|   Find a Doctor   |   Getting to NUH   |   Appointments   |   Contact Us   |   Newsroom   |   About NUH   |   Make a Gift

Home > Events & Health Information > Diseases & Conditions > Brain Conditions > Epilepsy

Epilepsy

About The Condition   Causes   Signs And Symptoms
 
Diagnosis And Treatment Options   Tips   Clinical Outcomes
 
 

 

What Is Epilepsy

Epilepsy is a brain disorder that causes one to have seizures. For a short time, the brain does not work the way it usually does. The body then gets the wrong signals, causing seizure manifestations.

 

Seizures only cause brain damage if they go on for a very long time, such as for more than an hour. Therefore, it is a medical emergency requiring immediate treatment if a seizures does not stop after 30 minutes. A series of non-stop seizures is also dangerous and immediate medical help should be sought.

 

People with epilepsy cannot stop the seizure when it wants to start. It is like a sneeze; you cannot stop a sneeze when it wants to come out.

 

What are the myths regarding epilepsy?

  • It is not true that your child will die if he or she bites his or her tongue during a seizure.
  • It is not caused by an evil spirit. It happens because of a sudden and abnormal increase in the activity in your child’s brain.
  • There is no proof that health foods stop seizures. Having seizures does not mean that your child needs more vitamins than others do.
  • It is nobody’s fault that your child has epilepsy. It is also not due to something that you have done.
  • It is not a contagious disease.

 

Back to top

 

Causes Of Epilepsy

Epilepsy can be caused by anything that affects the brain. These include brain infections (meningitis or encephalitis), head injuries, complications that happened before or during birth, brain tumour or inherited brain disorders such as tuberous sclerosis.

 

It may or may not run in the family. Everyone inherits a seizure threshold, which is the point at which we may have a seizure if the brain is sufficiently irritated. People with lower seizure thresholds tend to develop seizures with less irritation than others. This means that although two children may receive almost identical injuries, the one with the lower seizure threshold is more likely to develop epilepsy.

 

Occasionally, no definite cause can be found. This is due to imbalance in the neurotransmitters (brain chemical) or specific receptors in the brain nerve cells.

 

The following factors have been known to trigger seizures:

  • Lack of sleep. This is a common cause of increased frequency of seizures.
  • Not taking epilepsy medicine regularly. This is often the reason why children with epilepsy have more seizures.
  • Flashing or flickering light for children with some types of epilepsy such as juvenile myoclonic.
  • Illness or fever.

Back to top

 

Signs And Symptoms Of Epilepsy

The 3 most common paediatric epilepsy syndromes are Benign Childhood Epilepsy with Centro-Temporal Spikes (Benign Rolandic Epilepsy), Childhood Absence Epilepsy (Petit Mal Epilepsy) and Juvenile Myoclonic Epilepsy.

 

Benign Childhood Epilepsy with Centro-Temporal Spikes (Benign Rolandic Epilepsy)

This is the most common childhood epilepsy. The child will experience frequent simple partial seizures with sensory changes or jerks predominantly involving one side of the face or mouth. These often go on to limb jerks when the seizure spreads to become generalised.

 

Childhood Absence Epilepsy (Petit Mal Epilepsy)

A child with petit mal epilepsy usually has brief staring spells during which he or she is not aware or not responsive. It can be so brief that it can go undetected. These seizures may also produce blinking or chewing movements in the child. This condition occurs more commonly in girls. Such frequent seizures may result in learning difficulties if it is not recognised and treated.

 

Juvenile Myoclonic Epilepsy

Such seizures are brief, lightning-like muscle jerks that may cause the child to fall off a chair or spill what he or she is holding. Juvenile myoclonic epilepsy often starts during adolescence and is often mistaken for clumsiness. The seizures affect either the whole body at once or just the face or arms. These seizures may become generalised convulsions with loss of consciousness.

 

Back to top

 

Diagnosis And Treatment Options For Epilepsy

Anti-epileptic drug will be given to your child. It has to be taken for some time, usually for at least 2 years if there are no breakthrough seizures. It controls your child’s seizures and is not addictive.

 

For the anti-epileptic drug to work properly, it has to be kept at a steady level in the blood. The level has to be high enough to prevent seizures. Your child may need blood tests from time to time to ensure the drug dosage is right.

 

Drugs do not just sit in the body. They get converted and eliminated by body processes just as food does. Therefore to maintain the same level, your child has to take the medicine near the prescribed times each day to replace what the body has used up since the last dose. The need to replace what the body uses up is the reason it is so important to take medicine regularly.

 

Not having a seizure means the drug is working and not that it is not needed anymore.

 

Your child may start having seizures again after a long period of control with medication. This does not mean that the epilepsy is getting worse. It happens because the physical makeup of your child changes as he or she grows and his or her medication may have to be adjusted.

 

The process of slowly reducing the medication or even taking it off should only be undertaken with the doctor’s close supervision. Do not try it on your own.

 

Back to top

 

Tips For Taking Care Of Children With Epilepsy

What should I do when my child is having a seizure?

  • Keep calm.
  • Loosen your child's clothing.
  • Turn your child to the side to drain anything in his or her mouth to prevent choking.
  • Put something flat and soft under your child's head if this is available.
  • Move items like sharp objects or furniture away so that your child will not injure himself or herself.
  • Do not try to hold your child's tongue down with a spoon or any other objects.
  • Do not try to bring your child around by slapping, shaking or pouring water on him or her.
  • Do not give your child anything to drink.
  • Do not hold your child down or restrain him or her in any way.
  • Stay with your child until his or her breathing is normal and he or she is awake again.
  • Remember that your child may feel irritable and tired following a seizure. Make a special effort to be calm and reassuring afterward.
  • If your child is having a “wandering around” seizure, keep calm and tell other people what is happening. Talk in a quiet, friendly voice and guide your child gently away from anything that could hurt him or her.
  • It is important to take note of the type and duration of the seizures.

 

What precautions do I need to take?

  • Children or adolescents with epilepsy should avoid sports like rock climbing or gymnastics where falling from a height can occur.
  • When your child goes swimming, he or she should have one-to-one supervision at all times when he or she is in the pool.
  • It is safer for your child to take a shower instead of bathing in a bathtub to prevent drowning during seizures if he or she is not supervised during bath time.
  • It is advisable to wear a helmet for activities like cycling.

 

Bring your child to the Children's Emergency immediately:

  • When the seizure lasts for more than 5 minutes non-stop. Give rectal, buccal or intranasal diazepam if you have it.
  • When your child has two or more seizures in a row without regaining consciousness.
  • When your child does not wake up from the seizure even after it has stopped.

 

Useful Links

  • Singapore Epilepsy Foundation

    Singapore Epilepsy Foundation is a non-profit organisation dedicated to promoting public awareness and education on topics surrounding epilepsy for the welfare of people with epilepsy.

  • Epilepsy Care Group (Singapore)

    Epilepsy Care Group (Singapore) is a non-profit, volunteer-based organisation that addresses the needs of persons with epilepsy and their caregivers in Singapore.

 

Back to top

 

Clinical Outcomes

We see many patients with seizures and have a comprehensive medical, nursing and education programme to enhance control of seizures. Part of our education programme includes teaching parents and caregivers how to administer first aid medication (e.g. rectal diazepam) in the event of a fit. 86% of patients whose caregivers used rectal diazepam managed to abort seizures, with only 14% requiring further treatment in the emergency room and/or required admission to the hospital.

 

Information correct as at July 2016

 

Back to top

 

Our Team

We have a team of paediatricians specialising in neurology, nurses and allied health staff. We aim to improve the quality of care offered to infant, children and adolescents with acute and chronic neurological disorders affecting the brain, nerves and muscles.

 

Click here to find out more about our Division of Paediatric Neurology.

 


The information provided on this page is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your child’s health, physical fitness or medical conditions.