By Jacques Emmery, General Practitioner, “Order of Tarn’s doctors”’ vice-president

What are child epilepsies ?

We have to keep in mind that a child’s brain is delicate.Smaller problems, such as spiking fevers, can trigger a “short-circuit” in the brain usually called a “convulsion”, which can result in arms shakes, legs shakes, blank eyes sometimes deflecting to the left or to the right, a short loss of consciousness.

The seizure lasts 1 or 2 minutes and then normal consciousness returns. Convulsions are very frequent during rhinopharyngitis episodes. Children are very prone to these episodes during cold weather especially when they are at school. Prevention is simple: treat every child who has ever been subject to convulsions as soon as the smallest spiking fever appears. Every chid has a different convulsion threshold.Less often, children can experience a huge “tonic-clonic” convulsive seizure.

This is actually an epileptic seizure which is characterised by a “tonic” phase with the contraction of every muscle sometimes leading to considerable tongue biting and respiratory arrest in longer phases.

This is then followed by a “clonic” phase with whole body saccadic movements.

It ends with a “post-critical” phase with a complete muscular relaxation very often leading to urine flow and a period of unconsciousness which can be short or long. The recovery time usually depends on the seizure intensity.

However epileptic seizures can happen again after the first episode with decreasing intervals between two seizures until seizures permanently follow one another: known as “status epilepticus” which is seen in a wide range of pathologies, sometimes interlinked, more often during harsh cerebral infectious episodes or during the evolution of some brain tumours. This status epilepticus is life-threatening if nothing is done to control the seizures. Indeed, repetition of seizures can cause irreversible brain damage with huge after-effects, and sometimes death during a more severe seizures.

Nevertheless, there are many treatment options using a combination of drugs from Benzodiazepines (like Valium) to strong general anaesthetics (like Thiopenthal or Pentothal) or neuroleptics like Rivotril.

Administering these drugs and adding treatment of the cause (antibiotics, cerebral anti-odematous, possibly surgery) and resuscitation techniques (artificial ventilation) usually control and stop a status epilepticus with as little after-effects as possible.