Effective Treatment Approaches for Childhood Epilepsy

Epilepsy in children is caused by episodic dysfunction of the central nervous system caused by sudden and transient excessive discharge of nerve cells in the brain. In order to treat epilepsy in children, it is necessary to have a skillful combination of many methods and requires maximum patience from the pediatric patient and family.

Epilepsy in Children

Epilepsy is a brain injury characterized by repetitive, paroxysmal, rhythmic brain cell discharges that are manifested by:

• Paroxysmal motor (muscle convulsions, convulsions of the extremities), sensory, sensory, and mental states of a repetitive nature.

• With or without short-term loss of consciousness or altered state of consciousness.
Currently, for every 1000 people, there will be 5-8 people with epilepsy, of which epilepsy in children accounts for 60%.

Difficulties that children with epilepsy may face

Children with severe epilepsy that cannot be controlled by medication often have mental retardation, so they face many problems as follows:

Personal self-care problems

• Your child may have a sleep disorder.

• Having difficulty learning self-care and daily living skills.

• There are risks and dangers if a seizure occurs while commuting and using public transport such as falls or accidents.

Learning problems

• While some children with epilepsy have normal intellectual development, others may have difficulty learning to read, write, and calculate.

Sensory movement problems

• Children may have difficulty reaching motor development milestones.

• The child may have a loss of motor coordination.

• Children may have vision defects such as crossed eyes, drooping eyelids, nystagmus.

Cognitive abilities

• Poor perception or inattention, lack of concentration.

• Poor memory, poor hearing ability.

• Lack of problem-solving skills.

• Difficulty navigating.

Psychosocial

• Children can provoke themselves: like banging their heads, rolling on the ground.

• It may be difficult for children to control their actions.

• Children may have problems with normal social interactions.

Children with epilepsy have difficulty controlling their actions

How to prevent accidents for children with epilepsy

To avoid unfortunate accidents for children with epilepsy, families and caregivers need to pay attention to a few points as follows:

At home

• Do not use objects with sharp edges, pay attention to store boiling water containers in a high place so that children do not fall when they suddenly have a convulsion.

• Even if your child is able to bathe on his own, he should not be allowed to bathe alone if no one is at home.

• Children should be instructed not to lock the door when taking a bath.

• Do not use bunk beds for children with epilepsy, only children should sleep in low beds or sleep on the floor because seizures can occur while the child is sleeping.

• Children of school age, need to inform teachers in advance about the condition of the child's illness.

At school

• Teachers must know that children have a history of epilepsy to avoid unnecessary agitation and help classmates understand the disease to avoid stigma and bullying.

• Tell the school health care provider about any medications your child is taking or keep them in their bag in case of unforeseen circumstances.

In a public place

• Do not let children go out alone or climb too high.

• Do not allow children to ride bicycles on their own.

Measures to diagnose epilepsy in children

To accurately identify epilepsy in children, there are several important tests that need to be done, including:

• Blood test, liver function, blood sugar, electrolytes, blood calcium

• Brain magnetic resonance imaging (MRI).

• EEG has waves specific to seizure types.

Diagnostic criteria for epilepsy in children:

• Based on directional, brief, repeated episodes.

• Consciousness disturbances during a seizure (except for simple partial seizures)

• Disorders of nerve functions in terms of movement, sensation.

• After a quick recovery

• EEG with paroxysmal waves of epilepsy

Preventing epilepsy in children

Regular prenatal check-ups can help detect early maternal diseases and fetal abnormalities that cause brain damage to the baby.

Regular prenatal check-ups can help detect early maternal diseases and fetal abnormalities that cause brain damage in the baby.

Improving the quality of first aid for newborns at commune, district and provincial health facilities is the most active measure to reduce the rate of children with brain damage.

Measures to treat epilepsy in children

Treatment of epilepsy in children can include long-term drug therapy, patiently implementing rehabilitation methods to limit the occurrence of recurrent seizures.

Rehabilitation/treatment

• Early intervention after detecting epilepsy in children by using antiepileptic drugs in combination with rehabilitation, kindergarten and primary education.

• Assessment of motor development, language communication, personal, social, intellectual development every 6 months at rehabilitation departments or local rehabilitation centers.

Intervention target

• Stimulate the development of children's motor ability of two hands.

• Stimulate the development of daily living skills.

• Stimulate communication and language skills.

• Stimulate children's intellectual development.

Early interventions

• Medical: Treatment of convulsions in children, antiepileptic drugs.

• In terms of movement: Massage and techniques to facilitate rolling, sitting, crawling, standing

• Therapeutic activities: Hand motor skills training and daily living skills training.

• Speech therapy: Stimulate early communication skills and train language comprehension and expression skills in children.

Treatment of seizures in children
• Step 1: Take the child to a safe place.
• Step 2: Place the child on his or her side to avoid swallowing loose phlegm during a convulsion.
• Step 3: Loosen baby's clothes. Do not hold the limbs while the child is having a convulsion.
• Step 4: Place a rolled up spoon or towel across the child's mouth so that the child does not bite his or her tongue.
• Step 5: Remove surrounding objects that may cause injury to the child.
• Step 6: Avoid crowds of people around the child.
• Step 7: After the seizure the child usually sleeps, let the child sleep peacefully. Give medicine only if your child has a headache or is likely to have another one. Antiepileptic drugs must be prescribed by a doctor.

Use of antiepileptic drugs

Antiepileptic drugs must be prescribed by a doctor immediately after detecting epilepsy in children

• Antiepileptic drugs must be prescribed by a doctor immediately after detecting epilepsy in children.

• The dose of antiepileptic drugs must be strictly adhered to as prescribed by the doctor.

• Families should not automatically stop their child's antiepileptic medication.

• Epilepsy evaluations should be performed routinely by appointment with a physician at a psychiatric clinic, psychiatric hospital, or the psychiatric/neurology department of a local children's hospital.