Whether your child has just had his first seizure or several, you are understandably worried. They’re scary to watch and can seem catastrophic. Parents have explained to me that when they occur at night, they don’t get much sleep because they’re worried about leaving their child alone. Similarly, during the day parents have mentioned that they won’t send their child to school until she has been seen by their doctor or an epilepsy specialist.
These are all normal, understandable reactions, but as parents’ minds tend to go to the worst case scenario, I try to help put their minds at ease when I see them in clinic. I inform them that while seizures can be very dangerous and at times lead to injury or death, these are very rare outcomes. In the vast majority of cases kids recover well from the seizure and in fact, many kids can “outgrow” epilepsy as they get older.
Seizures are caused by electrical changes in the brain and the resulting symptoms can vary widely from person to person – from subtle staring spells to full-body convulsions. While seizures do not typically cause neurological damage, they certainly come with the potential for injury.
Parents often wonder if their child’s seizures will lead to epilepsy. We consider a child to have epilepsy when he has had two or more unprovoked seizures that occur at least 24 hours apart.
One of the important considerations when diagnosing epilepsy, and one in which we try to determine in our New Onset Seizure Clinic, is identifying any triggers to potentially help stop them from happening in the first place.
If you are concerned that your child has had a seizure, it is important to schedule an appointment with an epilepsy specialist who can help you determine if there is a trigger. Once a child has had a seizure, his risk increases for having more. A child that has had one seizure has approximately a 45% risk of having a second one. If he has had two seizures, then the risk for a third seizure increases to 75%-80%.
There are many potential seizure triggers, but only a few we know about for sure. If parents are rigorous about keeping track of their child’s seizures and the circumstances surrounding them, we will be more likely to help them narrow down the trigger.
Everyone has a seizure threshold in their brain – meaning that anyone can have a seizure but some of us are more susceptible to them than others. When a child has epilepsy, her seizure threshold is much lower and will be more likely to have one when encountering a trigger. Some of the more common seizure triggers are:
- Illness and fever
- Sleep deprivation
- Menstrual cycle in females
- Drugs and alcohol (in excess, they can be a trigger for anyone, but for teens with epilepsy, they will be more likely to cause a seizure)
If we can determine the type of seizure your child is having, we can better council families on what to expect in the future. For instance, nearly all children with BECTS (benign epilepsy with central temporal spikes) will grow out of them by adulthood. The majority of kids with CAE (childhood absence epilepsy) will stop having seizures by adulthood.
The good news is that the majority of children with epilepsy will be able to control their seizures with medications. We consider a child to have intractable epilepsy when two different medications, at adequate doses, have not been able to control his seizures.
In the New Onset Seizure Clinic, I try to help put parents’ minds at ease by explaining what happens during a seizure, helping to pinpoint the triggers, and explaining the potential outlook once we have established a diagnosis. While parents are understandably worried about their child, the ones who have been on this journey for a while tell me that it does get easier with time.