Signs to look for that may mean a young child is having seizures:

· Short attention blackouts that look like daydreaming.
· Sudden falls for no reason.
· Lack of response for brief periods.
· Dazed behavior.
· Unusual sleepiness and irritability when wakened from sleep.
· Head nodding.
· Rapid blinking.
· Frequent complaints from the child that things look, sound, taste, smell or feel "funny."
· Clusters of "jackknife" movements by babies who are sitting down.
· Clusters of grabbing movements with both arms in babies lying on their backs.
· Sudden stomach pain followed by confusion and sleepiness.
· Repeated movements that look out of place or unnatural.

Sometimes seizures start in the teen years. These seizures, too, may be hard to recognize. It is easy to mistake the behavior they produce for signs of drug or alcohol abuse. The following behavior or reported feelings may be signs that a teenager is having seizures:

· A blank stare, followed by chewing, picking at clothes, mumbling, random movements.
· Sudden fear, anger, or panic for no reason.
· Muscle jerks of arms, legs, or body, especially in the early morning.
· Odd changes in the way things look, sound, smell or feel.
· Memory gaps.
· Dazed behavior. Being unable to talk or communicate for a short time.

Early recognition and treatment of children who experience seizures is important to prevent further problems. Undiagnosed seizures can lead to learning disabilities when brief blackouts make it difficult to follow instructions and understand the lessons at school. There may be safety risks because a sudden loss of awareness in certain situations (swimming, climbing) can lead to injury. Behavior problems may be exhibited because the child experiences feelings that are difficult to communicate and thus acts out. There also may be social problems because the child, his family and others do not understand the cause or nature of the child's unusual actions or behavior.

Recognizing and treating childhood seizures offers the child with epilepsy the best possible chance of a normal childhood and a brighter future in adult life.

From Kids & Seizures: Know The Hidden Signs
Epilepsy Foundation of America,
2000.

Our brains depend on electrical circuits of brain cells to let us think, feel and move. Many disorders (stroke, head trauma, drugs and alcohol, genetic conditions) can short out these circuits, causing excessive sparking of brain cells. This results in seizures that range from brief staring spells to blackouts with strong shaking of all limbs. During our lives, 10% of all people will suffer at least one seizure and 1% of us will have more than one, qualifying for a diagnosis of epilepsy.

Most people with epilepsy have normal intelligence and abilities, although a few can have learning disabilities, cerebral palsy or other problems. Many new medicines are available, so that most people can control their seizures without side effects. However, women with epilepsy have many special issues, including the effects of seizure medicines on sexuality, contraception, fertility, menstruation, and pregnancy. The Epilepsy Foundation of San Diego provides information and referrals at 619-296-0161, and detailed information in English or Spanish can be downloaded from the Foundation website at www.epilepsysandiego.org, through links to the national website. A new, comprehensive book for consumers called "Women and Epilepsy" by Martha Morrell, MD is available in English on the national website or through Amazon.com.

Women with epilepsy usually have normal babies, but it is vitally important to select the best medicines and start a special vitamin called folic acid BEFORE getting pregnant. This reduces the risk of birth defects due to the seizures or the medications. Consult a neurologist or ob-gyn doctor before pregnancy. The SD County Medical Society provides doctor referrals at 858-565-8888, and has a special program called Reach Out for the uninsured. UCSD maintains a Teratogen Hotline with information on medicines and birth defects at 619-543-2040.

Additionally, birth control pills can be inactivated by some seizure medications but not others. Women with epilepsy should discuss with their doctors, to find the best contraception method for them.

The Latino community suffers special problems with access to care, including lack of health insurance, language and cultural barriers. Some years ago, the Epilepsy Foundation surveyed the Mexican community of San Diego and found many people have wrong information, thinking that epilepsy comes from spiritual or mental illness. "Natural" treatments and curanderismo do not work for epilepsy.

Many people receive health care on both sides of the border. While the latest information on women and epilepsy is more available in the U.S., many seizure medicines are cheaper in Mexico. Currently, it is legal to cross the border with medication for personal use, but it is safest to bring a prescription from a U.S. doctor to prove the medicine is needed.

Mexican brands of phenytoin (Dilantin) are not reliable, but most people can safely use other Mexican seizure medicines. Consult your doctor about whether buying medicine in Mexico will be safe for your particular case.

Dr Grisolía is Chief of Neurology at Scripps-Mercy Hospital and serves on the Board of the Epilepsy Foundation of San Diego.

Epilepsia tiene muchos impactos en la salud de la comunidad latina. En el Mes de la Salud de la Mujer, debemos de recordar los avances importantes y los problemas especiales de las mujeres con epilepsia.

Nuestros cerebros dependen de circuitos electricos de células cerebrales que nos permiten pensar, sentir y mover. Varios desordenes (embolias, uso de droga o alcohol, trauma cerebral, variación genética) pueden dañar estos circuitos, produciendo descargas descontroladas. Producen ataques epilépticos que pueden ser breves ratos de mirada fija hasta convulsiones fuertes de todo el cuerpo. Durante la vida, 10% de todos sufriremos por lo menos un ataque, y 1% de todos tendremos más de uno, asegurando un diagnóstico de epilepsia.

La mayoría de personas con epilepsia tienen inteligencia y abilidades normales, aunque unas pocas tienen defectos de aprendizaje, paresia cerebral u otros problemas. Se disponen muchas medicinas nuevas, tal que la mayoría de las personas pueden controlar sus ataques sin efectos secundarios. Sin embargo, para las mujeres con epilepsia hay muchos aspectos especiales, incluidos los efectos de medicinas anticonvulsivas en la sexualidad, la contracepción, la fertilidad, la menstruación y el embarazo. La Fundación de Epilepsia de San Diego provee información y referencias a médicos. Su teléfono es 619-296-0161, y se puede imprimir información detallada en inglés o español en su página en Internet www.epilepsysandiego.org, que tiene "links" con información detallada en la Fundación Nacional. Acabó de salir un libro conprensivo en inglés "Women and Epilepsy" por Dra Martha Morrell, escrito para pacientes, que se puede comprar del website de la Fundación Nacional or en www.Amazon.com.

En la mayoría de los embarazos, las mujeres con epilepsia tienen niños normales, pero es de suma importancia seleccionar la medicina correcta, y empezar una vitamina especial (se llama ácido fólico) ANTES de embarazarse. Ésto reduce mucho el riesgo de defectos congénitos debidos a las convulsiones o las medicinas. Consulte Ud un neurólogo o un obstétrico antes del embarazo. La Sociedad Médico provee referencias a médicos y tiene un programa especial (Reach Out) que ofrece discuentos para los que no tienen seguro médico. Se puede contactar en 858-565-8888. La Universidad de California mantiene un "hot-line" para información de las medicinas que afectan el embarazo en 619-543-2040.

Aparte de eso, las pastillas anticonceptivas pueden ser inútiles con algunas medicinas anticonvulsivas y no con otras. Por eso, es preciso que las mujeres con epilepsia consulten con sus médicos para encontrar el método de contracepción más indicado para ellas.

El pueblo latino tiene problemas especiales con acceso a trato médico, por no tener seguro médico, por problemas de idioma, a veces por factores culturales. Hace poco, la Fundación de Epilepsia hizo una encuesta de la comunidad mexicana en San Diego, y encontró que muchas personas tienen información incorrecta, a veces pensando que epilepsia viene de enfermedades mentales o espirituales. Tratamiento por "naturista" o curandera no es eficaz para la epilepsia.

Muchas personas reciban su cuido médico en los dos lados de la frontera. Aunque la información tocante a los efectos de epilepsia en la mujer es más actualizada en Estados Unidos, comprar medicinas anticonvulsivas es más barato en México. Es possible cruzar la frontera con medicinas para el uso personal de la persona o un familiar, pero es más seguro traer una receta de un médico americano para comprobar que la medicina sea indicada.

Las marcas mexicanas de fenitoina (Dilantin en USA) no son confiables, pero la mayoría de la gente pueden tomar otras medicinas mexicanas sin problemas. Consulte a su médico para asegurar que comprar medicina en México sea conveniente para Ud.

El Dr Grisolía es Jefe de Neurología en el Hospital Scripps-Mercy y es un Director de la Fundación de Epilepsia de San Diego.

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