Chandigarh : This year the PGIMER, Chandigarh is celebrating its GOLDEN JUBILEE YEAR (1962-2012). As a part of the celebrations we at the Department of Pediatrics, Advanced Pediatric Centre are holding a series of public lectures for the benefit of the public on topics of general interest to the public.
On the 23rd of November, 4-5 PM, the Pediatric Neurology Unit, of the Department of Pediatrics is conducting a public awareness program for the general public. The focus of this public awareness program will be “Epilepsy in Children”.
Epilepsy in children is one of commonest reasons for hospital visits in children. Seizures and epilepsy affect infants and children more than any other age group. Worldwide Epilepsy is about twice as common in children as in adults (about 7 per 1000 in children under the age of 16 years compared to 3 per 1000 in adults). More than 60% of epilepsy starts in childhood. In India the important causes are parasitic cyst in the brain (neurocysticercosis), birth associated brain injury such as hypoxic ischemic injury, and genetic causes.
Services for Children with Epilepsy at PGIMER
At the Advanced Pediatric Centre, the Neurodevelopment clinic has more than 7000 enrollments, with more than 50% of children having seizures of one kind or another. We also run a special clinic for Neurocysticercosis which has already enrolled nearly 5000 children. Our department also provides outreach services to children with various types of neurodisabilities at its outreach centre at PRAYAS since 1985. The unit has provided services to more than 20,000 children with disability. More than 1/3rd of these children also have Epilepsy. The Pediatric Epilepsy clinic has been started this year to cater to the special needs of epilepsy patients.
Topics to be discussed
Caring for a child with epilepsy requires knowledge on a variety of topics. The program would cover the following detailed discussions;
1. How various types of seizures manifest in children
The appearance of seizures in children is very different from those that are seen in adults. Some of the seizures are just like jerks or crying spells or transient stiffening of the body or drop attacks. They are often misdiagnosed as abdominal colic, simple jerks or startle. Childhood is also the age for the generally harm less febrile seizures and some benign epilepsies. On the other hand, many children have other events which are not seizures but can appear so. Therefore it is very important to have a correct diagnosis of seizures. Many a time’s even health care providers are not conversant with these various presentations. Sometimes due to these factors or due to the ignorance of parents, and different beliefs prevalent in the society, a delay in the diagnosis of epilepsy occurs. The delay in diagnosis often results in additional problems for these children such as; injuries, brain damage and at times even death.
2. Discuss- How to manage a child when he/she has a seizure at home
Seeing a child seizuring at home can be frightening for the parent. But by knowing what to do the parent can feel empowered and also prevent injury to the child. There are certain things which anyone should follow when he/she observes a child having a seizure.
· Do not panic
· Get the child to safe area, on a firm surface or bed
· Loosen any tight clothing
· Turn the child to one side [ to avoid saliva from choking the child]
· Observe carefully what is happening to the child and keep track of time
· Certain medications can also be given at home to stop the seizure-ASK YOUR DOCTOR
· Do not put any water or any object in the mouth or try to open the mouth forcibly
3. Discuss-Some myths surrounding childhood epilepsy
Some beliefs which are wrong regarding epilepsy are
o The child is possessed by an evil spirit
o Such children are mentally retarded
o Epilepsy is contagious
o Eating with a child, playing or sharing utensils can spread epilepsy
o Once drugs are started the child will need it for lifetime
o These children are dependent for life and cannot get employment
4. Interaction with parents to clear their doubts
o We would discuss how treatment of epilepsy is now not only easy but that most children outgrow this disorder to lead normal lives.
o There are several old and new drugs to control seizures in children with epilepsy. But the drugs need to be given properly as prescribed by the doctor.
o Newer options are available for some of the children who do not respond to drugs. These include epilepsy surgery, special diets or devices.
o Management of childhood epilepsy also entails special issues of how to raise a child with epilepsy. Parents tend to become over protective and restrict normal activities, play and interactions with peers. This can have a negative impact on the self esteem of the child. On the other hand, some precautions need to be taken to avoid common precipitants of seizures such as lack of sleep, flickering lights and alcohol exposure in adolescents.
The pressure of caring for someone with epilepsy can seem overwhelming at times. From ensuring medications are taken everyday and on time, to administering first aid during a seizure, to attending doctor’s appointments… the tasks of a caregiver can seem endless. These pressures can be eased to certain extent with proper knowledge and family support.