Managing Your Child’s Epilepsy In Hong Kong: Pediatric Neurologists & Where To Get Support

What Is Epilepsy?

Epilepsy is the fourth most common neurological condition worldwide. This disorder causes recurring seizures triggered by sudden, excessive electrical activity in the brain. If you or a loved one has received an epilepsy diagnosis, this guide can help you understand the basics and take positive steps forward.

What is Epilepsy?
Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures. A doctor may diagnose someone with epilepsy if they have experienced two or more unprovoked seizures, or one unprovoked seizure with a high risk of more to come. It's important to note that not all seizures are caused by epilepsy - they can also result from brain injuries, genetic factors, or unknown origins. The term "epilepsy" simply refers to seizure disorders, without specifying the underlying cause or seizure severity.

Information gathered from The Epilepsy Foundation.

How Is Epilepsy Diagnosed?

Recognizing a seizure and identifying the specific type or epilepsy syndrome can be challenging. Even if it's unclear whether a seizure has occurred, it's important to see a doctor if you or others suspect periods of unresponsiveness or unusual behavior in your child.

Your doctor will work to determine if a seizure has taken place and identify any underlying causes. If another medical condition, such as diabetes, is the root cause of the seizure, you'll need treatment for that condition. If your doctor suspects epilepsy, they'll likely order various tests and prescribe medication to prevent future seizures.

Gather Your Medical History
When you visit your primary care physician or neurologist, they'll ask detailed questions about your child's health and the events leading up to, during, and after the suspected seizure. Although it's counter-intuitive, and after you've ascertained that your child is safe and lying in a safe position, get your phone out and start filming. Showing your doctor a video of the seizure can greatly help.

Undergo a Neurological Exam
If your doctor believes your child may have experienced seizures, they'll likely refer you to a neurologist - a specialist in the brain and nervous system. The neurologist will conduct a comprehensive neurological examination to assess the functioning of their brain and other neural pathways.

Get an EEG
An electroencephalogram (EEG) is a painless, safe test that looks for abnormal electrical patterns in the brain associated with seizures. However, these patterns can occur with many conditions, not just epilepsy.

Receive Brain Imaging
Brain scans like CT, CAT, or MRI can detect structural changes in the brain that may contribute to seizures, such as a tumor or bleeding. These imaging tests can also reveal developmental differences that could lead to epilepsy.

Build Your Care Team
If you receive an epilepsy diagnosis, assembling the right healthcare team is crucial. You may work with epilepsy specialists, psychiatrists, psychologists, and other providers depending on your treatment plan.

Information gathered from The Epilepsy Foundation.

Treatments For Epilepsy

At this moment, and unfortunately, there is no cure for epilepsy. However, the symptoms or seizures can somewhat be managed with the appropriate treatment.

Medication

Medication is the primary treatment for most people living with epilepsy. There are many different anti-seizure drugs available, and finding the right medication or combination of medications can successfully control seizures for around 70% of individuals with the condition. Any medication does come with side effects, and it's important that you understand these prior to starting your child's course of treatment. In some cases, it might take time and some trial and error to identify the most effective anti-seizure medication for your child, so it is important to be patient in this case. Most doctors will want to achieve a 0 seizure standard.

Dietary Therapies for Epilepsy

In addition to medication, certain specialized diets can also be an effective way to help manage seizures for some individuals with epilepsy. The most common dietary approaches include:

• Ketogenic Diet: The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate eating plan that puts the body into a metabolic state called ketosis. This shift in metabolism has been shown to have anti-seizure effects for some people with epilepsy.
• Modified Atkins Diet: Similar to the ketogenic diet, the modified Atkins diet also focuses on high-fat, low-carb foods to induce ketosis and reduce seizure activity.
• Low-Glycemic Diet: This diet emphasizes foods that have a low glycemic index, meaning they don't cause rapid spikes in blood sugar levels. Maintaining stable blood sugar can be beneficial for seizure control.
• Medium-Chain Triglyceride (MCT) Diet: The MCT diet involves consuming a type of fat that is more easily converted into ketones than long-chain triglycerides. This can mimic the metabolic effects of the ketogenic diet.

Information gathered from The Epilepsy Foundation.

Practical Tips for Families Managing Childhood Epilepsy

Now that you've established a treatment plan with your child's healthcare team, it's important to prepare for various scenarios and equip yourself with the knowledge and resources to manage their epilepsy effectively. Here are some valuable insights and advice from parents who have been through this journey:

Keep a Seizure Diary
Maintain a log of your child's seizures, recording details like the date, time, location, what was happening before the onset, and the duration of the episode. This information can be invaluable for their doctors in monitoring the condition and adjusting the treatment plan as needed.

During a Seizure
Remain calm. Gently lay your child on their side in a safe, comfortable position, ensuring there is nothing that could obstruct their breathing. Use your phone to record the seizure, as this footage may help provide useful diagnostic clues.

Establish a Daily Routine
Consistency and structure can be very helpful for children with epilepsy. Maintain a predictable daily routine for meals, sleep, medication, and activities to provide a sense of stability.

Advocate for Your Child
Be an active voice in your child's care. Attend all medical appointments, ask questions (and keep a note of questions you may have along the way and beforehand), and work closely with the healthcare team to ensure their needs are being met. Pertinent questions to ask are: Should you call an ambulance when a seizure occurs? Should you carry or have some rescue medication (diazepam) at home if and when a seizure occurs?

Get First Aid Training
Consider enrolling in a first aid course, either on your own or with your child's caregiver. Being prepared with the proper skills to manage seizures can give you the confidence to respond effectively.

Create an Emergency Plan
Compile a printed document with your contact information, your child's doctor's number, and the steps to take during a seizure. Keep this readily available for any caregivers or school personnel who may need to reference it. Keep rescue medication accessible and make sure caregivers know how to administer it.

Communicate with Your Child's School
Inform the school about your child's epilepsy, their medication, and the protocol to follow if a seizure occurs on campus. Work collaboratively to ensure a safe, supportive environment for your child.

Monitor High-Risk Activities
Once seizures are well-controlled, your child can typically participate in most activities. However, for high-risk situations like swimming, ensure there is always a capable adult present to provide supervision.

Prioritize Your Mental Health
Caring for a child with epilepsy can be emotionally challenging. Don't hesitate to seek support from mental health professionals to help you navigate the anxieties and uncertainties.

Knowledge is Power
Familiarize yourself with reliable resources like the Epilepsy Foundation website to deepen your understanding of the condition and feel empowered to make informed decisions about your child's care.

Encourage Independence
As your child grows, empower them to take an active role in managing their own condition. Teach them about their medication, seizure triggers, and self-care strategies.

Foster Healthy Habits
Promote good sleep, balanced nutrition, and regular exercise to help your child's overall health and potentially reduce seizure frequency.

By being proactive, prepared, and surrounded by a supportive network, you can help your child with epilepsy thrive and live a full, enriching life.

Pediatric Neurologists In Hong Kong

Dr Ada Yung (Yung Wing Yan)

Dr. Ada Yung is widely regarded as the preeminent authority in pediatric neurology within Hong Kong, having served on numerous epilepsy-focused boards and committees that showcase her extensive expertise in the field; though her direct approach may at times seem stern, those familiar with Dr. Yung recognize that her tough demeanor is rooted in an unwavering dedication to providing the best possible care for her young patients. Remember to bring cash as they don't accept cards.

Dr Ada Yung, Room 1707, 17/F, Hong Kong Pacific Center, 28 Hankow Road, Tsim Sha Tsui, Kowloon, +852 2369 8833

Dr Theresa Wong (Yee Ling)

Dr Theresa Wong provides neurological pediatric consultations from her clinic in Central. She gained her medical qualifications from the UK and is also affiliated with a number of hospitals like Canossa, Sanatorium, Matilda and Adventist - useful in case of emergencies.

Dr. Theresa Wong, Room 901, Manning House, 48 Queen's Road Central, Hong Kong, +852 2525 5755

Dr Tim Liu

Dr. Liu, an honorary consultant in pediatric neurology at Gleneagles Hospital on Thursdays who also maintains his private practice in Central, received his medical qualifications from universities in Ireland and currently serves as an Honorary Clinical Associate Professor in Paediatrics and Adolescent Medicine at the University of Hong Kong.

Dr. Tim Liu, Room 2909A, 29/F, Bank of America Tower, 12 Harcourt Road, Central, Hong Kong, +852 2243 0000, childassessment@gmail.com, https://www.hkdpc.com/