Epilepsy What is Epilepsy? Epilepsy is a disorder of the brain. A child’s brain contains billions of nerve cells. They communicate with each other through tiny electrical charges. When some or all of these cells suddenly begin to fire together, a wave of electrical energy sweeps through the brain, causing a seizure. Seizures interfere with the brain’s normal functions. They can cause a child to have sudden changes in consciousness, movement, or sensation. Some people use the term “seizure disorder” instead of “epilepsy” to describe the condition. In fact, both words mean the same thing – an underlying tendency to experience seizures. Having a single seizure does not mean a child has epilepsy – epilepsy is the name for seizures that happen more than once without a known treatable cause such as fever or low blood sugar. Causes of Childhood Epilepsy Pinpointing the cause of epilepsy is difficult at any age. In seven out of every ten cases, there is no known cause. These children are then said to have idiopathic epilepsy. “Idiopathic” is a Latin word meaning “of unknown cause.” There are many possible causes of epilepsy in children, including: problems with brain development before birth; lack of oxygen during or following birth; a head injury that leaves a scar in the brain; unusual structures in the brain; tumors; a prolonged seizure with fever, or the after-effects of severe brain infections such as meningitis or encephalitis. When a cause can be identified, children will be described as having symptomatic epilepsy. The seizures are thought to be a symptom of the underlying brain injury. Types of Seizures Children with epilepsy, like adults, have seizures that can be divided into two broad groups: generalized seizures and partial seizures. When the electrical disturbance involves the whole brain, the seizure is called generalized. When only part of the brain is affected, it is called partial. If the electrical disturbance starts in one part of the brain and then spreads, it is called a partial seizure secondarily generalized. Some children have just one type of seizure, others have two or more.
Often called a convulsion, it starts with a sudden cry, fall, body stiffness followed by jerking movements as muscles tense, then relax, tense and relax. Breathing may be shallow or stop briefly. Skin may be bluish. There may be a possible loss of bladder or bowel control as muscles relax. It usually lasts a minute or two, after which normal breathing returns. The child may be confused or tired afterwards and fall into a deep sleep. He or she may complain of sore muscles or a bitten tongue.
It begins with a blank stare, beginning and ending abruptly and lasts only a few seconds, the seizures are often frequent. They may be accompanied by rapid blinking, upward rolling of the eyes and chewing movements. Children may drop what they are holding. Children are out of touch during seizure, but they quickly return to full awareness once it stops. This type of seizure is often mistaken for daydreaming or inattention.
A sudden loss of muscle tone makes the child collapse and fall. In some children all that happens is a sudden drop of the head. After a few seconds to a minute he or she recovers and regains consciousness. Drop attacks can cause injuries because of the force of the fall. Protective helmets may help, at least when the child is playing outside.
These are sudden, brief, involuntary muscle jerks, a bit like the kind everyone has when a foot or leg suddenly jerks in bed. May be mild and affect only part of the body, or be strong enough to throw the child abruptly to the floor. May occur as a single seizure or a cluster of seizures Partial Seizures:
These seizures affect movement, usually on one side of the body, but the child stays aware of his/her surroundings. They may cause jerking movements that start in fingers, toes, or other parts of the body, eventually affecting the entire side of the body. They may progress to a generalized convulsion. Partial seizures affecting sensations may cause things to look, sound, taste, smell or feel different. Effects can include stomach pain, nausea, a rising feeling in the stomach, or sudden fear or anger.
Consciousness is altered during these seizures; child won’t know what he’s or she’s doing or where he or she is during the seizure. Often starts with bland stare, followed by chewing, followed by repeated movements that seem out of place and mechanical. The child may seem dazed and mumble. He or she may pick at clothes, pick up and put down objects, try to take clothes off or may run and appear afraid. The child may struggle or flail at restraint. The same pattern of actions may happen with each seizure. It lasts only a minute or two, but child may remain frightened and confused for longer time afterwards. There’ll be no memory of what happened during the seizure. Partial seizures can arise from any part of the brain. The symptoms that the child experiences will depend on the seizure location. Most complex partial seizures arise from the brain’s temporal lobe and will have symptoms similar to those described above. If the seizures are coming from the frontal lobe, they may produce weakness or stiffness. They often occur in sleep and may include thrashing movements, fear, screaming and/or bicycling movements of the legs. Seizures arising from the occipital lobe are more likely to be disturbances of vision, in which the child “sees” things that are not really there. Managing Seizures Standard first aid for Generalized Tonic-Colonic seizures
Information from Epilepsy Foundation www.epilepsyfoundation.org
Play has many forms, one of which is music. The playful, co-creative musical space shared between a client and therapist is rich with possibility. Diara has been attending one-on-one music therapy sessions, and she has started to explore the different ways in which she can express herself both through playing and vocalising, experience contact and being heard, and become more spontaneous in expressing her inner world. There is a clear shift in her confidence from the beginning towards the end of sessions. She is starting to imitate basic rhythms and sounds, which forms part of unlocking her communicative potential.
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