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Epilepsy - children - discharge

Your child has epilepsy. People with epilepsy have seizures. A seizure is a sudden brief change in the electrical and chemical activity in your brain. The doctor gave your child a physical and neurological examination and did some tests to find out why.

What to Expect at Home

If the doctor sent your child home with some medicines, it is because more seizures could occur. The medicine can help your child avoid having seizures, but it does not guarantee that seizures will not occur. The doctor may need to change the dose of your child's seizure drugs or add new medicines. This may be because seizures happen even when your child is taking the medicines, or because your child is having side effects.

Activity and Lifestyle

Your child should get plenty of sleep and try to have as regular schedule as possible. Try to avoid too much stress. You should still set rules and limits, along with consequences, for a child with epilepsy.

Make sure your home is safe to help prevent injuries when a seizure takes place.

  • Keep bathroom and bedroom doors unlocked. Keep these doors from being blocked.
  • Younger children should not take a bath without someone present. Do NOT leave the room without taking your child with you. Older children should only take showers. See also: Bathroom safety - children
  • Put pads on sharp corners of furniture.
  • Place a screen in front of the fireplace.
  • Use nonslip flooring or cushioned floor covers.
  • Do NOT use freestanding heaters.
  • Avoid letting a child with epilepsy sleep on the top bunk.
  • Replace all glass doors and any windows near the ground with either safety glass or plastic.

Most children with seizures can lead an active lifestyle. Plan ahead for the possible dangers of a certain activity. Activities should be avoided if a loss of consciousness or control would result in an injury.

  • Some safe activities include jogging, aerobics, moderate cross-country skiing, dancing, tennis, golf, hiking, and bowling. Games and playing in gym class or on the playground are generally okay.
  • Supervise your child when they swim.
  • Your child should wear a helmet during bike riding, skateboarding, and other similar activities. See also: Preventing head injuries in children
  • Children should have someone to help them climb on a jungle gym or perform gymnastics.
  • Ask your child’s doctor about your child participating in contact sports.

It should be easy for a student to carry and take seizure medicines at school. Teachers and others at schools should know about your child’s seizures and seizure medicines.

Your child should wear a medical alert or ID bracelet. Tell family members, friends, teachers, school nurses, babysitters, swimming instructors, lifeguards, and coaches about your child's seizure disorder.

Seizure Medicines

Do not stop giving your child any seizure medicines without talking with your child’s doctor. Do not stop giving your child seizure drugs just because the seizures have stopped.

Tips for taking seizure medicines:

  • Do not skip a dose.
  • Get refills as soon as you can before the medicine runs out.
  • Keep seizure medicines in a safe place, away from young children.
  • Store medicines in a dry place, in the bottle that they came in. Throw away all old bottles.

If your child misses a dose:

  • Have them take it as soon as you remember.
  • If it is already time for the next dose, skip the dose that you forgot to give them and go back to the schedule. Do not give a double dose.
  • If your child misses more than one dose, talk with the child’s doctor or nurse.

Alcohol and illegal drugs can change the way seizure drugs work. Be aware of this potential problem in teenagers.

The doctor or nurse will need to check your child’s blood levels of many seizure drugs on a regular basis.

Understand that seizure drugs have side effects. If your child started taking a new drug recently, or the doctor changed your child’s dose, these side effects may go away. Always ask the child’s doctor about any side effects. Also talk to your child's doctor about foods or other medications that can change the blood levels of anti-seizure drugs.

How to Respond to a Seizure

Once a seizure starts, there is no way to stop it. Family members and caregivers can only help make sure the child is safe from further injury and call for help, if needed.

When a seizure occurs, the main goal is to protect the child from injury and make sure the child can breathe well. Try to prevent a fall. Help the child to the ground in a safe area. Clear the area of furniture or other sharp objects. Turn the child on their side to make sure the child's airway does not get obstructed during the seizure.

  • Cushion the child’s head.
  • Loosen tight clothing, especially around the child’s neck.
  • Turn the child on their side. If vomiting occurs, turning the child on their side helps make sure that they do not inhale vomit into their lungs.
  • Stay with the child until they recover, or professional medical help arrives. Meanwhile, monitor the child’s pulse and rate of breathing (vital signs).

Things to avoid:

  • Do NOT restrain (try to hold down) the child.
  • Do NOT place anything between the child’s teeth during a seizure (including your fingers).
  • Do NOT move the child unless they are in danger or near something hazardous.
  • Do NOT try to make the child stop convulsing. They have no control over the seizure and are not aware of what is happening at the time.
  • Do NOT give the child anything by mouth until the convulsions have stopped and the person is fully awake and alert.
  • Do NOT start CPR unless the child has clearly stopped having the seizure and is still not breathing and has no pulse

When to Call the Doctor

Call your child’s doctor if your child has:

  • Seizures that have been happening more often
  • Side effects from medications
  • Unusual behavior that was not present before
  • Weakness, problems with seeing, or balance problems that are new

Call 911 if:

  • A seizure lasts more than 2 to 5 minutes..
  • Your child does not wake up or have normal behavior within a reasonable time after a seizure.
  • Another seizure starts before your child returns to awareness after a seizure ends.
  • Your child had a seizure in water or appears to have inhaled vomit or any other substance.
  • The person is injured or has diabetes.
  • There is anything different about this seizure compared to the person’s usual seizures.

References

Foldvary-Schaefer N, Wyllie E. Epilepsy. In: Goetz C, ed. Textbook of Clinical Neurology. 3rd edition. Saunders. 2007: Chap 52.

Mikati MA. Seizures in childhood. In: Kliegmann RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th edition. Philadelphia, Pa: Saunders Elsevier; 2011:chap 586.

Trescher WH, Lesser RP. The epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 71.

Update Date: 9/6/2012

Updated by: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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