Daniel Francisco de Assis0 Comments
The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity.
A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.
In 2011, four-year-old Connor said his arm kept falling asleep. Connor was experiencing seizures caused by a benign brain tumor. ABC2 cameras followed the family during their medical journey as Connor had neurosurgery conducted by pediatric neurosurgeon, Dr. Edward Ahn.
The type of seizure depends on which part and how much of the brain is affected and what happens during the seizure. The two broad categories of epileptic seizures are generalized seizures (absence, atonic, tonic-clonic, myoclonic) and partial (simple and complex) seizures. Within these categories, there are several different types of seizures in children, including:
Focal seizures take place when abnormal electrical brain function occurs in one or more areas of one part of the brain. Focal seizures may also be called partial seizures. With focal seizures, particularly with complex focal seizures, the child may experience an aura before the seizure occurs. The most common aura involves feelings such as deja vu, impending doom, fear, or euphoria. Visual changes, hearing abnormalities, or changes in the sense of smell can also be auras. Two types of partial seizures include:
Generalized seizures involve both sides of the brain at the same time. There is loss of consciousness and a postictal state after the seizure occurs, although some generalized seizures have very brief postictal states. Types of generalized seizures include the following:
A child may experience one or many different types of seizures. While the exact cause of the seizure may not be known, the more common seizures are caused by the following:
The child may have varying degrees of symptoms depending on the type of seizure. The following are general symptoms of a seizure or warning signs that your child may be experiencing seizures. Symptoms or warning signs may include:
During the seizure, the child’s lips may become bluish and breathing may not be normal. The movements are often followed by a period of sleep or disorientation.
The symptoms of a seizure may resemble other problems or medical conditions. Always consult your child’s doctor for a diagnosis.
The full extent of the seizure may not be completely understood immediately after onset of symptoms, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a seizure is made with a physical examination and diagnostic tests. During the examination, the doctor obtains a complete medical history of the child and family and asks when the seizures occurred. Seizures may be due to neurological problems and require further medical follow up.
Diagnostic tests may include:
Specific treatment for a seizure will be determined by your child’s doctor based on:
The goal of seizure management is to control, stop, or decrease the frequency of the seizures without interfering with the child’s normal growth and development. The major goals of seizure management include the following:
Treatment may include:
While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:
The ketogenic diet is sometimes offered to those children who continue to have seizures while on seizure medication. When the medications do not work, a ketogenic diet may be considered. No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. However, the diet does not work for everyone.
The ketogenic diet is very high in fat (about 90 percent of the calories come from fat). Protein is given in amounts to help promote growth. A very small amount of carbohydrate is included in the diet. This very high-fat, low-carbohydrate diet causes the body to make ketones. Ketones are made by the body from the breakdown of fat. They are an alternate energy source that the body uses normally during fasting states. The brain and heart function normally using ketones as an energy source. During normal health and with a normal diet, the body generally does not make (or need to make) ketones. The presence of ketones is important to the success of your child’s diet. This means that your child’s diet must be strictly followed. Even one small snack that is high in carbohydrates will destroy ketosis.
Your child’s doctor will determine if this diet is right for your child. When the ketogenic diet is started, your child will be admitted to the hospital. It may take four to five days in the hospital to get the diet started and for you to learn how to plan the diet.
While in the hospital, your child may not be able to eat for one to two days until ketones are measured in the urine. Once ketones are present in the urine, special high-fat, low-carbohydrate shakes may be started. These are sometimes called keto shakes. After several meals of keto shakes, your child will be started on solid foods.
You may also be taught how to check your child’s urine for ketones. The dietitian will help determine how much fat, protein, and carbohydrate your child is allowed to have, usually divided into three meals a day. The ketogenic diet can by very challenging to prepare and requires that all foods be weighed using a food scale. The ketogenic diet is not nutritionally balanced, therefore, vitamin and mineral supplements are needed.
Some medications and other products, such as toothpaste and mouthwash, contain carbohydrates. It is important to avoid these products if your child is on the ketogenic diet. Your child may not make ketones in their urine if too many carbohydrates are included in the diet. Your child’s doctor and dietitian can give you a list of medications, and other products, that are free of carbohydrates.
Children usually stay on the diet about two years. The diet is then slowly changed back to a regular diet. However, some children may stay on the diet for many years.
Surgery for epilepsy and seizures is a very complicated surgery performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain.
A child may be awake during the surgery. The brain itself does not feel pain. With the child awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged.
Surgery is not an option for everyone with seizures. Discuss this with your child’s doctor for more information.
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