These are general terms used when your child has episodes which your doctor considers that it could lead to epilepsy. It is called epilepsy if these episodes are recurrent and associated with abnormal brain electrical discharges. As a parent, you want to know the following:
- Is it epilepsy?
- Does she/he need investigations?
- What treatment is necessary, if any?
- How will the condition and medication affect my child’s learning and behaviour?
Let us visit the questions one by one
Is it epilepsy?
This is important to clarify if the episodes are really epileptic seizures. There are many mimics which can masquerade as epileptic seizures. History is the most important component to make a diagnosis of epilepsy.
There are 2 types - Generalized and focal.
In Generalized epilepsy, discharges start from all over the brain and in focal epilepsy, discharges start from a point in the brain and can spread.There are many types of epilepsy and they vary in severity from a self limiting condition to one which makes the child wheel chair bound.As 30% of uncontrolled epileptic seizures [treated with drugs] do not have epilepsy, making a clear diagnosis at the onset is important.
Does he/she need investigations?
If epileptic seizures are considered the most likely, than Electroencephalogram [EEG] would be warranted. This records discharges from the brain. This helps to clarify the diagnosis of epilepsy. If can be normal in children with epilepsy and abnormal in children who do not have epilepsy. The other investigation often asked for is MRI scan of brain. This is generally not needed in Generalized epilepsy. ECG is also recommended.
What treatment is needed if any?
Again, another important question as there are epileptic seizures that often do not need treatment. These decisions are made by a doctor trained in epilepsy after discussion with you. Most drugs do have an effect on the child’s learning. Further some anti epileptic medication can make certain types of seizures worse!!
How will the condition and medication affect my child’s learning and behaviour?
There are multiple instances when I have withheld medication as the seizures cause less damage than the medication used. Both the condition and medication can affect the learning and behaviour. The extent varies from one condition to another.