Caring for an epileptic child is challenging, but you’re not alone
If you have a child with epilepsy, the risk of seizure magnifies all the typical concerns of parents. The usual warnings — never swim alone, always wear a helmet when you ride your bike — take on added urgency.
Parents need to remember two important points, says Deepak Lachhwani, MBBS, MD, a pediatric epileptologist at the Cleveland Clinic Epilepsy Center. “First, if you have a child with epilepsy, form a close partnership with your child’s doctor and medical team. Second, learn all you can about seizure disorders from reputable sources. We want families to be as informed as possible.”
Parents of a child diagnosed with epilepsy want to know what to expect. Dr. Lachhwani sizes up the global situation this way: “If we start with 100 kids with seizures, as many as 65 will respond to medications and half the others will respond to surgery.”
If your child starts medication, watch closely for any adverse reactions. Although epilepsy drugs have improved and are easier to tolerate, seizure medicines may have side effects such as sleepiness, or balance or thinking disorders, especially if the dose is inappropriate.
If your child is among the 35 youngsters not helped by drugs, take heart. Approximately 50 percent of these patients have focal epilepsy, which means they have seizures that originate in a specific area of the brain. “These kids are likely to be good surgical candidates,” Dr. Lachhwani says. “If all goes well, 70 to 80 percent of them will be seizure-free after surgery.”
During recovery, you want to ensure that your child does not sustain a sudden impact to the brain — not an easy assignment. As Dr. Lachhwani notes, “Kids are busy individuals by nature, who need to carry on with their everyday lives. They usually are back to school six to eight weeks after surgery and doing all their ordinary activities.”
Some patients who do not respond to any other treatment may benefit from electrical stimulation with an implantable device called a vagus nerve stimulator.
Even if your child is among the small group of patients who are not helped by medication and are not candidates for surgical treatment, you’re not without hope. The ketogenic diet, a high-fat, low-carbohydrate regimen, may help control seizures in some children. At the Epilepsy Center, a dedicated team supports families that commit to the diet, which demands discipline.
For safety, some families engage a specially trained companion of the four-footed variety to play a protective role. “It’s important to know the difference between seizure response dogs (which can seek help when their owner has a seizure) vs. seizure alert dogs (which can sense and warn of an impending seizure),” Dr. Lachhwani says. “Anecdotally, we know of families who say this works for them, but we have no study to validate this observation.”
To make an appointment with a specialist at the Cleveland Clinic Epilepsy Center, please call 866.588.2264. For more information, visit clevelandclinic.org/BeWellEpilepsy.
Cleveland Clinic Epilepsy Center
• Cleveland Clinic accepts some of the most complex epilepsy cases, many of which other national epilepsy centers have turned down.
• Epilepsy neurosurgeon William Bingaman, MD, performed his 1,000th pediatric epilepsy surgery in 2010.
• In 2009 alone, more than 300 adult and pediatric epilepsy surgeries were performed at Cleveland Clinic, among the most of any center in the U.S.
• Patients with medication-resistant epilepsy are monitored in our adult and pediatric epilepsy
monitoring units, which are fully staffed 24 hours a day, seven days a week.
• Our specialists use advanced imaging technology to pinpoint the focus of the seizure and propose the best treatment plan possible.
Hope and Healing Support
Cleveland Clinic’s Pediatric Epilepsy Support Group is for families caring for children with difficult-to-control epilepsy. Like a family itself, the group provides a forum for parents facing tough decisions about epilepsy surgery, invasive monitoring of seizures and other procedures.
The group hosts a biennial reunion for young Cleveland Clinic patients who have undergone epilepsy surgery and their families. These events have drawn attendees from as far away as South Africa and Ireland. Educational as well as social, the gatherings include doctor-led sessions designed especially for caregivers.
“I am very passionate about this group,” says Dr. Deepak Lachhwani. “For families with a child who has been a surgical patient, our reunion is a wonderful and heartwarming occasion."
For more information, email pediatricepilepsysupport@ccf.org or visit clevelandclinic.org/BeWellEpilepsySupport.
The Cleveland Clinic Foundation Copyright © 2010. All Rights Reserved. Reproduction of this article is prohibited except with the prior written permission of Cleveland Clinic. This article is for educational purposes only and should not be relied upon as medical advice. It does not replace the independent judgment of a physician about the appropriateness or risks of a condition or procedure for a given patient. For the latest health and wellness news, please visit www.ClevelandClinicHealth.com.
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How ‘love handles’ are linked to heart disease
Why is belly fat bad for your heart? Fat deposited around your middle — also called visceral fat — lies inside the abdominal wall, surrounding key organs. This firm fat is a different animal from the fat covering legs and buttocks, explains Stanley Hazen, MD, PhD, Head of Preventive Cardiology & Rehabilitation at the Cleveland Clinic Heart & Vascular Institute.
Visceral fat is dangerous because it is metabolically active — it directly impacts your body chemistry. In contrast, the fat padding our thighs and behinds is warehoused until our bodies need to burn it for energy.
Dr. Hazen explains 3 ways that visceral fat affects your heart:
1. Visceral fat wraps around your liver, interfering with insulin production and promoting diabetes, a strong risk factor of heart disease.
2. It lowers healthy (HDL) cholesterol while raising your lethal (LDL) cholesterol. This encourages the accumulation of sticky plaque on the walls of your heart’s arteries.
3. Belly fat pumps out hormones and proteins, promoting inflammation, a major contributor to many health problems. When hidden plaque becomes inflamed, it can burst. Platelets and blood-clotting molecules drawn to the site form a plug that can block the artery walls and cause a heart attack.
Belly fat has also been tied to mood. Recent studies link its presence to depression.
How do men and women measure up?
Most women collect fat around their hips and buttocks, developing a “pear shape,” while most men collect it around their bellies, developing an “apple shape.” So men tend to accumulate more visceral fat, Dr. Hazen says.
To find out the kind of shape you’re in, calculate your waist-to-hip ratio. Measure your waist where it is narrowest and your hips where they are widest, then divide the waist measurement by the hip measurement. If you’re male and your waist-to-hip ratio is above 1.0, or female and your ratio is above 0.8, you’ve got an apple shape and are at greater risk for heart problems.
An ounce of prevention
The good news is that exercise can work wonders in trimming girth. Take a brisk walk just 30 minutes a day, five days a week, to help stop the growth of visceral fat. Increase your exercise by jogging or doing another aerobic activity – with your doctor’s blessing, of course — and you’ll actually see your waistline shrink. Visceral fat is some of the first to go when you start aerobic exercise, Dr. Hazen explains.
Most of all, if you haven’t developed an apple shape yet, start exercising now and enrich your diet with plenty of fiber.
The Cleveland Clinic Foundation Copyright© 2010. All Rights Reserved. Reproduction of this article is prohibited except with the prior written permission of Cleveland Clinic. This article is for educational purposes only and should not be relied upon as medical advice. It does not replace the independent judgment of a physician about the appropriateness or risks of a condition or procedure for a given patient. For the latest health and wellness news, please visit www.ClevelandClinicHealth.com.
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