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Purple Day: understanding the relationship between birth injuries and epilepsy

Posted: 25/03/2019

Purple Day is held annually to raise awareness of epilepsy around the world. This is important as epilepsy is an often-misunderstood condition, which can present itself in many forms. It is diagnosed after a person has suffered from epileptic seizures, but these seizures can vary hugely in how they present themselves, and can develop because of an injury to the brain, genetic tendencies and a number of other causes. There are over 40 different types of seizures, ranging from someone going ‘blank’ for a couple of seconds, to a person dropping to the ground and convulsing.

When a child has an acquired brain injury, which may or may not be cerebral palsy, it is not unusual for this to be accompanied by epilepsy, due to the structural damage suffered to the brain. This damage can be caused in a number of different ways: a lack of oxygen in the lead up to or during delivery; an infection at birth, such as Group B Strep, which may go on to cause meningitis; meningitis on its own; or a stroke. In some cases, it is the epilepsy that can be the greater challenge for the injured person and their family, as it can prove difficult to manage.

In order to control an individual’s epileptic seizures, medication is often required in the form of anti-epileptic drugs. In other situations, a person may undergo surgery to remove the part of the brain that is causing the seizures. Alternatively, some patients may be treated with vagus nerve stimulation, which involves having a special device implanted in their chest that sends regular electrical signals to the brain through the vagus nerve in the neck.

Getting the balance of anti-epilepsy drugs right can be a significant challenge in itself, especially if the patient has a serious brain injury and their physical abilities have been affected. Some of the drugs used to keep seizures under control can have an accompanying detrimental effect on a person’s responses and alertness, undermining their abilities, which may already be limited by their brain injury.

Epilepsy can also make the general care of an individual challenging. A mobile teenager or adult who suffers from drop seizures will need to be safely lifted from the floor when such a seizure occurs, but this may well be without warning. Other individuals can present with demanding behaviour just before they have a seizure – the impact epilepsy can have on a person’s day to day life can be as varied as the condition itself.

Helen Hammond, senior associate in the clinical negligence team, who has a special interest in birth injuries, comments: “Having supported a number of families pursuing a clinical negligence claim for their child’s birth injury, I have repeatedly found the most challenging aspect of their care to be the management of their epilepsy. It is vital to understand from the outset how a child’s epilepsy affects them and to monitor any changes to this to make sure that they ultimately get the care and attention they need.”

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