EDmedblog. Health News and Information

Of course! You not only can, but must let him go out and play, go on trips, sleep at a friend’s house. “But suppose he has another seizure?” That’s a risk you have to take. A careful analysis of risks is an important part of raising any child. It is a particularly important part of raising a child with the uncertainties of epilepsy. It is the crucial ingredient in avoiding overprotection. His ability to run around and his intelligence are the same as before the seizures. Most children with epilepsy are neither retarded or learning-disabled. For most such children, the only impairment is that, from time to time, there may be a seizure. For 99.99 percent of the time your child is the same as always.”BUT ISN’T HE DISABLED?” The answer is NO! He can still run and play, go to school, sleep over at a friend’s house. There is virtually nothing that a child who has had a few seizures cannot do. “Can he ride a bike?” Sure. The chances of having a seizure while riding his bike are very small; he is only minimally at greater risk than before his seizures. “Can she swim?” Absolutely, but her swimming must be supervised, just as every child’s swimming must be supervised. “Isn’t there a higher risk that she could drown or have a seizure in the water?” Yes, but only a slightly higher risk, since she has had only occasional seizures and may never have another one. Technically, your child may have a disability. He or she may fit the government definition that enables a person to obtain special services if the seizures interfere with education or work. But having a disability is very different from being disabled.A handicap is often superimposed by society, parents, friends, or schools. A person can also impose it on himself.We find that the best approach to a child who has had several seizures, who has now been labeled “epileptic,” is for you to gain a realistic acceptance of your child’s limitations (if any) and to focus on his potential. This requires a conscious effort to put aside your anxiety and concern about all of the things that could happen. This is not an easy thing to do. It requires acceptance of the fact that there are risks inherent in rearing any child and that most children with epilepsy, especially those whose epilepsy is controlled, face only slightly greater risks than other children.Children who have severe, or intractable, epilepsy and those who have additional impairments such as mental retardation, cerebral palsy, or learning disabilities also require realistic acceptance. It is equally important that these children, too, be encouraged to reach their full potential, and that additional handicaps not be superimposed.*187\208\8*

Myoclonic seizures (myo, meaning muscle—clonic, meaning jerk) are abrupt jerks of muscle groups. A hand may suddenly fling out, a shoulder may shrug, the foot may kick. Occasionally an entire body may jerk, as in a startle response. All myoclonic jerks are not seizures. Myoclonic jerks can come from the spinal cord, not just from the brain. They need not be abnormal. Normal individuals who are falling asleep may suddenly experience a jerk of the body and startle awake. This is a normal phenomenon called sleep myoclonus and is not a seizure.
Myoclonic seizures (formerly called minor motor seizures) may take many different forms. They probably arise, or at least the jerk arises, from deep structures in the brain stem that control posture and tone in the body.
An abrupt increase in tone in a muscle group will cause a sudden movement of that part of the body. An abrupt increase in tone in the flexor muscles will cause the body to bend forward at the waist, the head to drop down on the chest, the arms to bend at the elbow, or the knees to come up to the chest. Any or all of these movements may occur during a myoclonic jerk or during myoclonic seizures. If they occur when a child is standing, she may suddenly be thrown to the ground, perhaps hitting her face, breaking a tooth, or cutting her forehead. If the tone is suddenly increased in the extensor muscles, the head may be thrown back, the back may arch, the legs extend, and the arms stiffen. A child who is standing may be thrown backward to the ground.
Myoclonic seizures are serious because they may be difficult to control and because they are often only one manifestation of a mixed seizure disorder commonly associated with mental retardation.
Myoclonic seizures are like being jolted by an electric shock. They are single jolts. On rare occasions, infants and young children may experience a series of these jolts, sometimes even many series per day. Such a series of myoclonic jerks constitutes a special, serious form of epilepsy called “infantile spasms”.
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An absence seizure, formerly called petit mal, is a very special and uncommon type of seizure. It starts suddenly and without warning. The child assumes a glazed look and stares. She doesn’t know what is happening and usually cannot recall things that occurred during the seizure. Occasionally, there is a little eye-blinking or head-bobbing. The episode usually lasts just seconds, occasionally as long as fifteen seconds, and ends just as abruptly as it started. When the seizure ends, the child is immediately alert. There is no confusion afterward. These seizures may occur many times a day and are often mistaken for daydreaming.
It is usually easy for the physician to produce an absence seizure in his office by making such a child take deep breaths. Usually fifteen to thirty deep breaths (hyperventilation) will produce a typical spell. (Don’t worry, exercise, such as running, swimming, or bike riding, which may make someone “out of breath,” does not produce one of these spells.)
A parent may only see a few seizures because the brain’s activity must be interrupted for more than one second before a spell is apparent. Thus, very brief electrical events (less than one second in duration) are observable only on the EEG. But, in a sense, the child’s awareness may be being interrupted frequently, and the child may miss some of what is going on around him.
Occasionally a person with these spells describes life “like a movie in which brief segments have been cut out.” Teachers describe the child as daydreaming. Friends may call the child “spacey.”
Atypical absence seizures are similar to absence seizures, but may have more pronounced motor symptoms, such as tonic or clonic spells, or may have automatisms as seen in complex partial seizures. The EEG does not have the classic three-per-second spike and wave pattern seen in simple absence seizures. Atypical absence seizures are more commonly seen in children with a damaged nervous system and are often associated with other types of seizures.
Absence seizures may superficially be confused with complex partial seizures because both involve staring. Since they both may require different treatments and have different outcomes, the differentiation may be important.
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