How to Help Your Child deal With Non Epileptic Seizures

Epilepsy is the condition of having two or more seizures that are caused by abnormal clusters of nerve cells in the brain. These nerve cells cause rapid and abnormal electrical activity in the brain, which leads to seizures.

Epilepsy is usually a long-term (chronic) disease that can be managed with anti-seizure medicine.

Not all seizures are caused by epilepsy. Seizures that are not caused by epilepsy are called non-epileptic seizures, and there are two types:

• Physiologic non-epileptic seizure. This is also called provoked seizure or organic seizure. This type of seizure stops when the cause goes away or is treated. Possible causes include:
  • High fever.
  • High or low blood sugar (glucose).
  • Brain injury.
  • Brain infection.
• Psychogenic non-epileptic seizure (PNES). This can look like another type of seizure, but it can be caused by a mental disturbance (psychological distress), not by abnormal brain activity or brain injury. A PNES may be called an “event” or “attack” instead of a seizure. Possible causes include:
  • Stress.
  • Major life events, such as divorce or death of a loved one.
  • Post-traumatic stress disorder (PTSD).
  • Physical or sexual abuse.
  • Mental health disorders, including anxiety and depression.

General treatment recommendations

Physiologic non-epileptic seizure

• If your child has a physiologic non-epileptic seizure, your child’s health care provider will treat the cause. These seizures are not likely to return, and they do not need further treatment.

PNES

• Your child’s health care provider may suspect PNES if your child:
  • Has seizures that keep coming back (recurring) and do not respond to seizure medicines.
  • Does not show any abnormal brain activity during electrical brain activity testing (electroencephalogram, EEG).
• It is very important to understand that PNES is a real illness. It does not mean that your child is faking the seizures. It just means that the cause is different. PNES can be treated.
• Your child will be referred to a mental health specialist (psychiatrist) to treat PNES. This is because PNES is a mental health disorder. Work with your child’s health care team to find a treatment that works for him or her. Treatment may include:
  • Talk therapy (cognitive behavioral therapy, CBT). This is the most effective treatment. Through CBT, your child will learn to identify and manage the psychological distress that leads to seizures.
  • Stress reduction and relaxation techniques.
  • Family therapy.
  • Medicines to treat depression or anxiety.
• In many cases, knowing that seizures are not caused by epilepsy reduces or stops seizures.

How to help your child cope with seizures

Talking about your child’s condition

• Talk openly with your child about his or her seizures. Do not use words like “problem” or “burden.” Be positive.
• With your child present, explain your child’s seizures to your child’s teachers, friends, family members, and others.
• Teach others what to do in case your child has a seizure:
  • Keep your child safe from injury. Move him or her away from any dangers.
  • Do not restrict your child’s movements.
  • Do not put anything in your child’s mouth.
  • Speak calmly to your child during the seizure.
  • Do not call emergency services unless your child is injured or the attack goes on for a long time.

Supporting your child

Provide support by:

• Being affectionate and loving.
• Creating a safe family environment.
• Talking together about feelings.
• Planning activities that let your child relax and have fun in a safe environment.
• Creating schedules and routines and following them.
• Helping your child find ways to regularly release stress and relax through hobbies, exercise, or telling others how they feel.
• Encouraging your child to ask for help when dealing with stress or other problems.

Coping with stress and anxiety

Help your child find ways to cope with stress and anxiety, such as:

• Breathing exercises.
• Meditation or yoga.
• Listening to music.
• Organized exercise and play.
• Expressing feelings through art or recreational therapy.
• Spending time with people who make your child feel safe.

General instructions

• Work with your child’s health care team to make a treatment plan. Make sure everyone who cares for your child knows this plan.
• Have your child carry a letter with him or her that explains what his or her condition is and what to do in case of a seizure.
• Understand what may trigger a seizure in your child, and help your child avoid triggers.
• Make sure your child:
  • Gets enough sleep.
  • Eats a healthy diet.
  • Gets regular exercise.
• Give your child over-the-counter and prescription medicines only as told by your child’s health care team.
• Follow your child’s treatment plan carefully.
• Keep all follow-up visits as told by your child’s health care team. This is important.

Where to find support:

You can find support for coping with seizures from:

• Epilepsy Foundation: www.epilepsy.com  
• University of South Florida College of Medicine (Psychogenic Non-Epileptic Seizures: A Guide for Patients & Families): hsc.usf.edu/COM/epilepsy/PNESbrochure.pdf  
• Your child’s health care team.
• A support group for parents of children with seizures. Look for support groups in your community.
• Therapy or counseling for you and your child.
• Local organizations that offer resources about seizures.

Contact a health care provider if:

• Your child shows signs of depression or anxiety.
• Your child is not interested in spending time with family and friends because of his or her seizures.
• Your child avoids school because of his or her seizures.
• Your child has difficulty in school due to his or her seizures. Also discuss this with your child’s teachers and school counselors.

Summary

• It is very important to understand that PNES is a real illness. It does not mean that your child is faking the seizures. It just means that the cause is different.
• Work with your child’s health care team to make a treatment plan. Make sure everyone who cares for your child knows this plan.
• Provide support to your child, and help your child find ways to cope with stress and anxiety.