Epilepsy is a neurological disorder affecting the brain. The child with epilepsy has had repeated seizures so let us begin by trying to understand what a seizure is.

Seizures, commonly referred to as 'fits', result from an abnormal discharge of electrical activity from the brain that affects the way the person feels or acts. The brain can be considered to be a large mass of nerve cells and supporting tissues. Each region of the brain controls a specific body function. This is possible as messages in the form of electric signals are sent from the brain to the rest of the body along the nerves. When a seizure occurs, there has been an abnormal electrical discharge from part of the brain. The type of seizure that the child experiences depends on the part of the brain that the abnormal electrical activity originated from.

Seizures can, therefore, take many forms:

Convulsions or stiffening of part of or all of the body.

Sudden falls forwards or backwards often resulting in injuries to the face or back of the head.

Brief episodes of staring.

Abnormal behaviours such as prolonged staring with drooling of saliva and repetitive movements.

Sudden limpness of the neck or body.

Commonly the child is unaware and cannot remember the details of the episode.

Who is affected by seizures?

Seizures may occur in children who are known to have suffered brain injury, or who have a family history of seizures, but in many cases the cause is not known. Seizures may occur in otherwise normally developing children.

When there are two or more seizure episodes and no direct cause, for example, fever or low blood sugar is found, the child is diagnosed to have epilepsy.

How is epilepsy treated?

Once the child experiences repeated seizures, treatment is advised. The goal of treatment is to render the child free of seizures. This is possible in most cases!

Here are some important points about medication used to treat epilepsy:

Medication is usually started at a low dose and gradually increased.

Medication should be taken on time daily as missing doses could result in a prolonged seizure.

While on treatment, the child will need to be monitored to ensure that there is the desired seizure control and to monitor for any unwanted effects of the medication.

Treatment is required for at least two years.

What should one do if a seizure occurs?

Remain calm.

The most important thing to do is to put the child to lie on the side. This position helps to prevent choking and suffocation which are possible during a seizure.

Do not put anything inside the child's mouth as the teeth can be dislodged and choking could occur.

Do not place anything over the child's mouth or nose.

Carefully observe the seizure and record the details in your child's seizure diary. This information will be useful to your child's physician on the next visit.

Most seizures will stop within five minutes. If the seizure lasts longer, take the child as quickly as possible to the nearest health facility.

Here are some tips to ensure the safety of the child who has epilepsy:

Due to the risk of drowning, the child with epilepsy should NEVER swim alone. A competent swimmer should be with the child in the body of water at all times. Bathing in a tub of water is discouraged and the bathroom door should not be locked.

Climbing of trees, etc., is discouraged and a helmet is advised while cycling.

Older children should cook on the rear burners of the stove to reduce the risk of burns should a seizure occur.

It is important that the child who has epilepsy lead as normal a life as possible. Care must be taken to ensure that the treatment plan is followed and that the child's safety is maintained. On the bright side, most children outgrow the seizures or remain seizure free on medication and continue to develop normally attaining their full potential.

In Jamaica, there is an epilepsy support group for affected persons and their families - the Jamaican Epilepsy Association at Andrews Memorial Hospital, Kingston.

Very useful information can also be found at http://www.epilepsy.com/

Dr Roxanne Melbourne Chambers is a paediatric neurologist.