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EPILEPSY IN CHILDREN
PRESENTED BY
Dr.MEERA PRAMIL
DEPARTMENT OF KAUMARABHRITYA

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 CONTENTS
INTRODUCTION APASMARAM

EPIDEMIOLOGY NIDANA

AETIOLOGY SAMPRAPTI
CATEGORIES OF SAMANYA LAKSHANA
EPILEPTIC SEIZURES
SYMPTOMS OF A PURVARUPA
SEIZURE IN A CHILD
DIAGNOSIS LINE OF TREATMENT

TREATMENTS ASADHYA LAKSHANA

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 INTRODUCTION

NOVEMBER is National Epilepsy Awareness Month.

MARCH 26 is Epilepsy Awareness Day or Purple Day.

• Children under 2 & Adults over 65years are likely to develop

epilepsy

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 EPIDEMIOLOGY

• SEIZURES are common in the pediatric age

group (10%).
• <1\3rd of seizures in children are caused by epilepsy.
• The incidence of childhood epilepsy - 1% to 2%.

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.
AETIOLOGY

IDIOPATHIC

GENETICS

ACQUIRED

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CATEGORIES OF EPILEPTIC SEIZURES
• FOCAL(Partial) SEIZURE :
SIMPLE FOCAL SEIZURE
COMPLEX FOCAL SEIZURE

• GENERALIZED SEIZURE:
ABSENCE SEIZURE
ATONIC SEIZURE
GENERALIZED TONIC-CLONIC
MYOCLONIC SEIZURE
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 FOCAL SEIZURE
• Abnormal electrical brain function  1 or more areas of one
side of the brain
SIMPLE FOCAL SEIZURE COMPLEX FOCAL SEIZURE
Occipital lobe Temporal lobe

Sight may be altered,more often Stops being aware of what's going

muscles are affected on around

Sweating/nausea/pale Tired/sleepy

Consciousness maintained Loss of consciousness

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 GENERALIZED SEIZURE

ABSENCE SEIZURE ATONIC SEIZURE

Petit mal seizure
< 30 seconds
A brief changed state of
consciousness & staring
Mouth/face may twitch/eyes may
blink rapidly
Drop attack
<15seconds
Sudden loss of muscle tone may
fall from a standing position
Sudden drop of head

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GENERALISED TONIC-CLONIC MYOCLONIC SEIZURE
SEIZURE
Grand mal seizure Quick movements

Problems with vision /speech Sudden jerking of a group of

muscles
Sleepy Occur in clusters

Loss of consciousness Consciousness likely preserved

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 SYMPTOMS OF A SEIZURE IN A CHILD
.

Breathing Loss of Bowel

problems control
Periods of rapid Falling suddenly for
Eye Blinking & no apparent reason
Staring
Body stiffening Not responding
Loss of Bladder Nodding head
control rhythmically

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 HOW ARE SEIZURES DIAGNOSED IN A CHILD?
1)DETAILED MEDICAL HISTORY
2)DETAILED ACCOUNTS OF THE SEIZURE
3)PHYSICAL EXAM
4)BLOOD TESTS
5)COMPUTERIZED AXIAL TOMOGRAPHY(CAT OR CT SCAN)
6)ELECTROENCEPHALOGRAM
7)MAGNETIC RESONANCE IMAGE(MRI)
8)LUMBAR PUNCTURE(SPINAL TAP)
9)OBSERVATIONS
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What is childhood epilepsy syndrome?

Epilepsy has some specific signs & symptoms includes:

• Seizure type
• Age
• EEG pattern
• Brain scan pattern

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IDENTIFYING EPILEPSY SYMPTOMS
In babies signs can be very subtle
• A change in breathing.
• A facial expression that is unusual such as a
movement of eyelids / mouth.
• Muscle movements such as jerks, episode of stiffness,
cycling of the legs.
• Loss of alertness / difficulty focusing the eyes.

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 PREVENTION

• Reduce risk of :
Traumatic brain injury
Stroke and heart disease
• Keep vaccinations up to date
• Practice good hand washing and food safety habits to avoid
an infection called cysticercosis
• Prenatal care

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HOW ARE SEIZURES TREATED IN A
CHILD?

• The goal of treatment control/stop/reduce seizure

occurrence
• Medicines type of seizure , age , side effects , cost
& ease of use.
• Route of administration Mouth,Nose,Rectum,IV

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While child is on medication he/she may need
tests to see how well the medicine is working.
.

BLOOD TEST
URINE TEST
EEG

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 OTHER TREATMENTS:
Ketogenic Diet

Vagus Nerve Stimulation(VNS)

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 SURGERY
• To remove the part of the brain where the seizures are
occuring.
• Stops the spread of bad electrical currents through the
brain.

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 STATUS EPILEPTICUS
TYPES:
• CONVULSIVE STATUS EPILEPTICUS
• NONCONVULSIVE STATUS EPILEPTICUS
CAUSES SYMPTOMS
Withdrawal from Muscle spasm
Medicines Confusion
Low blood sugar Clenched teeth
Stroke Trouble speaking

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 FEBRILE SEIZURES
• Seizure associated with fever and is not epilepsy.
• Common in children between:
6months to 5 years + family history
• <15 minutes SIMPLE (No long term neurological
effects)
• >15 minutes COMPLEX ( May cause long term
neurological changes )

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 DO’s in Febrile Seizure
•Gently place child on the floor
& remove nearby objects
•Place child on his/her side to
prevent choking
•Loosen clothing around head
and neck
•Watch for signs of breathing
problems
•Keep a track on how long the
seizure lasts
DONT’s in Febrile Seizure
•Don’t try to hold or restrain
child.
•Don’t put anything in child’s
mouth.
•Don’t try to give fever reducing
medicine.
•Don’t try to put child into
cool/lukewarm water to cool off.
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HELP A CHILD TO LIVE WITH EPILEPSY

• Make sure child understands the type of seizure and

the medicine needed.
• Know the dose, time & side effects
of all medicines.
• Talk with Doctor before giving other
medicines to child.
• Avoid Triggers
• Regular checkup

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APASMARAM

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NIDANA

(Carakasamhita-chikitsasthana 10/3,4)

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 SAMPRAPTI
Persons whose mind is afflicted
by
raja-tamo dosa

NIDANA

DOSA VITIATION STHANASAMSRAYA IN HRDAYA

HRDAYA PIDANA
AFFLICTING INDRIYA AYATANA
When patient is seized by
kama,krodha,bhaya,lobha,
irsya (doshapurana) APASMARA
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.
PITTAJA

APASMARA
VATAJA KAPHAJA

SANNIPATAJA 28
 PURVARUPA

BRYUDASA ANANNABILASA KUKSHERATOPA MOHA

SATATAM AROCHAKA DOURBALYAM TAMASO

AKSHANA DARSANA
VAIKRTHAM
ASABDHA AVIPAKA ASTHIBEDHA MURCHA
SRAVANAM
LALASINGANA HRDAYAGRAHA ANGAMARDA BHRAMA
PRASRAVANAM

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 SAMANYA LAKSHANA

(Carakasamhita-chikitsasthana 10/3,4)

अकस्मा‍दट्टहसनमपस्मा‍राय ‌क‌‍ल्‍पते ।
(K.S.Su25/20)

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 CHARACTERISTIC FEATURES
VATAJA PITTAJA KAPHAJA
Losing & regaining Losing & regaining Delay in losing & regaining
consciousness consciousness instantaneously consciousness
instantaneously
Vision of Vision of bleeding, angry Vision of white ,heavy,
unstable,coarse,dry looking,terrifying,frightful & unctuous objects
objects burning objects
Grinding of teeth Suffers from morbid thirst Dribbling of saliva

Trembling Green/Yellow White face,skin,eyes,nails

face,skin,eyes,nails
Vomiting of frothy Yellowish froth Whitish froth
matter
Incoherent speech Suffers from morbid heat Feeling of cold & heaviness
Projection of eyeball Sees fire all over Falling down

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 LINE OF TREATMENT

VATIKA APASMARA VASTI

PAITIKA APSMARA VIRECHANA

KAPHAJA APASMARA VAMANA

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 INTERNAL MEDICINES

Dhanadanayanadi Kashayam
Panchagavya Ghrita Aswagandharishtam
Mahapanchagavya Ghrita
Mrtasanjeevani Gulika
Brahmi Ghrita
Kalyanakam Ghrita Manasamithram Gulika
Jeevaniya Yamaka
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 EXTERNAL MEDICINES

Vranabhairava Taila

Lakshadi Taila

Himasagara Taila

Chandanadi Taila

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EXTERNAL THERAPIES

Nasya
Vasti
Shirodhara
Talam
Dhupana

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 RASAYANA
• If Chronic & Incurable
• Arised from aggravation of dosa of mind & body
together
• Taila + lasuna + satavari + milk + fresh juice of kushta
or vaca consumed daily(A.H.U.7/33-34)
• Kushmanda Rasayana
• Chyavanprasham

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Yoga and Pranayama

Vrikshasana
Shavasana
Tadasana
Meditation
Anuloma-Viloma
Bhramari

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ASADHYA IN:

SANNIPATAJA

Durbala

Chronic

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 AYURVEDIC MANAGEMENT OF BALAPASMARA
W.S.R. TO EPILEPSY IN CHILDREN ALONG WITH
ANTI-EPILEPTIC DRUG
• CASE STUDY : A 9 year old boy with complaints of seizure
episodes associated with rolling up of eyeballs and slanting of
neck towards right side since 3 years. He also had complaints
of frothing, involuntary passage of urine/stool during seizures.
He also had headache, drowsiness, weakness after a seizure
episode.
• AYURVEDIC MANAGEMENT OF BALAPASMARA W.S.R. TO EPILEPSY IN CHILDREN ALONG WITH ANTI-
EPILEPTIC DRUG: A CASE STUDY,Vd. Kiran Prakash Nandeshwar, Vd. Prashant Laxmanrao Patil and Vd.
Minakshi Chandrakant Choudhari,EUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL
RESEARCH www.ejpmr.com, 2017,4(12), 354-357

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• Investigations - EEG showing abnormal epileptiform activity
over occipital and temporal lobes.
• Ayurvedic View - Vatapitha Doshadushti
• Diagnosis - The case was diagnosed as Generalized Seizure.
Ayurvedic diagnosis is Vatapitha Apasmara
• Assessment Criteria - Subjective For assessment the result four
symptoms will be kept as parameter.

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Treatment Plan

• (Deepana-Pachana) Chitrakadi vati -- 3 days

• Hingvashtaka Churna -- 3 days
• Kala vasti -15 days:
Anuvasana vasti – maha chaitas ghrita
Niruha vasti – dasamoola kwatha
• Sarvanga Snehana by tila taila
• Sarvanga Swedana
• Nasya

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MEDICINES USED

Mahachaitas ghrita

Chitrakadi vati

Hinguvashtaka choornam

Dasamoolakwatha

Tila tailam

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 DISCUSSION

• The most effective treatment protocol;

Daiva vyapasraya chikitsa
Sattvavajaya chikitsa
Yukti vyapasraya
• Stigma and discrimination against epileptic people

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 CONCLUSION

• Around 50 million people worldwide have epilepsy.

• If properly diagnosed and treated up to 70% of people

living with epilepsy could live seizure – free life.

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 REFERENCES

1. Dr.S.R.Sudarshan,Diet & Regimen In Various

Diseases,Epilepsy,Daivajna K N Somayaji,Svastha-
Vrta Positive Health In Ayurveda,1st Edition,Kalpatharu
Research Academy Bangalore,2001.
2. Dr.Ram Karan Sharma,Vaidya Bhawan
Dash ,Diagnosis Of Epilepsy,Caraka Samhita , Vol
II,Chowkhamba Sanskrit Series Office Varanasi ,2008.
3. Kliegman,Behrman,Jenson,Stanton,Seizures In
Childhood,Nelson Textbook Of Pediatrics,Vol II
Elsevier India Private Limited,New Delhi,2008.
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4. Dr.Parvathi Sethumadhavan,Manovaha
Srotas,Apasmaram,1st Edition,Vasudevi
Publications,Vasudevi Nilayam,Thrissur,2017.
5. Dr.Anil K Mehta,Dr.Raghunandan Sharma,The Role Of
Ayurvedic Physiotherapy On Nervous
System,Ayurvedic Physiotherapy & Yoga,1st
Edition,Chaukhamba Sanskrit Pratishthan,38
U.A.BungalowRoad,Delhi,2010.
6. Prof.K.R.Srikantha Murthy,Apasmara
Pratisedha,Vagbhata’s Astanga Hrdayam,Vol III,
Chowkhamba Krishnadas Academy,Varanasi,2006.
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 PRECAUTION

• The patient suffering from Apasmara , should be

specially protected from water , fire , trees, mountains
and uneven places. As these may cause instantaneous
death of the patient.

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 CHILDHOOD EPILEPSY SYNDROME
SYNDROME :
Group of signs & symptoms happen together, helps
identifying a unique medical condition

What is childhood epilepsy syndrome?

Epilepsy has some specific signs & symptoms includes:
• Seizure type
• Age
• EEG pattern
• Brain scan pattern
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Syndrome can vary greatly
• Benign
• Severe

Childhood epilepsy syndrome

BENIGN ROLANDIC EPILEPSY
CHILDHOOD ABSENCE EPILEPSY
JUVENILE MYOCLONIC EPILEPSY
INFANTILE SPASM / WEST SYNDROME
LENNOX – GASTAUT SYNDROME
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 BRE JME
• Affects 15% •12 – 18 years CAE
• 3 to 10 years •40%-flashing light
• Seizure free – 16years •Medications
•Affects 12%
• Simple focal seizure •4 to 6 years
•Frequent
•Seizure free
WEST SYNDROME LGS 2years
•First year
•3 to 5 years
•Effects
•Difficult to treat
•Spasm in cluster
•Adult life
•25%
•LGS

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CASE STUDY
• Initiation with Deepana-Pachana with Aampachak vati & Hingvashtaka
Churna for 3 days.
• After that started Kalavasti i.e. 15 days. Sarvang Snehana by Tila-Taila
and Sarvaga Swedana, I st Anuvasana basti by Mahachaitas ghrita then
alternate 11 Niruha Basti by Dashamoola kwatha and Anuvasana Basti,
last 3 Anuvasana basti.
• Simultaneously Pratimarsha Nasya with Mahachaitas Ghrita 2 drops
• After then internal medicines Mahachaitas Ghrita orally and Tab. Eptoin
(Sodium Valproate) 200mg 1 BD after meal for 15 days.
• 3 Months these treatment done 3 times with 15 days follow up.
• With above mentioned line of treatment patient got partial relief from the
symptoms of Epilepsy and improved his quality of life.

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• Deepana-Pachana control the formation of ama in the initial
stage, which is very important in preventing the manifestation of
the disease. Acharya Charaka has mentioned shodhana as a
line of treatment so in this case study Kalabasti and
Pratimarsha Nasya Chikitsa has been chosen and they showed
good results along with Mahachaitas Ghrita.

• Mahachaitas Ghrita is indicated in treatment of Apasmara by

Bhaishajyaratnavali,due to it's property in bringing all the
doshas to normalcy.

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• Aampachana Vati act to digest (waste food material) and
prevent adhesion of the channels. Nose is the entrance of the
head so Nasya directly effects on brain. It helps to remove
vitiated Dosha from head.
• Mahachaitas Ghrita contents are mostly Jeevaniya Dravyas
which plays Rasayana effect on body. It also contain
Dashamoola which is Tridoshghna and shodhana properties.
Mahachaitas Ghrita also effective for congnitive development of
patient.

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