July 1st, 2011
For 80 percent of children with epilepsy, seizures can be controlled. For those children and their families, epilepsy is not and should not be a substantial handicap. For zo percent, the uncontrolled seizures themselves may constitute a significant impairment; and for some children with mental retardation or cerebral palsy, epilepsy may be a substantial secondary disability. These children and their parents carry a significant burden, a greater degree of guilt, anger, frustration, sorrow, and just plain hard work. These parents need to understand these disabilities so they may help their children as much as circumstances allow.Damage to the brain causes these problems. Damage in the motor areas of the brain causes cerebral palsy. When damage or dysfunction occurs throughout a considerable area of the brain it may lead to mental retardation. Epilepsy also exists because the brain is not functioning properly. Mental retardation and cerebral palsy, while sometimes accompanied by epilepsy, never cause epilepsy. Epilepsy never causes cerebral palsy and seldom causes mental retardation.Parents with a severely disabled child must also gradually come to a realistic acceptance of their child’s disability. Mechanisms for coping are the same as for the parent of the less disabled child, but the goal is often far more difficult to achieve. In addition to working through your own adjustment, you must also help your child get the service he will need. You must be an advocate. Both you and your child will have special needs. Finding the help is sometimes difficult; for some people, accepting the help is even more difficult.*193\208\8*
Categories: Epilepsy |
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June 8th, 2011
Infantile spasms may occur in the young child who has developmental problems of the brain or with brain damage caused by birth injury, meningitis, or head trauma. Abnormalities of metabolism such as low blood sugar or amino acid problems may also be responsible. All of these are designated as “symptomatic” infantile spasms, since they are caused by the underlying process. A second and smaller group of infantile spasms are called “cryptogenic” since their cause is unknown. Children with cryptogenic infantile spasms appear perfectly normal in development before the seizures begin.Infantile spasms are virtually always accompanied by an abnormality of the EEG known as “hypsarrhythmia,” a wildly chaotic pattern with multiple spikes and slow waves. While it may or may not be true, it is useful to think of this EEG pattern as imposing severe “static” on the brain waves so that the brain functions poorly and the child’s functioning deteriorates.A physician evaluating a child with infantile spasms should search for treatable metabolic causes of the spasms and infectious processes. An EEG and a CT or MRI scan should also be requested. Unless a specific treatable condition is found, and one rarely is, treatment for the spasms should begin promptly.We initially treat all such children with ACTH (adrenocorticotropic hormone), a form of steroid given twice a day by intramuscular injection. However, some physicians use oral steroids, benzodiazepines such as diazepam (Valium) or clonazepam (Klonopin), or valproic acid (Depakote, Depakene). The relative effectiveness of these various forms of treatment has not been tested, nor has the duration of treatment been established. Each treatment has substantial risks or side effects, but, as indicated above, there are also substantial risks in not treating this form of epilepsy. Clearly we do not understand the reason for the related retardation or its optimal treatment. Further research is needed.*94\208\8*
Categories: Epilepsy |
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