What is Epilepsy?
Epilepsy is a very complex neurological condition that according to the Epilepsy Research UK currently affects over six hundred thousand people in the United Kingdom alone and is the cause of twenty one deaths every week. Every one in two hundred children will either be born with it or develop symptoms at some point within their childhood. It is characterised by the onset of seizures which are caused by excessive electrical activity in the brain. Simply put, this means that the brain cells will abnormally fire at the same time which in turn disrupts the brain’s normal electrical seizures. Seizures come in many varieties and one person can suffer from multiple types of seizures depending on which part of their brain is affected. There are known to be over forty different types of seizures that are identified as three main types – Generalised Onset, Focal Onset, Seizures of Unknown Onset.
Causes of Seizures in Babies –
Neurologists are constantly studying epilepsy, its causes and how to treat it. In some cases it may be hereditary and passed on from a parent or in many cases no cause can be found especially if the cause is due to something that occured whilst the baby was still in the womb. For example if a mother had a minor viral illness during pregnancy that would be undetectable after the birth.
However there are many other known causes.
- It could be caused from a newborn illness such as an infection passed on before birth or after.
- Abnormal development in the womb.
- A genetic disorder – for example tuberous sclerosis.
- Premature birth which can then lead to bleeds in the brain tissue.
- As a result of Encephalitis, which is an infection in the brain.
- As a result of Meningitis which is an infection in the membranes covering the brain.
- It can be caused due to a lack of oxygen either before the birth or during labour. Unfortunately sometimes a lack of quick action when a birth does go wrong can leave lasting damages. As Diane Rostron says “Starting, or growing, a family is a precious and joyous time. For some families however, this can quickly turn into a life changing and profoundly traumatic experience if significant mistakes are made in the medical care provided.
Epilepsy and Babies
Seizures in babies are called Neonatal seizures. The risk of seizures are high within their first year of life but are at their highest within the first twenty eight days after birth. Neonatal seizures can be difficult to detect and diagnose in a newborn as they can often be subtle and very short. Added to this they can also mimic normal behaviours in healthy babies.
The Moro Reflex is a typical and perfectly normal behaviour seen in babies that is often mistaken for a seizure. When a baby is suddenly startled by a loud noise, sudden movement or a bright light they will suddenly stiffen and throw their legs and or arms out. This is a completely natural reflex for them up until they are at least three months old.
Seizures in newborn tend to look very different from seizures in an older child or an adult. They are normally a lot shorter and many times end on their own without intervention needed at the time. The seizures are often fragmented due to the fact that the baby’s brain is still developing and is unable to make the responses generally seen in seizures of those that are older.
Symptoms of Subtle Seizures –
1 – Random or rolling eye movements, Eyes blinking quickly or fluttering. Wide eye opening and staring into space.
2 – Sucking, smacking, chewing or protruding of the tongue.
3 – Unusual bicycling or pedalling movement of the legs.
4 – Thrashing or struggling movements.
5 – Long pauses in their breathing.
Symptoms of Clonic Seizures –
1 – Rhythmic jerking movements of the muscles of the face, tongue, legs or arms.
Symptoms of Tonic Seizures –
1 – Stiffening and tightening of the muscles.
2 – Turning the head or eyes to one side.
3 – Bending or stretching one or both of the arms or legs.
Symptoms of Myoclonic Seizures –
1 – Quick and single jerking movement in one or both or the arms or legs, or sometimes the whole body.
Even experts in Epilepsy sometimes have difficulty diagnosing seizures in a newborn due to the fact that so many of the symptoms are present in healthy babies. For a diagnosis to be made then doctors will look for several things.
- That the episodes cannot be stopped by gentle manipulation of either the arms or the legs.
- That the repeated episodes are identical in both symptoms and their duration.
- That the episodes can happen in both an awake and sleep state.
- That the behavioural changes are not typical of babies of the same age.
Along with eye witness accounts, a history of symptoms and video recordings the neurologist will also look to perform an EEG. This is a harmless test where small electrodes are placed onto your babies scalp and are connected to an EEG computer. The test will look at the electrical activity in the brain and help with a diagnosis.
What to do if your baby has a seizure –
- Stay calm
- Place your child on a soft surface such as the sofa or the bed.
- To prevent choking ensure that they are lying on their side.
- Never place anything in their mouth during a seizure.
- Be sure to note how long the seizure lasts and if you can video at least part of it as this will help the neurologist with their diagnosis.
If you think that your baby may possibly have Epilepsy or is suffering from Neonatal seizures and you are still in hospital after birth then alert your attending midwife or doctor as soon as possible. If you are already at home then be sure to keep a log of any episodes where you believe a seizure has occurred. Try to record at least part of the episode and contact your general practitioner, midwife or health visitor.