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Understanding children with epilepsy (seizures)

Although science is silent on witchcraft as a cause of epilepsy or disability, it asserts that about 30% of the causes of disability is unknown.

EPILEPSY is a health-related disability whose causation is often associated with witchcraft in the context of Zimbabwe. But from the lens of scientific knowledge systems, witchcraft cannot be associated with the aetiology of epilepsy or disability because scientists have not explored that area with any measure of success.

Although science is silent on witchcraft as a cause of epilepsy or disability, it asserts that about 30% of the causes of disability is unknown.

Arguably, one can infer from a de-colonial perspective that witchcraft may be factored into the 30% of the unknown causes of disability.

The issue of aetiologies of disabilities aside, this opinion piece intends to share with the readership insights into understanding the physical and behavioural characteristics and management of children with epilepsy.

Science claims that there are more than 20 types of seizures (epilepsy), but this opinion piece will just major on three categories of seizures (Grand mal, Psychomotor, Petit mal) which the writer witnessed during his teaching experience as a specialist teacher of children with special needs in general and children with intellectual disabilities in particular.

From the outset, it should be mentioned that children with epilepsy should wear medic alert bracelets.

Epilepsy is a sign or symptom of a structural or chemical disorder which occasionally produces sudden electrical discharges within the brain which may cause seizures. It is also important to add that brain tumours can also cause epilepsy.

These seizures can range from severe to minimal and are exhibited in multiple ways as shall be shown below as Grand mal, Psychomotor and Petit mal are unpacked.

Grand mal is characterised by seizures in which there is a loss of consciousness and convulsive, rapid and generalised uncontrolled body jerks or movements.

A child experiencing the Grand mal form of epilepsy will usually fall down as the convulsions or seizures begin and may froth at the mouth or urinate during the seizure or even empty their bowels. This type of seizure may last two to three minutes.

A child may not recall what happened during a seizure and this is called cognitive dissonance, which is also associated with confusion and disorientation. If Grand mal should occur, it is advisable for teachers and parents not to panic, rather remain calm because seizures cannot be stopped once they have begun.

Essentially, it is important to ease the child to the floor, loosen clothing and also place the child on his or her side to maintain a clear airway so as to prevent choking on saliva or biting of the tongue. Please do not put anything between the teeth of a child experiencing a seizure as that may complicate the process of the seizure.

The Petit mal form of epilepsy often goes unrecognised and the preschool centre may be the first place to recognise that a child has this disorder. This type of seizure is more common in children than in adults and most children outgrow these seizures. This form of seizure is characterised by a brief loss of consciousness usually lasting 15 to 20 seconds.

With this type of seizure, the child may cease all activity and appear to be staring into space, day dreaming or rapidly blinking.

Furthermore, the child may exhibit a series of muscle jerking and a brief loss of muscular control and in the process smacks his or her lips.

After the seizure, the child usually resumes his or her activity as if nothing had happened. The child may be totally unaware of the seizures.

For Early Childhood Development teachers, it is important to record the frequency of seizures, when they are most likely to occur and under what circumstances they are most likely to occur and share these observations with parents for referral purposes.

Local epilepsy associations help with appropriate forms for recording behaviours that are associated with seizures and are also critical sources of support for children with epilepsy.

The Psychomotor form of epilepsy, just like Petit mal is found in young children. The seizure generally lasts two to five minutes followed by a period of amnesia (inability to remember events for a period of time).

Observable behaviours include uncontrolled body movement, inappropriate actions such as chewing, facial distortions, uncontrollable violent physical outbursts and less observable symptoms include abnormal pains, headaches, buzzing in the ears, dizziness and smacking of lip.

In the event of a Psychomotor seizure, teachers and parents should remove dangerous objects (chairs or tables with sharp corners) from the area to prevent accidental injury.

The child’s movements during a seizure should not be restricted, except to prevent injury to the head and body. It is also not advisable to insert an object between the teeth and avoid panicking if the child seems to stop breathing momentarily. It is not in the best interest of a child experiencing a seizure to have people standing over him or her.

In terms of intervention, epilepsy can be managed through medication and surgery, that is depending on its nature and severity.

It is important for parents and teachers of young children to take note of physical and behavioural characteristics that are associated with epilepsy and get in touch with local health officials or physicians that deal with children.

Early identification for prompt intervention is critical for child safeguarding, protection and effective mainstreaming in regular schools. It is also important for schools to keep directories for referral pathways.

Parents of children with epilepsy should also be helped to connect with epilepsy associations for moral, social, intellectual, medical, counselling and emotional support.

Nicholas Aribino is the ZimCare Trust country director. He writes here in his personal capacity.

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