Epilepsy Ontario :: Questions & Answers (Summer 2007)

Questions and Answers

I have been wondering about the effect of compact fluorescent bulbs on people with epilepsy. Have any studies been done? I keep hearing about how great these bulbs are and I have also heard some criticisms of them concerning mercury content, but not once has the effect on people with epilepsy or migraines been mentioned.
Currently there are no studies or evidence to suggest any adverse side effects on seizures with the use of compact fluorescent bulbs. There is evidence however, that regular fluorescent bulbs can trigger seizures in persons with photosensitive epilepsy. The fluorescent bulbs available today are a vast improvement compared to those available when they were first introduced. Light "flickering" was believed to be associated with seizures and migraines, but improvements have increased the frequency so that they are barely detectable by most. However, a small percentage of people with photo-sensitivity remain extremely sensitive to these lights and should avoid using them whenever possible. It is still undetermined however, whether the use of compact fluorescent bulbs will actually increase seizure frequency, lower it, or have no differences in effect compared to regular fluorescent bulbs.

Our daycare provider had just told us that she has epilepsy. She has been seizure free for one year. She is alone with the children most of the day in her own home. Can you tell me if it is appropriate for her to be looking after small children on her own? I know very little about epilepsy. My concern is what happens to the children if she has a seizure.
Many parents with epilepsy are able to care for their children with minimal supervision although some precautions may be necessary if there is a strong likelihood of a seizure. Depending on the type, severity and frequency of seizures it is okay for someone diagnosed with epilepsy to provide day-care services. Since your day-care provider has been seizure free for a year already, it may mean that she has gained good control of her seizures with medication. It may be useful to discuss your concerns with her and to learn more about her condition such as the type of seizures, likelihood of an onset and any precautionary measures in place in case of an emergency. For more information, visit our website at epilepsyontario.org and type "child care" into the search engine.

My dog is now taking the medicine called phenobarbital for seizures. She had just started taking it on Wednesday and today is Friday. My question is would this medicine have any effects on my dogs walking ability while having hip displasia? She even has trouble getting up from the laying down position.Please let me know. I am very concerned about my dog.
Phenobarbital is most commonly prescribed for dogs with epilepsy as it is considered a highly effective drug for controlling canine seizures. It is common however for your dog to experience side effects within the first few weeks of beginning treatment with phenobarbital. These may include poor coordination, lethargy, sedation, frequent urination etc. These usually decrease over time as your dog becomes adjusted to the medication. However, if these side effects do not seem to improve over time, then you may wish to contact your veterinarian to discuss the possibility of reducing the dosage without compromising the concentration of the medication so that it is below the therapeutic range. The goal should be to minimize side effects of the medication while maintaining adequate control of seizures.

Is it possible to have seizures only while you are sleeping? My mother in law who has had two operations to remove brain tumors, which have not returned, and to which she seems to be her normal self again, was being informed that when asleep she was having a seizure but not waking till the next morning, feeling no affects. Please enlighten me.
Seizures during sleep are also known as nocturnal seizures. Some believe that there may be a relationship between the changes in brain-wave activity during sleep and seizures. Nocturnal seizures are however more common during the light stages of sleep; upon waking, right before falling asleep or even while daydreaming. Seizures during deep sleep in which a person is completely unaware are uncommon. To be correctly diagnosed, your mother-in-law may need to consult with her doctor and discuss the possibility of having tests done by a specialist, preferably an epileptologist to conduct a sleep electroencephalogram (EEG) analysis to determine if there is any abnormal brain activity during stages of sleep. Following this test, the specialist may determine if treatment with anti-epileptic medication is necessary. For more information, please visit our website at epilepsyontario.org and type "nocturnal seizures" into our search engine.

My grandson will be four in May. One year ago he had his first seizure after a trip outside Canada. This was swiftly followed by another and he was diagnosed with epilepsy. He had a wide variety of seizure types with the drop attacks being the worst. He was given Epilim (valproic acid), then had Clobizam and later came Keppra, which I must say is working well. He goes to school in the afternoons and his behavior is causing concern. He has started to lash out at other children and his one-to-one teacher. Today, his behaviour was watched by a medical team and they have said that they think he has autism. No eye contact?? He always makes eye contact with us. He does fly into rages sometimes, but this little boy has been to hell and back this year. For 7 solid months we were frightened to let him move around due to the amount of injuries he was sustaining. This now seems under control (last 2 weeks) and he is back to his old self again. Well not quite, because the drugs do seem to slow him a bit. He is very bright. Could hold a full conversation at 18 months, knew his colours, shapes, alphabet and numbers before 2 years. His range in vocabulary has always amazed all who meet him. This just does not seem to fit with your notes. He has been recently diagnosed with Lennox Gastaut Syndrome due the wave and spikes of several EEGs. Could they be mistaken? Could this be autism instead? If it must be one or the other, I am not sure what to think. What do you think?
Both autism and epilepsy are caused by underlying neurological conditions. Diagnosis for autism should be made by a group of specialists involving a developmental psychologist, neurologist, speech language pathologist etc. However, before an accurate diagnosis of autism can be made, doctors must first rule out any complications that may be associated with his diagnosis of Lennox-Gastaut syndrome. Lennox-Gastaut syndrome is a form of seizure not yet fully understood and quite difficult to control. It is also often associated with development and behavioural difficulties. Children with epilepsy are also more likely to have emotional and behavioral difficulties coping with seizures. Living with epilepsy can be a source of anxiety for even adults, and children may have a harder time coping and understanding their condition, which is demonstrated by irritability, hyperactivity, aggression and even depression. Some researchers believe that the process responsible for causing seizures might play a role in these behaviours, suggesting that the abnormal discharges in the brain which trigger seizures might cause disorganization in the areas of the brain which also control behaviour. Others have noted that these behavioural changes coincide with treatment (with high doses of medication). If this is the case, and his behaviour has become intolerable then it might be in his best interest to reduce the dose of medication. The goal of anti-epileptic drug treatment is to minimize side effects and maximize control of seizures. We recommend consulting with his doctor about the possibility of reducing his dosage, and the likelihood that his seizures might be just as effectively controlled with these changes.

Saturday, my 7-month old son took a shower with me, I got out to get a towel when he started to cry for no reason, then all of a sudden he turned red and collasped. I picked him up so quick and was blowing air towards his mouth when he awakened and he seem to be ok. Then Sunday, he hit his head on the ground (not very hard) and again was crying, so I was comforting him and suddenly he was quiet. I looked at him and he was white and limp, but breathing very slowly. Once he awakened he was my happy little boy, like nothing had happened. My husband has epilepsy and takes Dilantin. Can epilepsy or seizures be passed down to my son?
Epilepsy is somewhat genetic. Children of parents with epilepsy have a higher risk of inheriting epilepsy; that is 4-8% compared to 1-2% of the general population. This still leaves the risk of not inheriting epilepsy from a parent with the condition greater than 90%. However, inheriting epilepsy is a much more complex process which involves a combination of multiple genes and environmental triggers. When combined, these can influence from no expression of epilepsy to varying degrees of severity of the condition. If you have concerns that he might be having seizures, then it would be a good idea to discuss this with his pediatrician as soon as possible so that he/she can refer you to a specialist such as a neurologist, preferably an epileptologist. If there is cause for concern, he/she may perform an EEG and/or MRI to determine if there is abnormal brain activity and prescribe appropriate medication if necessary. It is sometimes useful to discuss these concerns with a Genetic Counselor who is trained to gather information on family history and from genetic tests to predict the likelihood of inheritance and offer guidance and support.

My niece has photo-sensitive epilepsy and I'm concerned with her attraction to mesh screens, which triggers seizures. She has on several occasions gone into other rooms, most recently climbed up to stare at a screen above the sink (fell off and sprained her ankle, but did not have a seizure). Something isn't right about my niece's behaviour - I don't think she can control it. Have you come across any other situations where a child is "attracted" to screens or other patterns which then brings on a seizure? My niece has been diagnosed since the age of 3 and is now 12 years old.
This is a very interesting case, and we did manage to find some information regarding the rare occurrence of self-induced photo-sensitive epilepsy (SIPE). It is believed that some people with photo-sensitive epilepsy, with some level of control over their seizures, may gain 'ictal � pleasure' from self-induced seizures. This form of pleasure however is rare for people with unpredictable and uncontrollable seizures. This is a conditioned behaviour which is re-enforced by the enjoyment your niece probably gains from it; she may therefore require psychological evaluation and treatment, perhaps by a cognitive-behavioural therapist to help her re-condition this behaviour.

Our 15 year old son just had two back to back grand mal seizures for the first time; both of which were severe. The second seizure lasted 5 minutes and he was given Lorazepam and a high dose of Dilantin to try and control the seizure. We have taken every safety precaution that we can think of, however, in all of the reading I have done, I cannot find anything about people who have seizures while they are alone. There is always an assumption in all of the information that an observer is present. Should we ensure that we have someone with him 24/7? Can he walk to school on his own?
The sudden onset of epileptic seizures can be an overwhelming experience. We are however happy to hear that you are making an effort to take precautionary measures regarding your son's condition. Seizures if moderately controlled usually last for a short while before disappearing and without causing any adverse effects on an individual. There are as you mentioned precautionary measures that should be taken in the event of a seizure, whether in the presence or absence of a witness. These include avoiding swimming alone, taking showers instead of baths, avoiding cooking over hot stoves, etc. If your son's seizures are not yet moderately controlled, he has a high risk of prolonged (over 5 minutes), severe seizures, and you are still in the process of finding the right combination of medication/dose, then it may be a good idea to provide him with some supervision when necessary, perhaps walking to school with a friend. It is however important to ensure that he does not feel a sense of lost independence or privacy and that he learns to manage his condition on his own. It may also be a good idea to inform anyone who might be present where he spends most of his time such as teachers and friends so that they may be aware of the appropriate response in the event of a seizure. It is important to note that many people with seizures who have gained moderate to good control of their seizures are able to live alone and function independently. The goal is to find the ideal medication and dosage to minimize the frequency and severity of seizures, and to take as many safety precautions as necessary to reduce injury in the event of a seizure.

I experience seizures during my menstrual cycle either a few days prior or 7-10 days after. I am on Dilantin 600mg @ bed. I have had no problem until this occurred about two years ago when I was also put on blood pressure meds and laid off as well. I'm due to see a neurologist, but wondered if my life could go back to normal, I would like to return to work, and I do have a eight year old daughter as well.
There is a type of epilepsy that is specific to women called Catamenial epilepsy, refers to changes in the frequency of seizures following fluctuations in hormone levels throughout the menstrual cycle. There are 3 patterns of catamenial epilepsy: pattern 1--seizures around the start of your menstrual cycle; pattern 2--seizures occurring at the end of your period for a couple of days; pattern 3--seizures occurring during the days between your periods.
Some seizures types, such as complex partial and secondarily generalized secondarily show all 3 patterns. It is not guaranteed that you will find a definite pattern. There is still no universally accepted definition of catamenial epilepsy. My suggestion would be to determine the relationship between your seizures and your menstrual cycle by keeping a detailed diary of each. This can be more complicated than it seems at first. It is helpful to learn how to test when you are ovulating and to record that information as well as keeping track of the days during which you are menstruating. It is also important to record factors that may affect these patterns: missed pills, lack of sleep, stress, changes in physical activity and illness should be noted. Depending on the regularity of your menstrual cycle, this relationship may be easy or difficult to determine. Seizure frequency can vary in different phases the menstrual cycle for several reasons. In some cases the reasons are not known or there may be no relationship at all. In other cases, the relationship is based on estrogen's excitatory effect and/or progesterone's inhibitory effect on the brain. As the levels of these and other hormones vary, the likelihood of having seizures changes. Different types of seizures are more likely to occur in different phases of the cycle. Sometimes, increased metabolism of antiepileptic drugs just before menstruation may cause decreased levels of the drugs in the blood allowing seizures to occur. Therefore, the relationship between seizures and menstruation may help you to find out a more effective treatment. Hormonal therapy, the use of add-on drugs or adjustments in dosage can sometimes give you better seizure control. Your GP or neurologist may be able to suggest options, or may refer you to a gynecologist or endocrinologist to help establish appropriate treatment.

Epilepsy Ontario would like to thank Liselle Chieverton-Kearns and the entire research team for their time, effort and compassion in researching and writing these answers.

We hope this information has been useful. Please e-mail us if you have any further questions or comments.