Epilepsy, seizures and medication

What is epilepsy?

Epilepsy is a long-term condition that makes the brain more likely to have seizures. A seizure happens when there is a sudden, temporary change in the brain’s electrical activity.

Epilepsy can also affect thinking, emotions, and social life.

In Flanders, it is estimated that at least 15,000 children have epilepsy. This means that almost every school in Flanders has at least one child living with epilepsy.

Epileptic seizures: what you should know

Epileptic seizures can look very different. We usually distinguish between noticeable and less noticeable seizures:

• Convulsive seizures
  These are the “major” seizures where the body shakes violently and the child loses consciousness.
• Absence seizures
  These are much more subtle. The child stares blankly for a few seconds and does not take in any new information during that time.

Absence seizures can lead to a sudden decline at school. Because the brain does not process information during those brief moments, learning can be disrupted. Do you notice that a child often seems to daydream and suddenly performs worse? This may be related to new or insufficiently controlled absence epilepsy.
Please note: daydreaming or staring is also common in children with attention problems such as ADHD, without epilepsy being involved.

Each type of seizure requires a different approach. On the UZ Leuven website, you will find useful documents to print and fill out, such as:

• A seizure protocol
• A sheet for administering emergency medication
• Instructions for using the VNS magnet

Severe Seizure (Tonic-Clonic Seizure)

A tonic-clonic seizure is a severe form of epilepsy. You can recognize this type of seizure by:

• Loss of consciousness
• Intense jerking of arms and legs
• Lasts longer than 3 to 5 minutes

What can you do?

• Gently lay the child on the ground and make sure the airway remains clear (recovery position).
• Do not put anything in the mouth – this can be dangerous.
• Most seizures stop on their own within 1–2 minutes and do not cause harm.
• If the seizure lasts longer than 3–5 minutes, administer emergency medication (provided by the parents).
• If no emergency medication is available and the seizure lasts longer than 3 minutes, call 112.
• After a seizure, the child is often confused and very tired. This is called the postictal phase.

Subtle Seizure (Absence or Focal Seizure)

This may be an absence seizure (child stares for a few seconds) or a focal seizure (child makes repeated movements such as rubbing hands or smacking lips).

What can you do?

• Let the child be, but ensure they cannot injure themselves.
• Emergency medication is usually not needed.
• If the seizure lasts longer or occurs differently than agreed with the parents, alert medical staff.

Medication

• Anti-epileptic drugs can sometimes affect concentration and behavior, but they are not the cause of major learning problems.
• The more medications are combined, the greater the impact.
• Medication is usually taken at home (twice a day), but sometimes a dose is needed at school.
• Ensure supervision during intake and request a medical certificate for administration at school.
• Children who still experience severe seizures despite treatment receive a personalized emergency plan from the doctor.