What is Epilepsy?

Epilepsy is the most common neurological condition. It affects around 1 in 200 children in the UK.

• Epilepsy is currently defined as a tendency to have recurrent seizures (sometimes called fits).
• A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. This disruption results in the brain’s messages becoming halted or mixed up.
• The brain is responsible for all the functions of your body, so what you experience during a seizure will depend on where in your brain the epileptic activity begins and how widely and rapidly it spreads. For this reason, there are many different types of seizure and each person will experience epilepsy in a way that is unique to them.

Causes of epilepsy
In 60%- 70% of people diagnosed with epilepsy no specific cause can be found
• Genetic Causes
• Abnormalities of the brain
• Brain injuries
• Infections
• Tumours
• Vascular Disease

Diagnosis of epilepsy

The diagnosis of epilepsy can be a very difficult and complex process. Epilepsy is primarily diagnosed from an eye witness account (detailed description) of what you see during your child’s seizure. There is no specific test that can diagnose epilepsy, although investigations can provide useful additional information when making the decision that your child has epilepsy or not.
• Investigations
• Physical Examination
• EEG (when relevant)
• CT scan (when relevant)
• MRI Scan(when relevant)
• Blood Tests

Other investigations may be requested from your Consultant Paediatrician or Consultant Neurologist on an individual basis.

There are over 40 different types of seizures, and children/young people with epilepsy will have different experiences.
Generalised Seizures
They occur when the abnormal activity that causes the seizure involves both sides of the brain
Absences: Brief lapse of awareness (Vacant stare) can also involve twitching of the eyes or flickering of the eye lids. They may occur many times throughout the day. Absences usually last between 5-30 seconds.

• Myoclonic: Brief, sudden jerk of the muscle usually in the arms or legs. Myoclonic seizures may also present as a simple head nod.
• Clonic Seizures: Rhythmical jerking/twitching of the limbs and/or body.
• Tonic Seizures: Sudden stiffening of the arms and legs, often causing the person to fall to the ground.
• Atonic Seizures: Sudden loss of muscle tone, often causing the person to fall to the ground.
• Tonic Clonic Seizures: Sudden stiffening of the arms/legs, causing the person to fall to the ground. Followed by rhythmical jerking/twitching of the limbs/body.

Focal Seizures
They occur when the abnormal activity that causes the seizure starts in one part of the brain, on one side (one hemisphere). It will depend on where in the hemisphere/lobe the abnormal activity is to determine what the child/young person may experience.
These seizures can be Sensory:
• Smell
• Feeling/Sensation
• Taste

or Motor: Twitch Usually on one side of the body Jerking (the opposite side of the abnormal activity in the brain)
There can be key lifestyle factors that can contribute to the frequency of seizure and in some circumstances can be avoided.

Common Triggers

• Lack of sleep / late nights
• Excitement
• Concordance/Compliance with medication
• Anxiety
• Stress
• Alcohol (binge drinking)
• Drugs
• Illness
• Hormones/Menstruation
• Skipping meals (low blood sugar levels)
• Photosensitive epilepsy (fewer than 1 in 20 have photosensitive epilepsy)
• Hyperventilation
• Altered blood chemistry/Dehydration