Usually there is a previous history of convulsions with these patients. These may be minor or major fits. Minor fits (called petit coal) are common in children with epilepsy. Often the patient will become blank and stare into space for a minute or two. They may drop things they are holding, or actually fall. Usually they recover promptly of their own accord, forget what has occurred, and will continue with the activity taking place before the episode.
Major fits (grand mal) are characterized by a sudden onset of convulsions, which are writhing movements of the whole body. It may be preceded by a cry, and the patient may fall to the ground. The head and neck become congested and may be blue from inadequate oxygen. Jerking motions of the body take place, there is froth emanating from the mouth, and there may be blood (from bites of the tongue and lips). Urine may be passed involuntarily. Then suddenly the patient becomes quite limp. With the slow return of consciousness the patient will seem dazed for some time.
First aid measures are aimed at helping patients not to hurt themselves. Remove them from danger. Do NOT put your fingers into a patient’s mouth. Current practice does not favor placing anything between the back teeth, since caps and crowns break off readily, and can lodge in airway passages.
Get medical aid. If the casualty falls asleep after the fit, do not disturb. Supervision is necessary for some time after the bout, for “post epileptic automatism” can occur, in which the patient may do strange things.
Most children with epilepsy can lead normal lives and participate in most activities, including sports. Some physicians prefer to exclude children with convulsive disorders from collision sports such as football and hockey. However, unless seizures resulted from head trauma or tended to occur following blows to the head, it is likely that most children can compete while wearing protective headgear. Boxing is not recommended as an athletic activity for any children because of its potential for causing damage to the brain. It is definitely not appropriate for a child with a seizure disorder.
Children with well-controlled seizures may swim, but when doing so, they should be on a buddy system with someone else in the pool. Some convulsions can be provoked by flickering light patterns, and children with this tendency may experience a flare-up of seizures if they spend long periods of time playing video games. Loss of sleep, erratic eating habits, and alcohol use – behaviors that sometimes occur during adolescence – are also risky for the person with epilepsy and should definitely be avoided.
Of great concern for the teenager with a history of seizures is whether driving will be allowed. Laws vary from state to state, but most require evidence of an extended seizure-free period (for example, ten years) before a learner’s permit or driver’s license will be granted. Medications that are being taken to prevent seizures should not impair the teenager’s ability to operate a car safely. It is important for parents to follow these guidelines explicitly. Failing to report an adolescent’s recent seizure activity because of fear of losing driving privileges could be a major, if not fatal, mistake. These regulations exist for your child’s protection, as well as for the safety of everyone else on the road.