This information is for people affected by or concerned about self-limited epilepsy with autonomic seizures (SeLEAS), including parents and carers. On this page we talk about how SeLEAS is diagnosed, what causes it, symptoms, treatment options and long-term outlook.
Use this page as a general guide and speak to a health professional for more information and support.
On this page:
What is self-limited epilepsy with autonomic seizures?
Self-limited epilepsy with autonomic seizures (SeLEAS) usually starts in early childhood, between the ages of three and six years. It used to be known as Panayiotopoulos syndrome.
It’s called ‘self-limited’ because nearly all children will stop having seizures within one or two years of age.
What causes self-limited epilepsy with autonomic seizures?
What causes SeLEAS is not known. Children with SeLEAS do not usually have a family history of epilepsy and there is not usually any history of problems during birth or developmental delays. More research is needed to understand why SeLEAS occurs.
What are the signs and symptoms of self-limited epilepsy with autonomic seizures?
Children with SeLEAS get focal seizures, which affect one side of the brain. The main seizure type in this syndrome is known as an autonomic seizure.
Symptoms of an autonomic seizure include:
- feeling (nausea) or being sick (vomiting)
- becoming very pale, or sometimes looking flushed
- very large (dilated) pupils
- changes in heart rate, breathing rate and temperature
- sweating lots and drooling
- losing control of their bladder or bowels and accidentally going to the toilet (incontinence)
- producing tears without crying.
When children with SeLEAS first start to have a seizure, they may become restless, frightened or unusually quiet. They may be aware of what’s happening at first, but then may become confused and unresponsive during the seizure.
During a seizure, the child may move their eyes and turn their head to one side. The seizure may end with jerking movements down one or both sides of the body.
Seizures commonly start during sleep and may last for 30 minutes or more.
How is self-limited epilepsy with autonomic seizures diagnosed?
If you think a child has epilepsy, including epilepsy with SeLEAS, contact their doctor. You may be referred to a paediatrician (a doctor who specialises in child health).
A diagnosis of SeLEAS is usually based on a description of the child’s typical seizure pattern and an EEG (electroencephalogram) test – a painless test that uses small sensors attached to the scalp to pick up the electrical signals produced by the brain. An EEG test will show spikes, mainly in the occipital lobe of the brain (the part involved in processing visual information).
The specialist doctor will talk to you about any other tests your child may need.
Treatment for self-limited epilepsy with autonomic seizures
SeLEAS seizures do not happen very often and most children do not have them for long. For these reasons, many children with SeLEAS will not need anti-seizure medication.
However, anti-seizure medication may be prescribed if your child is having a lot of seizures, particularly if they are interfering with their learning and development at school.
Your child’s doctor may prescribe sodium valproate (also known as Epilim). Sodium valproate is medicine that comes as capsules, tablets or a liquid that you swallow. It also comes as granules that you mix with food or drink. It can also be given by injection, but this is usually only done in hospital or in emergencies.
However, sodium valproate may not suitable for everyone. Sodium valproate may affect fertility (the ability to get pregnant naturally).
For women who can have children, and young girls who are likely to need treatment when they’re old enough to have children, a doctor should consider the following things before prescribing sodium valproate:
- The benefits and risks of sodium valproate, including any risks to an unborn child.
- The likelihood of pregnancy and if appropriate, a pregnancy prevention programme should be put in place.
Read more about the process for prescribing sodium valproate and how it can affect fertility.
They may also suggest a rescue or emergency care plan if your child is having prolonged or repeated seizures. Find out more about emergency medication.
Sodium valproate
In January 2024, new rules were introduced for prescribing sodium valproate.
Two specialists are now needed to approve:
- New or ongoing valproate treatments for girls and women.
- New valproate treatments for boys and men
The specialists must agree that your epilepsy does not respond to other treatments and the benefits of treatment outweigh the risks.
For girls and women, valproate can seriously harm an unborn baby when taken during pregnancy.
For boys and men, valproate may cause infertility. Some people’s fertility may return when their treatment is stopped or reduced. There is also some evidence that valproate can cause harm in the testicles of animals, but it’s unclear what this means for humans.
Never stop taking valproate before talking to your specialist first. Not taking medication as prescribed can increase the risk of a seizure.
Your epilepsy specialist will let you know when your treatment is due to be reviewed.
If you are planning a pregnancy it is important to speak to your healthcare professional as soon as possible about your treatment options.
If you have any questions or concerns about valproate, please speak to your healthcare professional.
Find out more about sodium valproate in the MHRA’s patient guide.
Find out more about Anti-seizure medications, contraception and pregnancy.
What’s the long-term outlook for people with self-limited epilepsy with autonomic seizures?
Most children with SeLEAS do not have many seizures. Some children only have one seizure, and most have less than five in total.
Nearly all children with SeLEAS will stop having seizures one to two years after they start, whether or not they have anti-seizure medication or other treatment. But, some children may go on to develop another epilepsy syndrome as they get older, such as SeLECTS.
SeLEAS is not associated with any developmental, learning or behaviour problems.
Living with self-limited epilepsy with autonomic seizures and getting support
Having a child with any form of epilepsy can be challenging and upsetting. Talk to the child’s doctor for help on how to support them well. And talk to your own doctor if you need support for yourself. If you’re caring for someone with SeLEAS, it’s important that you look after yourself and get the support you need.
You may find it helpful joining an in-person or online support group, where you can listen to or share experiences with other people who understand what you’re going through.
Other useful organisations
Epilepsy Action
A charity that provides support and information to people affected by epilepsy, including people affected SeLEAS.
