, staring spells, confusion spells, shaking spells, or unexplained deterioration of school performance. The doctor can refer you to a pediatric neurologist, who will take a patient medical history and examine your child, looking for findings that suggest problems with the brain and the rest of the neurologic system.
If the doctor suspects epilepsy, tests will be ordered, which may include:
• electroencephalography (EEG), which measures electrical activity in the brain via sensors secured to the scalp while the child lays on a bed. Usually the doctor will ask that a child be sleep-deprived (put to bed late and awakened early) before this painless test, which takes about 1 hour.
• a magnetic resonance imaging (MRI) test or a computerized tomography (CT) scan, both of which look at images of the brain
Treating Epilepsy
Your doctor will use the test and exam results to determine the best form of treatment. Medication to prevent seizures is usually the first type of treatment prescribed for epilepsy management. Many kids can be successfully treated with one medication — and if the first doesn't work, the doctor will usually try a second or even a third before resorting to combinations of medications.
Although medications often work, if your child is unresponsive after the second or third attempts, it's less likely that subsequent medications will be effective. In this case, surgery to remove the affected part of the brain may be necessary. Epilepsy surgery is done in less than 10% of seizure patients, and only after an extensive screening and evaluation process.
Additional treatments can be used for epilepsy that is unresponsive to medications. The doctor may implant a vagus nerve stimulator in the neck, or recommend a ketogenic diet, a high-protein, high-fat, low-carbohydrate diet that can be very successful in helping to manage seizures.
Even people who respond successfully to medication sometimes have seizures (called "breakthrough seizures"). These don't mean your child's medication needs to be changed, although you should let the doctor know when they occur.
Living With Epilepsy
To help prevent seizures, make sure your child:
• takes medication(s) as prescribed
• avoids triggers (such as fever and overtiredness)
• sees the neurologist as recommended — about two to four times a year — even if responding well to medication
Keeping your child well-fed, well-rested, and non-stressed are all key factors that can help manage epilepsy. You should also take common-sense precautions based on how well-controlled the epilepsy is. For example:
• Younger kids should have only supervised baths, and older kids should take showers — and only when there is someone else in the house.
• Swimming or bike-riding alone are not good ideas for kids with epilepsy (although they can certainly enjoy these activities with other people). A helmet is required during bicycling, as for all kids.
With some simple safety precautions, your child should be able to play, participate in sports or other activities, and generally do what other kids like to do. State driving laws vary, but teens with epilepsy will probably be able to drive with some restrictions, as long as the seizures are controlled.
It's important to make sure that other adults who care for your child — family members, babysitters, teachers, coaches, etc. — know that your child has epilepsy, understand the condition, and know what to do in the event of a seizure.
Offer your child plenty of support, discuss epilepsy openly, and answer questions honestly. Kids with epilepsy may be embarrassed about the seizures, or worry about having one at school or with friends. Consider having your child talk with a mental health counselor or psychologist if he or she struggles with these feelings.
If your child has epilepsy, he or she is not alone — 2.5 million Americans have this disorder.
Anyone can get epilepsy at any age, but the majority of new diagnoses are in kids. About two-thirds of all kids with epilepsy outgrow the seizures that accompany it by the time they're teens.
Epilepsy is a nervous system condition that causes electrical signals in the brain to misfire. These disruptions cause temporary communication problems between nerve cells, leading to seizures. One seizure is not considered epilepsy — kids with epilepsy have multiple seizures over a period of time.
Epilepsy:
• is not the only cause of childhood seizures
• is not a mental illness
• does not usually affect intelligence
• is not contagious
• does not typically worsen over time
Causes of Epilepsy
In about half the cases of epilepsy, there is an identifiable cause. These include:
• infectious illness (such as meningitis or encephalitis)
• brain malformation during pregnancy
• trauma to the brain (including lack of oxygen) during birth or an accident
• underlying metabolic disorders
• brain tumors
• blood vessel malformation
• strokes
• chromosome disorders
The other half of epilepsy cases are idiopathic (the cause is unknown). In some of these, there may be a family history of epilepsy — a child who has a parent or other close family member with the condition is more likely to have it too. Researchers are working to determine what specific genetic factors are responsible.
Understanding Seizures
Seizures vary in severity, frequency, and duration (they typically last from a few seconds to several minutes). There are many different kinds of seizures, and what occurs during one depends on where in the brain the electrical signals are disrupted.
The two main categories of seizures are generalized seizures, which involve the whole brain, and partial seizures, which involve only part of the brain. Some people with epilepsy experience both kinds.
Seizures can be scary — a child may lose consciousness or jerk or thrash violently. Milder seizures may leave a child confused or unaware of his or her surroundings. Some seizures are so small that only an experienced eye could detect them — a child may simply blink or stare into space for a moment before resuming normal activity.
During a seizure, it's very important to stay calm and keep your child safe. Be sure to:
• Lay your child down away from furniture, stairs, or radiators.
• Put something soft under his or her head.
• Turn your child on his or her side so fluid in the mouth can come out.
• Never stick anything in your child's mouth or try to restrain him or her.
Do your best to note how often the seizures take place, what happens during them, and how long they last and report this to your doctor. Once a seizure is over, watch your child for signs of confusion. He or she may want to sleep and you should allow that. Do not give extra medication unless the doctor has prescribed it.
Kids who suffer from partial seizures may be frightened or confused by what has happened. Offer plenty of comfort and reassure your child that you're there and everything is OK.
Most seizures are not life-threatening, but if one lasts longer than 5 minutes or your child seems to have trouble breathing afterward, call 911 for immediate medical attention.
Diagnosis
Talk to your doctor if your child has seizures, staring spells, confusion spells, shaking spells, or unexplained deterioration of school performance. The doctor can refer you to a pediatric neurologist, who will take a patient medical history and examine your child, looking for findings that suggest problems with the brain and the rest of the neurologic system.
If the doctor suspects epilepsy, tests will be ordered, which may include:
• electroencephalography (EEG), which measures electrical activity in the brain via sensors secured to the scalp while the child lays on a bed. Usually the doctor will ask that a child be sleep-deprived (put to bed late and awakened early) before this painless test, which takes about 1 hour.
• a magnetic resonance imaging (MRI) test or a computerized tomography (CT) scan, both of which look at images of the brain
Treating Epilepsy
Your doctor will use the test and exam results to determine the best form of treatment. Medication to prevent seizures is usually the first type of treatment prescribed for epilepsy management. Many kids can be successfully treated with one medication — and if the first doesn't work, the doctor will usually try a second or even a third before resorting to combinations of medications.
Although medications often work, if your child is unresponsive after the second or third attempts, it's less likely that subsequent medications will be effective. In this case, surgery to remove the affected part of the brain may be necessary. Epilepsy surgery is done in less than 10% of seizure patients, and only after an extensive screening and evaluation process.
Additional treatments can be used for epilepsy that is unresponsive to medications. The doctor may implant a vagus nerve stimulator in the neck, or recommend a ketogenic diet, a high-protein, high-fat, low-carbohydrate diet that can be very successful in helping to manage seizures.
Even people who respond successfully to medication sometimes have seizures (called "breakthrough seizures"). These don't mean your child's medication needs to be changed, although you should let the doctor know when they occur.
Living With Epilepsy
To help prevent seizures, make sure your child:
• takes medication(s) as prescribed
• avoids triggers (such as fever and overtiredness)
• sees the neurologist as recommended — about two to four times a year — even if responding well to medication
Keeping your child well-fed, well-rested, and non-stressed are all key factors that can help manage epilepsy. You should also take common-sense precautions based on how well-controlled the epilepsy is. For example:
• Younger kids should have only supervised baths, and older kids should take showers — and only when there is someone else in the house.
• Swimming or bike-riding alone are not good ideas for kids with epilepsy (although they can certainly enjoy these activities with other people). A helmet is required during bicycling, as for all kids.
With some simple safety precautions, your child should be able to play, participate in sports or other activities, and generally do what other kids like to do. State driving laws vary, but teens with epilepsy will probably be able to drive with some restrictions, as long as the seizures are controlled.
It's important to make sure that other adults who care for your child — family members, babysitters, teachers, coaches, etc. — know that your child has epilepsy, understand the condition, and know what to do in the event of a seizure.
Offer your child plenty of support, discuss epilepsy openly, and answer questions honestly. Kids with epilepsy may be embarrassed about the seizures, or worry about having one at school or with friends. Consider having your child talk with a mental health counselor or psychologist if he or she struggles with these feelings.
