Yash D Shah MD MPH

Your child has epilepsy. You leave with a diagnosis. But what do you need to hear next? First, a quiz: with proper diagnosis and treatment, up to how many people with epilepsy could become seizure-free? A) 3 in 10 B) 5 in 10 C) 7 in 10 D) 9 in 10 Reply before the reveal. 🧵

Fire or firefly? 🔥✨ Day 6 of #EpilepsyAwarenessMonth 💜 Yesterday we went to a forest in California: small flames are the sparks on the EEG, a campfire is one seizure. Today, a summer night in Louisiana. On the porch at dusk, little lights blink between the trees. They glow like sparks. They aren't fire. They're fireflies. Many of the "seizures" I see in clinic are fireflies: episodes that look like a seizure but are not. In one children's video-EEG unit, about 1 in 5 children admitted had a look-alike, not epilepsy (19.3% of 1,173). Almost half of them had already been told they had epilepsy. Every age has its own fireflies: 👶 Infant: jerks only in sleep (benign sleep myoclonus); jerks or head nods in an awake baby with a normal EEG (benign myoclonus of infancy) 🧸 Toddler: breath-holding spells, shuddering, eyes stuck looking up (benign tonic upgaze) 🎒 Child: daydreaming, tics, night terrors 🎧 Teen: fainting, functional seizures How do you tell them apart? ✨ A firefly has a season, a trigger, and a trick that stops it: wake the baby, tap the child, lay the teen down. 🔥 A seizure picks a direction and sticks with it, and it usually leaves ash: sleepy and confused afterward. My favorite test? "Your phone video is the best test I have for the episode itself." Card 3 is a quiz: four episodes, fire or firefly? Comment your answers (1 to 4) before you get to the last post 👇 A firefly still deserves a look. If you're not sure, film it, time it, and ask your child's neurologist. If it lasts 5 minutes, follow the seizure plan and call 911. General information, not medical advice for your child. @EpilepsyFdn @AmEpilepsySoc @ChildNeuroSoc @AANmember @CureEpilepsy #Epilepsy #PediatricNeurology #ChildNeurology #EpilepsyAwareness