CHILDREN WITH EPILEPSY: PRACTICAL SAFETY TIPS
Posted: under Epilepsy.
Get an engaged notice to hang on the outside of bathroom and lavatory doors instead of locking them.
Baths are a potential hazard for anyone who has seizures. Showers are safer. When baths are taken, always run in cold water first, then add hot, so that the water never reaches a dangerously hot temperature. Bathwater should be kept shallow: about six inches is safest.
A regular routine with regular meals and plenty of sleep is important for any child, but especially so for the child who has epilepsy.
Do not leave your child alone after a seizure. They may be confused and need comfort and reassurance. If the seizure seems worse or different from usual, contact your doctor immediately.
Make sure the child always carries something (a Medic-Alert bracelet, for example) with their name and address and the information that they have epilepsy.
FEBRILE CONVULSIONS
Children’s brains are more excitable, and therefore more seizure-prone than adults. Between three and six per cent of children sometimes have convulsions when running a high temperature. These febrile convulsions tend to run in families. They usually last only a few seconds or, at the most, a minute or two, and take the form of a grand mal seizure. Febrile convulsions are nearly always harmless for the child, though frightening to watch. Most children grow out of them by the time they are two or three years old.
However, children run a greater risk than adults of developing status epilepticus (prolonged or repeated convulsions) during a fit. This is dangerous, and may cause permanent brain damage and even, occasionally, be fatal. About five per cent of children who have febrile convulsions go on to develop epilepsy later in life. This is probably because during severe febrile convulsions the brain has been damaged through a partial deprivation of oxygen. The damaged area is usually the temporal lobe, which is the part of the brain most vulnerable to lack of oxygen. There is some recent evidence to suggest that a few children are born with an abnormality in this part of the brain which causes them to have severe febrile convulsions. But whatever the cause, the result is that after a severe febrile convulsion these children are left with an area of damage in the temporal lobe which later acts as a focus for seizures.
It is therefore important that febrile convulsions should be treated quickly; always call your doctor or an ambulance if your child develops a convulsion during a fever. Once your child has had one febrile convulsion, your GP will want to take steps to ensure they do not have another. Some years ago most doctors believed that children who have a tendency to febrile convulsions should be given regular anticonvulsant medication, usually Epilim (sodium valproate), to prevent fits until they have outgrown the tendency. The view now is more flexible, and practice varies quite widely. It is most likely that your doctor will not give regular medication after a first febrile convulsion unless it was very prolonged and led to the child being kept in hospital for a day or two. Some doctors will not even give medication after a second or third febrile convulsion, but wait for a trend to be established before giving regular anticonvulsants.
When your doctor makes the decision, one of the most important guiding factors will be whether there is a strong family history of febrile convulsions which have not led to the development of epilepsy. A strong family history is usually seen as a sign of a child being likely to outgrow the convulsions without permanent damage, and so the need for medication is less.
In addition, your doctor will probably suggest that if your child has had a fit in the past, you should give them paracetamol whenever they start to run a temperature, and sponge them with tepid water to help bring the temperature down. The fact that your child has a tendency to have febrile convulsions and may even have to take an anticonvulsant drug does not mean that they have epilepsy; the treatment is just to prevent further convulsions which might eventually cause epilepsy.
A few children may have a short-lived paralysis down one side of the body after a severe febrile convulsion. If this happens, it is worthwhile noting and remembering which side of the body is affected. Some of these children may later go on to develop temporal lobe epilepsy; if they do, and if it is thought they might benefit from surgery, it can be very helpful to the doctor to know which side was paralysed at the time of that early seizure. The side of the paralysis is a very good indication of the side of the brain in which the seizure focus is likely to lie.
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