Veronica Lambert and colleagues describe the complex factors that may prevent children and families from making known an epilepsy diagnosis

Despite worldwide campaigns to enhance public awareness, understanding and acceptability of epilepsy, stigmatising feelings remain among children with epilepsy and their families. Stigma can be internally felt by the child (shame and embarrassment) or enacted by others (discrimination). Many children with epilepsy and their parents fear disclosure of the condition and exercise a variety of disclosure or concealment strategies. Maintaining these strategies can have a negative, stressful impact on the child’s social and psychosocial development and quality of life. Continuing dialogue among families, friends, teachers and health professionals should be initiated and supported.