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Epilepsy: recognition and management of seizures in children and young people

02 June 2021

Clinical

02 June 2021

Volume 2 | British Journal of Child health · Issue 3

ISSN (print): 2633-5417

ISSN (online): 2633-5425

Abstract

A seizure describes the signs and symptoms associated with a sudden surge in brain activity. It is a symptom of either acute brain disturbance, or may indicate a diagnosis of epilepsy, which describes an underlying tendency to have seizures. There are many different seizure types, which account for the wide variation in seizure symptoms. The principles of management remain constant for all seizure types: maintain child safety, ABC support, and arrange emergency assistance and hospital transfer for prolonged episodes. In addition to this, tonic-clonic seizures lasting for more than 5 minutes require treatment with benzodiazepines. Buccal midazolam or rectal diazepam are first-line options when intravenous or intraosseous access is not available. Children and young people with epilepsy should have individualised treatment plans which, if available, further simplify emergency treatment decisions.

Epilepsy is the most common neurological condition in childhood, affecting approximately 50 000, or 1 in 240, children and young people under the age of 16 years in the UK (Joint Epilepsy Council of the UK, 2011). Epilepsy describes a tendency to have seizures, where a sudden surge in brain activity manifests as abnormal behaviour patterns (Fisher et al, 2005). There are many different seizure types and so appropriate recognition and response to seizures can be difficult (Kramer et al, 1998). Furthermore, a prolonged convulsive seizure, termed status epilepticus, can cause serious brain damage, or in rare cases, death (Appleton et al, 2000). As such, the capability to recognise and appropriately respond to childhood seizures is critical for healthcare professionals caring for children and young people with epilepsy.

‘Epilepsy describes a tendency to have seizures, where a sudden surge in brain activity manifests as abnormal behaviour patterns….There are many different seizure types and so appropriate recognition and response to seizures can be difficult… the capability to recognise and appropriately respond to childhood seizures is critical for healthcare professionals’

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Epilepsy

Seizure

Status epilepticus

Management

Treatment

Children and young people