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Epilepsy is a neurological condition affecting children, characterized by sudden bursts of abnormal electrical activity in the brain, leading to seizures. Seizures can manifest differently, including episodes where a child loses consciousness and experiences uncontrollable body movements. However, not all seizures have the same appearance, as some children may exhibit behaviors like staring or confusion during a seizure.
It’s essential to note that while epilepsy can cause seizures, not all seizures in children are necessarily due to epilepsy. To confirm an epilepsy diagnosis, a healthcare provider will assess whether a child has experienced multiple seizures not linked to an underlying medical condition.
Healthcare professionals may refer to this condition as pediatric epilepsy or a seizure disorder. Treatment options for epilepsy in children can include medical interventions, surgical procedures, implanted medical devices, and the use of a ketogenic diet.
There are several types of epilepsy in children, including:
- Absence epilepsy: It leads to brief episodes of confusion and staring, during which the child cannot respond to stimuli.
- Rolandic epilepsy: This type of epilepsy occurs during sleep transitions and can cause uncontrolled movements, often on one side of the body, and affect speech.
- Juvenile myoclonic epilepsy: Common in puberty, it causes muscle twitching and jerking, mainly upon awakening.
- Infantile spasms (west syndrome): These are severe seizures in infants, leading to twitching, jerking, and uncontrollable body movements, often during sleep transitions.
- Lennox-Gastaut syndrome (LGS): LGS causes seizures characterized by sudden muscle stiffness and relaxation, as well as moments of nonawareness and unresponsiveness during seizures.
Symptoms
The first sign of epilepsy in children is seizures. During a seizure, epilepsy in children shows as follows:
- Fainting or loss of consciousness.
- Uncontrollably jerking, twitching, or repeatedly moving a certain body part.
- Not being able to speak, lip-smacking, or using their mouth to chew.
- Rapid heart rate.
- Fast breathing.
Identifying a seizure in a baby can be more difficult than in older children. As a caregiver, it’s important to observe any unusual behaviors, note their duration, and discuss these observations with the child’s healthcare provider.
Following a seizure, a child might experience fatigue or feel confused by what happened. Until the seizure stops, they may not remember anything about it. Seizures frequently result in headaches.
Seek medical attention if the child experiences the following:
- The frequency of the seizures increased.
- Side effects from antiseizure medication.
- Anxiety or depression.
- Developmental milestones not reached at the expected age.
Causes
Epilepsy in children results from uncontrolled electrical activity in the brain, disrupting communication between brain cells. Possible causes include head injuries, birth complications, infections, brain abnormalities from birth, genetic predisposition, or it can occur without a clear reason. Ongoing research aims to better understand the origins of childhood epilepsy.
Risk factors
A child may be more likely to develop epilepsy if they have the following factor:
- Genetic tendency, or past history of epilepsy in their biological family.
- Traumatic brain injury history.
- History of a brain infection.
- Additional neurological disorders or issues.
Diagnosis
A healthcare provider will diagnose epilepsy in children after a series of examinations and testing that may include:
- Physical examination: During a physical examination, a healthcare provider will check your child’s vital signs, learn more about their symptoms, and take a complete medical history, including a detailed biological family history.
- Neurological examination: A healthcare provider will evaluate how your child’s brain and nervous system are functioning.
- Blood tests: A healthcare provider may order blood tests to check if an underlying condition has caused your child’s symptoms.
- Imaging tests: Imaging tests, such as magnetic resonance imaging (MRI), can help your child’s care team learn more about their brain activity.
- Electroencephalogram (EEG): This painless test measures your child’s brain’s electrical activity.
These tests help your healthcare provider understand the underlying causes of your child’s seizures and rule out conditions that may be causing them. An epilepsy diagnosis may take time and usually does not happen overnight.
Treatment
Treatment options for epilepsy in children can include the following:
- Medications for seizure control: Antiseizure medications are often prescribed to manage and reduce the frequency of seizures. These medications work by preventing abnormal electrical activity in the brain that leads to seizures. It is crucial for your child to take these medications as prescribed to maintain their effectiveness.
- Surgery: In cases where medications do not effectively control seizures, specialized brain surgery may be recommended. This surgical intervention aims to target the underlying cause of epilepsy in your child.
- Implanted medical devices: Advanced medical devices can be implanted to assist in managing epilepsy symptoms when medications prove insufficient. Common devices include:
- Vagus nerve stimulator (VNS): This device delivers controlled electrical impulses to the vagus nerve, helping regulate brain cell activity.
- Deep brain stimulator (DBS): DBS devices send precise electrical currents to specific brain areas to modulate their function.
- Ketogenic diet: For children with challenging-to-treat epilepsy, the ketogenic diet may offer benefits. This dietary approach involves a high-fat, low-carbohydrate meal plan and should be closely supervised by a medical team.
