Watch out for signs of epilepsy in fits

In the West, most epileptic children are evaluated at least once in a Neurology center. This trend is fast catching up in the Gulf States as well, according to Dr Rajshekher Garikapati, Specialist Neurologist, Zulekha Hospital, Dubai.

Occasionally, the problem lies in identifying some behaviour change in the child as an epileptic fit. Even in this modern day, despite dissemination of knowledge and availability of information at the click of a mouse-button, parents do miss them, he said.

How can one know that one’s child is having an epileptic fit or not?

“It may be better to err on the side of caution and get an evaluation,” said Dr Garikapati. This is because the only fool-proof way to finally label a fit as non-epileptic is to show that while the child is having the fit, the EEG (Electroencephalograph) is showing waves just as in the normal state (i.e. non-epileptic state). This particular study is called an ictal-EEG.

Another helpful method of differentiating an epileptic fit from a non-epileptic fit is to visualise the activity of the child during the event, he advised.

“Only occasionally, parents are able to give a fairly accurate description of the events. Most of the time they are too emotionally over-wrought by the event,” he added.

Bits of data when correlated with other clinical data about the patient allow the neurologist to form a fairly good idea about the child’s problem. For a complete diagnosis, one has to consider the exact cause, the type or types of fits, and the age of onset, and other factors, such as family history of epilepsy, and so on. The type of treatment also depends on the diagnosis.

The choice of medication has to be made keeping in mind several factors, including the child’s age, the types of fits, the epilepsy diagnosis, and other co-existing illnesses.

Control of fits can be achieved with a single drug. “These have to be rationalised, and sometimes other issues such as side-effects have to be tackled,” said the doctor.

Fits come with a cost to the child. Apart from the immediate risk of falling down and hurting themselves, these children also suffer other subtle problems such as decline in performance at school due to lack of attention and poor memory. “Attacks at school may make them the butt of jokes from class-mates who are ignorant about the real nature of their attacks and this may make them shy and inhibited at school, avoiding social contact,” added the doctor.

“It is vital that such a child be given the best of care. Ensure that your child with epilepsy is seen by a neurologist and given the standard of care as dictated by the International League Against Epilepsy (ILAE),” said Dr Garikapati.

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Dr Rajshekher Garikapati, Specialist Neurologist, Zulekha Hospital, Dubai