From Population Health

A Wolf in Sheep’s Clothing

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I spent the day yesterday in clinic, seeing a few fantastic kids, all with a rare epilepsy syndrome that is known to cause a lot of cognitive and learning problems. This is exactly what I worry about most in childhood epilepsies – the effect of the seizures and the epilepsy on learning and development.

So as odd as it may sound, making a diagnosis of one of the more ‘benign’ epilepsy syndromes can be reassuring for me as a clinician. If I have a child with typical childhood absence epilepsy in clinic, I know that there is a good chance we will get the seizures under control, and that after puberty many patients will become seizure free. Yet ‘benign’ in medicine is always a double edged sword: Whilst all the above may be true, it turns out childhood absence epilepsy in some ways is not a harmless condition without any lasting effects. 
It’s Purple Day – aka Epilepsy Awareness Day. So yes – let’s get talking about Epilepsy! It’s great to see so many people, differently affected by epilepsy join the discussion on twitter and give a public face to the condition.

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Let’s talk about death

When making a new diagnosis of epilepsy, I often encounter fear – I speak to parents who have seen their child having a seizure in front of them, becoming unresponsive and shaking uncontrollably. And from their faces I can see that they were worried about one thing above all: Is my child going to die?

In the majority of cases the answer is clearly no. Seizures themselves very rarely cause mortality, and other than the rare sudden unexplained death in epilepsy (SUDEP), or patients with significant neurodevelopmental disabilities and life-limiting comorbidities, we rarely see deaths in our paediatric patients with epilepsy.

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