Hi Pamela,
        My 8 year old daughter has epilepsy, and also has seizures only after
falling asleep.  She has visual hallucinations all the time, and they
intensify in the dark, because her seizure focus is in the occipital
lobe.  She also has always been a terrible sleeper.  She was finally
diagnosed at age 6 when she had her first convulsive seizure.  I was
grateful that we comforted her when she crawled into our bed scared in
the middle of the night (several times, every night), and that we
believed her when she said she saw spots and some of them looked like
monsters (though we tried to think up rational explanations to calm
her).  Anyway, she has a very mild case of epilepsy, which I attribute
to her having been breastfed to self-weaning.  The neuro's at the ER
thought her first seizure must have been hypoglycemia or something,
since they thought she was "too healthy and bright" to have epilepsy.
(No offence to other healthy, bright people with e, that was their
ignorance.)  So, I would certainly recommend that this mom continue
breastfeeding, for both the comfort and the brain development.
        About epilepsy (e) and myclonic seizures (sz):
There are two major kinds of epilepsy: idiopathic or genetic, and
symptomatic.  Symptomatic e is an increased tendency to have sz after a
brain lesion, either an injury or tumor.  A Cat scan and an MRI, if they
are available to this family, would usually show a brain lesion.
Sometimes the person with symptomatic epilepsy stops having seizures as
the injury heals, but often they have it for life.  Idiopathic epilepsy
is an increased susceptibility to seizures based on one of many genes,
some of which have just been isolated and sequenced.  Depending on the
particular syndrome (area of abnormal brain activity and symptoms),
there is a chance that the child will grow out of seizures.  There are
many many different epilepsy syndromes, and each has it's own
prognosis.  It is also possible that this child has a gene that lowers
her sz threshhold, and that the head injury was the final straw that
provoked the seizures.
        Myoclonic sz are caused by rapid, involuntary jerks of muscle groups,
like myoclonic jerks only much more severe.  Unfortunately, they can be
difficult to control.  It is fortunate that this child only has them in
her sleep, people with myoclonic sz can get injured if they are holding
a hot beverage and a sz causes them to spill it on themselves, for
example.  Some myoclonic sz are so strong that the child is pulled
upright into a sitting position in bed; they can also be pulled
backward.  One e internet friend has repeatedly dislocated his shoulder
this way.
        It is important that parents DO NOT take children off epilepsy
medications without consulting the doctor first.  Some people can get
very dangerous, nonstop seizures from the withdrawal of the medication,
called status epilepticus.  Status can be life-threatening.  One
medication that is often offered to young children is phenobarbital, and
it often makes them zombies or agitates them.  There are many other
anticonvulsants, the parents should talk to the doctor about changing
the medication if they are unhappy with the side effects, or seek a
second opinion.  Personally, I delayed treating my daughter for a year
and a half, but with the knowlege and co-operation of her doctor. This
is a decision that needs to be made on an individual basis and with
knowlege of the potential consequences.  There is a theory from animal
studies of induced epilepsy (from repeated electrical stimulation of the
brain) that sz induce more abnormal electrical activity which provokes
more sz.  Docs who believe that this "kindling" theory applies to humans
believe that keeping a child sz free with medication helps the brain to
calm the abnormal activity, thereby helping the child "outgrow" sz.
After 2-5 years, the medication is slowly withdrawn.  Some docs, like my
daughter's, don't believe this applies to spontaneous e in humans, and
are agreeable to wait to treat until there is clear need.
        Support:
        If this mom has internet access, there are many good sources for
information and support.  There is an epilepsy mailing list, like
Lactnet; there is a newsgroup called alt.support.epilepsy that anyone
can access with a newsreader program; there are many web sites,
including one devoted to epilepsy in young children.  Some nations have
a national organization to help people affected by e, in the US it is
called the Epilepsy Foundation of America (EFA, soon to be called simply
Epilepsy Foundation).  Their URL is http://www.efa.org/index1.htm
Epilepsy International may have a group in Zimbabwe, their URL is
http://epilepsy-international.com/english/main.html
The Epilepsy in young children page is at
http://www.geocities.com/HotSprings/1000/
Another good contact for parents it the Epilepsy COntact Database at
http://www.datasync.com/~josw/epilepsy.htm
Children's hospitals, if any exist in your area, also sometimes run
support groups for parents of children with e.  I hope you'll find as I
did that the e support network is as rich as the breastfeeding one.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]