Normally, brain cells maintain their functions such as thinking and managing the body through bio-electrical activities. The requests and orders that arise as a result of these activities are transferred along nerve extensions called axons, which extend from brain cells to other nerve cells and organs such as our muscles. In this way, functions such as moving our hands and arms and walking may be possible. In epilepsy, abnormally short and sudden excessive bio-electrical discharges occur in the entire brain or in a group of brain cells in a certain region. This causes involuntary changes (seizures, seizures) in the person's consciousness and movements (in the arm, leg or the whole body). Epilepsy is a continuous disease in which seizures occur involuntarily and sometimes lead to changes or loss of consciousness.
What are the symptoms?
Seizures may show different symptoms depending on the cell groups in the brain where they originate. While it may occur as absent-mindedness, staring, freezing, sometimes a feeling of fear and abnormal perceptions (SEIZZLES WITHOUT CONTRACTION), some seizures may include sudden loss of consciousness, falling to the ground, constant contraction in the arms and legs, convulsions, foaming from the mouth, sneezing, clenching of teeth and It may also occur in the form of bruising (SEIZES COMING WITH CONTRACTION). Seizures in young babies may not be as pronounced as in older children. Unreasonable and frequent sudden jumps, unilateral pulling of the mouth, mouth smacking, frequent eye blinking, sudden dropping of the head, boxing-like movements of the hands, pedaling movements of the legs, stiffness of the hands and arms, rolling of the eyes to one side and staring fixedly may be seizures. If your child interrupts an activity and becomes sluggish, and if this is accompanied by small hand, arm or facial movements that he/she makes unconsciously, he/she should be examined for seizures.
Do seizures always occur in epilepsy?
Convulsive seizures are always noticed in epilepsy. In nonconvulsive seizures, silent seizures may sometimes go unnoticed during sleep until they become obvious (e.g., seizures). Very rarely, there may be seizures (electrical seizures) that can only be detected by EEG. In such cases, daytime activity decreases and sleep quality deteriorates. �, deterioration in school performance and changes in temperament that are not appropriate for one's age should be considered as clues to suspect the disease.
What are the causes?
In 50-60% of all epilepsy cases. No reason can be found. This type of epilepsy usually begins before the age of 15. The reasons for the rest are; congenital causes (familial or genetic reasons), innate metabolic diseases, events affecting the brain development of the child during pregnancy (intrauterine infections, etc.), deprivation of oxygen to the brain during birth, injuries and intracranial bleeding, meningitis, head trauma, accidents in the postnatal period, They can be listed as brain tumors and long-lasting febrile seizures.
What triggers epilepsy?
Insomnia, extreme fatigue, some medications (allergy medications, cold medications, macrolide antibiotics, etc.). ), some foods and drinks (grapefruit, chocolate, caffeinated and alcoholic beverages, etc.), prolonged exposure to the sun, and head trauma may trigger seizures. Since there may be sensitivity to light in some types of epilepsy, flashing lights, television, computer and mobile device screens can trigger seizures. Spending too much time on these devices and using them too closely should be restricted. Stress, infections, skipping or interrupting epilepsy medications are the most common reasons for seizures to occur again. In such cases where seizures recur, the prescribed treatment period is extended. For this reason, it is very important to give epilepsy medications on time and in the specified amount.
Is high fever a cause of epilepsy?
Not every person with high fever will develop epilepsy unless there is an underlying disorder. High fever caused by infections may cause seizures in people receiving epilepsy treatment and reduce the effectiveness of the medication. Epilepsy, which occurs with recurrent afebrile seizures, occurs in a statistically very small proportion of febrile seizures.
How is epilepsy diagnosed?
When symptoms of epilepsy occur, it is suspected and a physician is consulted. Not every seizure seen immediately leads to a diagnosis of epilepsy. Crying seizures, childhood tics, fainting, childhood masturbation, sleep disturbances Jumping and shaking, shuddering, bowing movements, recurrent dizziness, night fear, migraine, cardiac arrhythmias and head movements due to gastroesophageal reflux are not epileptic seizures. However, since it can be confused with epileptic seizures and their treatments are different, it should be diagnosed and differentiated by a child neurologist. In diagnosing epilepsy, observing the seizure and giving detailed information, and if possible, in suspicious cases, VIDEO IMAGES of the seizure moment taken on the camera are very valuable in the doctor's diagnosis. Apart from general blood analysis, EEG RECORDING (Electro-Encephalo-Graphy), which detects the electrical discharges of the brain with electrodes attached to the scalp and reflects them on paper or computer screen, has an important place in diagnosing epilepsy and monitoring the course of its treatment. EEG recording has no side effects or harm to the child. It is usually taken during sleep and wakefulness, taking into account the child's age and seizure history. MRI (Magnetic Resonance Graph) is sometimes required to image and investigate the brain structure for the causes of epilepsy and seizures. Computed tomography (CT) is generally not preferred in the diagnosis of epilepsy in children, except for head trauma, intracranial bleeding and some rare cases (taking into account the side effects of radiation).
How is epilepsy treated?
Epileptic seizures are primarily treated with drugs called anti-epileptics. Medications treat seizures by suppressing them. Depending on the patient's condition and the course of the disease, the treatment period may last between two and four years. There are also some types of epilepsy that require lifelong medication. The medications taken may have side effects such as mild nausea, dizziness, mild drowsiness, tremors in the hands, and mild imbalance. It is usually temporary. Other treatment options such as ketogenic diet, vagal neural stimulation (VNS), and epilepsy surgery are also used in resistant patients who do not respond to epilepsy medications.
Can epilepsy be completely cured?
Different seizures Although there are different causes and types, the majority of pediatric patients respond well to medications and seizures are controlled. Children who respond well to treatment, have no other neurological problems, and have a seizure-free period for at least two years recovery is considered and medications can be tapered and discontinued. I would especially like to point out that sudden, uncontrolled discontinuation of epilepsy medications will lead to recurrence of seizures.
At what intervals should it be checked?
The epilepsy medications used must be at an effective blood level in the body. Unlike adults, children develop and grow both brain and body over time. In fact, in some periods (such as adolescence), growth and development show leaps. As the child grows, the distribution of the drug in the body changes. If dose adjustments are not made, the effective drug level cannot be achieved and the risk of seizure increases. Epilepsy medications also have some harmful side effects. Allergy-like rashes on the skin may be significant. Some may experience nail changes and hair loss (be sure to inform your doctor). Epileptic drugs may have negative effects on the blood table, platelets (blood elements that enable clotting), bone and liver enzymes, and kidneys in some patients. Drug side effects are generally not common. However, for such drug side effects, your doctor will call you for regular check-ups and follow up with examinations and laboratory tests. In our clinic, if our patients do not have a special condition, follow-up examinations and examinations are performed at three-month intervals.
What are your suggestions to families?
-Do not treat your children as if they are sick. Provide information about his illness. Remember that with appropriate treatment, the majority of childhood epilepsies can be completely cured.
-It is very important to give the medications on time and in the right amount.
-During your check-ups, the child's neurological examination, monitoring the course of the disease, blood analysis for drug side effects, and adjusting medications. Drug blood level analysis (for some drugs) and EEG recording are performed at a certain frequency. In patients whose drug blood levels will be checked, a blood test should be given in the morning before taking the medication. Good follow-up is crucial for complete recovery. Do not neglect your controls. -Do not treat the child unnecessarily and differently than other family members. You don't have to do whatever your child wants just because he has epilepsy. Raise it according to your normal upbringing style, no special behavior required.
- Protect your child from excessive fatigue, hunger, insomnia and malnutrition. -Generally, there is no harm in doing light sports. Sports and activities that are extremely tiring and have a high risk of getting hit on the head are not recommended. What should be done during an epilepsy attack?
Although seizures may seem life-threatening, they generally do not have any life-threatening medical consequences. Most seizures end on their own after a few minutes without any adverse consequences and do not require urgent medical attention. Afterwards, the child falls asleep tired and rests. This period may vary depending on the severity and duration of the seizure. After sobering up, he returns to his normal life. If the child does not have a persistent disease that affects the brain during the time he does not have a seizure, he can lead a normal life. Seizures may gradually increase in people who cannot be controlled or receive treatment and may negatively affect brain functions.
NEVER DO THESE DURING A SEIZURE
People who see a child with a seizure may reactively panic. They may get caught and sometimes harm the patient. Thoughts and actions such as that he cannot breathe, that his tongue is tucked back, that his tongue needs to be pulled out, that he needs to put something between his teeth are absolutely wrong. It is impossible for a person to choke by swallowing his own tongue. Never insert an object or finger into the mouth of a person having a seizure, or attempt to open the jaw. Otherwise, the finger placed in the mouth and the person having the seizure may be seriously injured.
Do not panic
Do not try to open the child's mouth by putting your finger in it.
Do not hold the child too tightly, do not try to open the stiff arms and legs.
Do not perform heart and respiratory massage, do not give oral medication.
Do not shake, slap, or make the child smell onion-garlic or cologne to make the child conscious.
Do not pour cold water on him or her head, do not hold them under water.
During seizures accompanied by contractions, the child falls to the ground, his body becomes rigid, his muscles twitch, and his breathing becomes irregular. Foaming from the mouth, bruising and leaking may occur. In this case;
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