Archive for the ‘Epilepsy’ Category

EPILEPSY AND ITS SPECIAL FORMS/EPILEPSY SYNDROMES: TUBEROUS SCLEROSIS

Tuberous sclerosis is an inherited condition in which children may have white birthmarks on their skin and other skin lesions, mental retardation, and epilepsy. There is an abnormality of cell development affecting many organs of the body. In the brain, cells may be abnormal and may form small tumors. The cellular abnormalities and tumors, in turn, may cause epilepsy, either focal or generalized. The most common form of epilepsy is infantile spasms, discussed above. A diagnosis of tuberous sclerosis is indicated if multiple white spots appear on the skin. Older children may develop acne-like changes on their faces. The CT or MRI scan may show the tumors or areas of calcification.
The outcome of children with tuberous sclerosis varies, as does the epilepsy. Some individuals may be of normal intelligence with no significant problems. Others may have substantial mental retardation and seizures difficult to control.
If your child has this condition, it is important to talk with your physician about the possibility that your other children may also be affected.
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LIVING WITH EPILEPSY: CHILDREN WITH EPILEPSY—WHAT CAN AND WHAT CAN’T THEY DO?

We emphasize that the vast majority of children who have epilepsy can take part in all the activities and games that make childhood such fun and an exciting time of life. Unfortunately, many people-including parents, are too afraid and concerned about what may happen if a child has an attack, and because of this become over-protective. Being over-protective is, in some ways, more of a danger to the child than not caring enough; children may never learn to do things for themselves, may never be involved in decisions about their own treatment and may never develop the necessary skills to become independent. This is very important because parents will not be around for ever to care for their children.

Swimming is perfectly safe, providing it is not done alone, but with someone who knows what to do if a seizure does occur in the pool; a swimming-pool attendant must also be told. The child should not swim in deep or very cold water, and if in the sea, should be within wading distance of land. For sailing obviously a life-jacket should be worn.

Cycling and horse riding are popular activities, and safety helmets should be worn by everyone who cycles or rides, whether or not they have epilepsy. Care should be taken when cycling on a busy road or in traffic, and ideally horse riders should not ride alone, in case of an accident.

Most children enjoy climbing—whether it is trees, rocks and cliffs on the beach, or apparatus in the gym at school. Where the child’s epilepsy is fully controlled, then climbing is usually safe. However, it is probably unwise to climb mountains (using ropes) either alone or with friends, as the risk of severe injuries (to others as well as oneself) is greater if there is a fall due to a seizure.

Sports such as badminton, squash, tennis, hockey, and football are likely to be entirely safe. It is reasonable to take part in contact sports such as rugby and wrestling, but boxing is best avoided. A very small proportion of people with epilepsy may have seizures triggered by flashing or flickering lights, particularly if they are tired. Certain precautions should be taken when playing video games or even when watching television. These include the following:

• sitting at least three feet (if playing a video game) or ten feet (if watching television) from the screen;

• when changing TV channels use a remote control unit, or if there is no remote control, one eye should be covered as the channel is changed;

• the video game should not be played in a dark room; a bright light should be on in the room; and the video game should not be played for more than an hour at a time, nor late at night when tired.

The use of computers or word processors for work either at home or school only rarely causes seizures and they may be used safely.

Most parents of children who do not have epilepsy will encourage adventures and taking part in activities, whilst taking sensible precautions to reduce the risk of injury, but there are always certain hazards—and accidents do happen, such as falling off bicycles, off playground equipment, or out of trees. It is important that parents do not become too anxious or worried about these risks, just because their child has epilepsy. Some families live in constant fear of the recurrence of a seizure—in the home, at school, or just outside playing. This fear is very easily detected by children, so that everyone becomes afraid of epilepsy and further seizures. Other parents may be ashamed of their child’s epilepsy and will never talk about it; this is very unfortunate and will frequently cause the child to become isolated, withdrawn, and ashamed of having epilepsy. This may then limit their expectations and opportunities in life.

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