Children from 4 to 10 years of age are often inexplicably dazed or distracted, and they do not respond. Parents should not mistakenly think that it is because the child is older and worried. In fact, this may be caused by “children’s absence epilepsy”! In the Department of Pediatric Neurology, it is not uncommon for children with epilepsy like this to show children’s absence. Parents must not be negligent. “Children’s absence epilepsy” is a kind of epilepsy in which “cramps” cannot be seen, and a doctor should be diagnosed in time.
A piece of A4 paper to judge whether the child has absence epilepsy?
Xiaomei (pseudonym) is 5 years old this year, just in the kindergarten class, is a well-behaved and obedient child, often praised by the teacher. But recently, I have always been in a daze for some reason. Often when she was doing something, she stopped suddenly and told her not to respond. Sometimes the toy in her hand fell to the ground unconsciously. The teacher found that Xiaomei’s daze was getting worse and worse, and suggested that parents take their children to the hospital for examination.
The pre-inspection nurse at the hospital’s outpatient department advised Xiaomei’s mother to take her child to the pediatric neurology department. There is nothing wrong with the child’s brain! Xiaomei’s mother came to the neurology clinic very puzzled. The doctor helped Xiaomei’s mother recall a little bit: When did the child start to have this phenomenon? Was there any discomfort before the daze? Are there any other small actions in a daze? Are there any discomforts after a daze? Does he know the process of being in a daze…
After inquiring, the doctor took out a piece of A4 paper and asked Xiaomei to inhale hard and blow again, repeating it again and again like blowing out a candle. About 20 seconds later, a strange phenomenon appeared-Xiaomei suddenly looked dull and didn’t respond when she called her to shoot her, as if she was asleep; after nearly 5 seconds, she woke up immediately. Xiaomei’s mother told the doctor that the child usually looks like this. When she was young, her eyes became straight, as if she didn’t know where she was looking. She felt as if she was asleep, but she woke up after a while. Come here, as if nothing happened.
The doctor told Xiaomei’s mother that the child’s illness was called absence epilepsy. The test just now simulates her usual hyperventilation scenarios, such as emotional agitation and fatigue, to see if the child will have a lack of seizure-like reaction at this time. Then, the doctor asked Xiaomei to do an EEG examination, and the results showed that Xiaomei’s EEG was abnormal, which was a typical epileptic discharge.
Different forms of absence seizures in children
In the traditional impression, epilepsy is “shofar wind” and “cramps.” In children with absence epilepsy, “cramps” cannot be seen. It is a generalized epilepsy syndrome with absence as the main type of seizure. Before the onset of the disease, most of the children were in normal physical and mental state. During the attack, the movements suddenly stopped and the eyes were hollow. The time lasted for 2 to 10 seconds, generally no more than 30 seconds. After an instant, they continued to play or participate in activities. It can occur several times a day to hundreds of times. The seizure stops suddenly, during which the consciousness is lost and there is no memory, but the body movements can be completely unchanged, and the previous behavior can be continued after the seizure. This type of seizure is often difficult to detect, and is medically called “absence epilepsy.” Emotions, nervousness, and hyperventilation are easily induced. The difference from a general daze is that outsiders will not immediately regain consciousness when outsiders shoot him (her) or call him (her).
Absence epilepsy is special because it occurs in childhood (3 to 10 years old). 5 to 6 years old is the high-incidence period of the disease, and has the above-mentioned specific seizure form and EEG (typical epileptic discharge, That is, spike wave, spike slow wave, multiple spike slow wave, sharp wave, sharp slow wave, paroxysmal high amplitude slow activity or paroxysmal abnormal discharge on one side, etc.). Since the manifestations of epilepsy in children are not necessarily obvious, it is easy to be ignored by parents. Especially for infants and young children, sometimes they may just twitch for a few moments, or suddenly start to froze, the toys in their hands may fall unconsciously, or they may nod suddenly, or even hurt their head and face. Therefore, once the child appears inexplicably dazed or distracted, parents should pay more attention. If this happens often, you must go to the hospital in time.
The appearance of absence epilepsy in children has a great relationship with congenital heredity. If someone in the family has epilepsy, the child has a very high rate of this disease. There is also a situation that is caused by external stimuli, such as a child’s mental stimulation or severe head injury, which leads to obstacles or lesions in the brain nerve tissue, etc. If the condition is not particularly serious, it will gradually alleviate as the child’s age continues to grow.
Principles of treatment of absence epilepsy in children
When a child is diagnosed with absence epilepsy, the most worrying question for parents is “can epilepsy be cured” and “will this disease affect the child’s brain development”.
First, the neurodevelopment of most children with absence epilepsy is normal. The main hazard of the disease is that the child may cause other accidents in the process of temporary absence. For example, a sudden onset and a brief loss of consciousness during the process of crossing the road, climbing a mountain, swimming, etc. may endanger the life of the child. However, if absence epilepsy is not treated in time, it may also cause generalized tonic seizures; it is still not controlled after adolescence, which may have a negative impact on the mentality, behavior, and social interaction of adulthood. In addition, repeated attacks can have a serious impact on children’s intelligence and mental development. Therefore, timely treatment and prevention are the key.
Absence epilepsy is a kind of epilepsy disease with relatively good therapeutic effect. For a simple absence seizure, due to its short duration, it occurs suddenly and stops abruptly. It can be relieved by itself without medication. For authors with frequent seizures and complex absences, appropriate antiepileptic drugs should be selected.
Sodium valproate and ethosuximide are traditional first-line drugs for single-agent treatment of absence seizures in children, and lamotrigine is the second-generation broad-spectrum antiepileptic drug. If the single-agent treatment effect is not satisfactory, the combined application can improve the efficacy. 70% to 80% of children have undergone 2 to 5 years of scientific treatment to ensure a reasonable and regular life, which can effectively control the onset of the disease, and most children can gradually stop the drug. Therefore, it is very important to detect the condition in time, actively treat it, and strictly follow the doctor’s prescription. Parents must pay attention to it.
Life care for children with absence epilepsy
Once a child suffers from childhood absence epilepsy, in addition to actively taking the child to the hospital for formal treatment, more care must be given to the child in daily life. It is necessary to take care of the children’s daily life and help them adjust their mentality. During the treatment period, let the children participate in social activities as little as possible to avoid the influence of external stimuli. In the course of treatment, I have to go to the hospital for review regularly to relieve the epilepsy disease.
1. Standardized treatment. Adhere to long-term, regular medication and regular review, the absence can be completely controlled or cured without affecting the children’s intellectual development. A small number of children with other types of epilepsy have poor results.
2. Avoid incentives. Patients must try to avoid the triggers, such as emotional agitation, mental stress, overwork, overeating, and other physical and chemical stimuli, such as large temperature changes. Therefore, do not allow children to play video games and watch TV for a long time, avoid the intake of coffee, cola, sugary drinks, and the negative emotions around them.
3. Adjust your diet. To provide patients with abundant protein, eat more lean meat, eggs, milk, fish and shrimp, soy products and other foods containing high-quality protein to promote the development of children’s nervous system and promote the growth and development of children’s memory and thinking ability; Appropriate intake of fresh vegetables and fruits to increase the intake of vitamin E, vitamin B family and vitamin C will play a very good auxiliary role in the treatment of epilepsy.
4. Exercise. The patient should exercise a proper amount of regular exercise. When conditions permit, suitable outdoor exercises can be carried out to enhance resistance; it is not advisable to sit still in front of the TV computer for a long time.
5. Adjust psychology. Patients should adjust their psychological and emotional, keep the body and mind happy and calm, and should not be irritable, anxious and depressed.