Childhood Epilepsy and Neurofeedback: What Parents Should Know

Picture this. The school secretary's number lights up on your phone at ten in the morning, and your heart is in your throat before you answer. Your daughter has had another seizure, in class this time. She is fine now, sleepy and embarrassed, and you drive to fetch her wondering whether there is anything more you could be doing.

Medical care comes first, always

Before anything else, the most important point in this article: epilepsy is a medical condition, and your child's neurologist or paediatrician leads their care. Anti-seizure medication is the proven foundation of treatment and controls seizures well for many children.

Neurofeedback is only ever an addition to that care. It is not an alternative to it. Never reduce, skip, change or stop seizure medication without your child's neurologist, even if things seem to be going well. Stopping medication suddenly can be dangerous.

Please also see a doctor before considering any brain training if your child has had a first seizure, if seizures are changing or becoming more frequent, or if there is no clear diagnosis yet. Call emergency services if a seizure does not stop within a few minutes, if one follows another without recovery in between, or if your child is injured or struggling to breathe. Ask your neurologist for a written seizure plan so that you know exactly when to call.

What is a seizure threshold?

Brain cells communicate through small electrical signals, and they normally fire in an organised way. A seizure happens when a large group of cells suddenly fires together in an uncontrolled burst. What it looks like depends on where in the brain this happens: a blank stare, a jerking limb or a full convulsion.

Every brain has a seizure threshold, the point at which that burst can take hold. Picture a river wall. In some brains the wall is high and almost nothing spills over. In epilepsy the wall is lower, so things like poor sleep, illness, fever, stress or flashing lights can tip the water over. Anti-seizure medication is there to help raise the wall.

The goal is never to manage epilepsy without the neurologist. Anything else is, at most, an addition to that care.

What neurofeedback is

Neurofeedback is a form of brain training. Sensors on the scalp read the brain's activity. They only listen, and nothing is sent into the brain. When the brain produces a little more of a chosen pattern, a video or sound responds, and the idea is that the brain gradually learns from that feedback. Our article on how the brain learns through neurofeedback covers the learning process itself.

One pattern used in training is the sensorimotor rhythm, or SMR. It is a steady rhythm linked to a still body and a calmly alert mind.

What can honestly be said about epilepsy

SMR neurofeedback has been studied for epilepsy. It is not a standard medical treatment for epilepsy, results vary from person to person, and nobody can promise fewer seizures. Any such training belongs under the guidance of your child's neurologist, as an addition to the treatment they prescribe.

Children with epilepsy can also struggle with sleep, attention and anxiety. Neurofeedback has been studied for attention difficulties, insomnia and anxiety, with mixed-to-encouraging results. These are areas where families may hope training could offer support:

• More settled sleep.
• Better concentration at school.
• Less worry and a calmer mood.
• More confidence after a frightening run of seizures.

None of these is guaranteed. Sleep is discussed further in our article on rebuilding healthy sleep.

Talk to your neurologist first

Speak to your child's neurologist before starting any neurofeedback, and never change medication without them. Useful questions to take to that appointment include:

• Is neurofeedback a sensible addition for my child's type of seizures?
• Are there triggers, such as tiredness or screens, that we should plan around?
• What should happen if my child has a seizure during a session?
• How will we judge whether anything is changing, and when should we come back to you?

If the neurologist is comfortable with the idea, tell whoever provides the training about your child's seizure type, triggers and medication, and what to do if a seizure happens. Keeping a seizure diary is helpful, and it is worth taking to every neurology appointment.

Everyday steadiness at home

Whatever you decide about brain training, ordinary routines matter. Common-sense steps include a regular bedtime, giving medication at the times the doctor prescribed, and making sure the school has a copy of your child's seizure plan. A simple diary of dates, times, what happened and what was going on beforehand gives the neurologist far more to work with than memory alone. Look after yourself too. A parent who has slept and eaten copes better with the next phone call from school.

What to expect at the practice

At Fix Your Brain, every client begins with a 19-channel brain map, which takes about an hour and a half. It is not a diagnostic test for epilepsy, and it does not replace the tests your neurologist orders. Training sessions are 45 to 60 minutes and begin with a short check-in on how your child is feeling. Our what to expect page describes the process.

Common questions

Can neurofeedback replace my child's seizure medication?

No. Neurofeedback is only ever an addition to a neurologist's care, never a replacement for it. Seizure medication must not be reduced, changed or stopped without the neurologist, because doing so can be dangerous. If training seems to be helping, share that with your child's doctor and let them decide whether anything about the treatment should change.

Is neurofeedback safe for a child with epilepsy?

The sensors only read brain activity, and nothing is sent into the brain, so the method is non-invasive. SMR neurofeedback has been studied for epilepsy, but that does not make it right for every child. Speak to your child's neurologist before starting any neurofeedback, and tell them about any change you notice in sleep, mood or seizure patterns.

Will neurofeedback stop my child's seizures?

Nobody can promise that. SMR neurofeedback has been studied for epilepsy, but it is not a standard medical treatment, results vary, and some children may see no change. Any such training belongs under your neurologist's guidance, and your child's medical team should be the ones to judge whether anything is changing.

Living with a child's epilepsy means carrying a constant, quiet watchfulness. If you would like to discuss whether neurofeedback could be a sensible addition to your child's medical care, please contact us, and bring your neurologist's advice with you.