Safety and seizures in childhood: The human side

William B. Svoboda, MD, is a retired pediatric neurologist. He is the founder and former Director of Via Christi Epilepsy Center of Wichita, Kansas.

This series of articles about the effects of epilepsy on children's lives and personalities, and how parents can help their child achieve a happy, independent life, is based mostly on an interview with Dr. Svoboda that was conducted by Shawna Cutting, a writer for epilepsy.com.

Parents worry that their children could be injured if a seizure happens during certain activities. What restrictions do you think are reasonable?
There are certain things to avoid. We haven't figured out a way to get around heights, for instance. I don't like to see kids with uncontrolled seizures climbing tall trees, even though I've never personally seen a child who has had a seizure in a tree. (I have seen three patients without seizures who have fallen out of trees and broken their arms.)

To minimize restrictions, parents can try to figure out alternate ways of doing things. Some parents won't let their child ride a bicycle because he or she might have a seizure and get hurt. Well, the simple thing is to make sure that the child wears a bicycle helmet at all times and rides only on sidewalks or paths. In that way the child is not over-restricted.

Just follow basic safety rules in general. I like to have kids take part in sports if they can. The only general exception is that they probably should be restricted for a while if they've just had seizure surgery or another kind of craniotomy.

How do restrictions based on seizures affect a child's friendships?
A lot of bonding is related to sports and other activities, so the child who isn't allowed to participate misses out on being around other kids. If you can't go on the ski trip, then you've missed out on the opportunity for socializing with the group. I review the risks with parents and we look for ways to get around them. Sometimes using the buddy system works, if the child has a good friend who's able to go and the parents and teachers feel safe about it.

Children with epilepsy need to do things with the other kids in their class. It helps not just then but also the next day, when everyone talks about what they did. It gives the child a chance to be a part of something. If a child who used to be restricted is allowed to play sports and then hits a home run to win the game, there's nothing better. That happened to one boy and he was ecstatic for the rest of the school year.

But you can't hit a home run if you are not allowed to play baseball because you have attention problems or because your pills make you too slow or because you might have a seizure and not run when you should. Parents and coaches use these reasons but they are often not valid. I asked one coach whether he knew of any other Little Leaguers who have had problems because they weren't paying attention. You see, I knew that another boy on the team had been hit in the head by a fly ball in the outfield because he was looking at a gopher hole instead of paying attention!

Some restrictions on children with epilepsy can be really surprising. Here in Wichita, one child with epilepsy was not allowed to use the community swimming pool because the people who ran it were waiting to get long rubber gloves for the lifeguards. They didn't want the child to swim until they got the gloves because they were afraid that if he had a seizure in the water, the electrical problems in his brain might shock the lifeguards. I pointed out that the electrical output from the heart was more powerful than the electrical output from the brain, and I gave the lifeguards some materials to read through. Then they figured it would be safe and the child was allowed to swim. There are some very wild, old-fashioned ideas out there, and some of the wildest restrictions. I can't imagine what will come up, but I've learned to keep a straight face.

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