Epilepsy and behaviour

There are thought to be several reasons why behavioural problems are more common in children with epilepsy. Some of the causes could be:

A child may be fearful, stressed and anxious about having seizures.
It may be that the child is not achieving at school.
Frustration if a child has learning or language difficulties.
The area of the brain that controls emotions and behaviour may be abnormal and not function as it should.
There may be abnormal epileptic activity going on which inhibits normal brain function resulting in verbal and physical aggression.
Some antiepileptic drugs may alter the chemical balance in the brain that regulates behaviour.
Sometimes there may be changes in behaviour, personality and mood for minutes or days before seizures.

Whatever the cause, it is very important that every attempt is made to curb difficult or aggressive behaviour. Just because a child has epilepsy, it should not stop you disciplining them in the same way you would if they did not have it.

Physical aggression or violence that is manageable when a child is small, will be harder when they are a fully grown adolescent.

If a child starts to exhibit behavioural problems, let the epilepsy team know as soon as possible and keep a diary of events to help determine the cause. If the medication is thought to be affecting behaviour, the child’s neurologist will decide whether a reduction in the dose or a change of medication is needed.

Coping with behavioural problems

Try to find out if there are any recognisable triggers to the child’s behaviour so that you can remove them and defuse difficult behaviour early. Other strategies include:

Most children like to have a routine, try to keep some structure to the day.
Give plenty of warning before moving from one activity to another (if the child is very young, use visual clues to demonstrate what is going to happen next).
Decide which behaviour you are going to tackle and concentrate on achieving the goals you set.
Try to be consistent when dealing with difficult behaviours.
Use their name at the beginning of the sentence to attract attention and make sure you have their full attention before you attempt to give any information or instructions. Maintain eye contact throughout.
Give the information or instruction in a clear, calm and positive manner.
If the child has memory problems make sure you give only one or two staged commands at a time. Break down any instruction or task into small stages.
Remember to reward them for having achieved or attempted what was asked of them. If the child is older and can understand the concept, a written chart between you and the child makes clear the expectations which, if achieved, can be rewarded by a token system.
If you see that they are becoming angry, try to calm the situation by distracting them, encouraging them to take deep breaths or if possible by counting to 10.
For bad or aggressive behaviour consider using ‘time out’ in a corner of a room, their bedroom or on a stair. When using ‘time out’, explain why they have been put there and how long they will have to stay.
Talk to the child’s doctor and ask if you think that the child might benefit from counselling.

It is important to note if any strategies help with dealing with the challenging behaviour. If any are helping, make a note of them and ask teachers and any other adults caring for the child to use them.

Information for schools

If your child is experiencing problems at school, we have produced a range of resources to educate both staff and pupils and increase epilepsy awareness.

Further information

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