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December 5, 2024

Childhood Epilepsy: Types, Causes, Symptoms & Treatments

Epilepsy is one of the most common neurological disorders in children, yet it remains poorly understood by many. When your child receives a diagnosis of epilepsy or a seizure disorder, it is essential to learn about epilepsy and its various types. The different forms of pediatric epilepsy vary in severity, causes, and symptoms of seizures, necessitating early diagnosis and management.

Experiencing a seizure is frightening for any child, as well as for family members and caregivers who hope to see the child improve. However, with the right information and necessary medical support, a child does not have to endure a completely miserable existence. Understanding the nature of the illness in children, along with the types of epilepsy and seizure disorders, is crucial. This guide aims to assist parents in comprehending what their child is experiencing and how to pursue the best treatment options.

This article provides an overview of various aspects of epilepsy in children, including types of seizures and management strategies for epilepsy.

What is Epilepsy? An Overview

Epilepsy is a long-term neurological condition characterized by periodic, unprovoked seizures, which are brief electrical disturbances in the brain. These seizures can range from minor involuntary twitches lasting only a few seconds to severe episodes where the person convulses dramatically for several minutes. Furthermore, epilepsy does not refer to a single disease but encompasses various types of seizures that can occur.

Childhood epilepsy presents differently compared to adults. Among the population, children are more affected by epilepsy because the firing patterns of their brains are influenced by their age and overall health. If a child is diagnosed with seizures, failing to treat them may adversely impact the child’s learning abilities and social interactions.

Pediatric epilepsy is typically diagnosed when a child experiences two seizures of different origins occurring a day apart or if they happen over more than one day. Diagnosis involves a medical history interview, neurological tests, and potentially EEGs and MRIs to identify any abnormal electrical activity or structural changes in the brain.

Common Types of Epilepsy in Children

1. Generalized Epilepsy

This type of epilepsy is termed bilateral because it affects both sides of the brain from the onset of the seizure. Generalized epilepsy is further categorized into several subtypes, such as:

Absence Seizures: These are brief episodes where the child may appear to daydream. They typically last only a few seconds and can easily be mistaken for daydreaming.

Tonic-Clonic Seizures: Also known as ‘grand mal,’ these seizures involve a phase of stiffness (the tonic phase) followed by shaking (the clonic phase) and may lead to loss of consciousness.

Myoclonic Seizures: These are short and involve a tonic contraction of muscles within a limited range, often mistaken for normal movements or clumsiness.

2. Focal Epilepsy

Focal epilepsy, also referred to as partial epilepsy, occurs when seizures originate from a specific area of the brain. Symptoms will vary depending on the affected region. Focal seizures can be:

Simple Focal Seizures: In these cases, the child remains aware and may experience sensations such as numbness, tingling, or see flashes of light.

Complex Focal Seizures: These may involve changes in mental status, repetitive movements or complex motor patterns, and other unusual movements such as lip-smacking.

3. Childhood Epileptic Syndromes

These are specific syndromes that typically arise in children:

Benign Rolandic Epilepsy: The most common form seen in children, characterized by seizures occurring at night or early in the morning.

Lennox-Gastaut Syndrome: A severe type characterized by the presence of multiple seizure types, which may require significant therapeutic intervention.

Dravet Syndrome: A form of epilepsy marked by seizures and developmental delays, associated with genetic mutations that occur at birth or shortly thereafter.

Different Types of Seizures in Children

Seizures characterize epilepsy, but they are not always the same. There are various types of seizures, as detailed below. By developing awareness of the symptoms, parents should take their children to a doctor for checkups. Here’s a closer look at the major categories of seizures that children with epilepsy may experience:

1. Generalized Seizures

These seizures affect the entire brain. Key types include:

Tonic Seizures: These involve stiffening of the muscles, which may cause a child to drop or remain rigid.

Clonic Seizures: These consist of rapid twitching movements that involve the limbs, extremities, or face, including both lower and upper limbs.

Atonic Seizures: Also known as “drop attacks,” these result in slumping or falling, and occasionally head nodding.

2. Focal Seizures

Focal seizures differ from generalized seizures as they start from a specific area of the brain rather than affecting the whole brain. These may generalize if the abnormal activity spreads or change into other types of seizures. Common focal seizures include:

Aware Seizures: The child remains conscious and can perceive their surroundings, experiencing sensations such as hearing sounds or seeing lights.

Impaired Awareness Seizures: The child becomes disoriented and may be seen fidgeting or appearing generally confused.

3. Febrile Seizures

While not classified as epilepsy, febrile seizures are common in young children and are triggered by a high fever. Most are self-limiting, and having one does not automatically mean a child will develop chronic epilepsy.

Understanding the type of seizures your child experiences will aid in determining the appropriate treatment and managing the overall situation.

Causes of Childhood Epilepsy

Epilepsy in children can be attributed to numerous factors, some of which can be somewhat difficult to comprehend. While the exact cause may not always be identified, the following are common triggers:

  • Genetic Factors: In some cases, epilepsy is caused by gene inheritance within the family line.
  • Brain Injuries: Some babies may suffer a head injury during birth or from a fall or other mishap in their early years, which may affect normal brain activity.
  • Developmental Disorders: Related conditions, such as autism spectrum disorder or cerebral palsy, can also increase a person’s vulnerability to epilepsy.
  • Infections: Infections of the brain, such as meningitis or encephalitis, may lead to epilepsy.
  • Metabolic Disorders: Additionally, imbalances in metabolism, including low blood sugar or inadequate oxygen supply at birth, may be contributing factors.

Often, the root of the problem remains undiagnosed even after tests are conducted. In the absence of a physiological or genetic cause, this condition is classified as idiopathic epilepsy. In either case, early recognition of these factors, along with prompt treatment, can have a particularly positive impact on a child’s epileptic condition.

Diagnosing Epilepsy in Children

Diagnosing epilepsy in children can be quite challenging, as not all kids experience seizures or have noticeable episodes that are easily identifiable. The specific nature of epilepsy must be established so that a proper management plan can be developed and initiated. Here’s an overview of the diagnostic process:

  1. Medical History
    The first step is taking a medical history, which is performed on the patient and may take some time as comprehensive information is gathered. The doctor will inquire about:
  2. The child’s developmental status in relation to their age, as well as their overall condition.
  3. Specific characteristics of any seizures, including their duration, frequency, and presentation.
  4. Any peculiarities in the family history, such as epilepsy or other neurological disorders.
  • Neurological Examination
    Assessing the child’s brain function involves conducting a physical and neurological examination. In this step, reflexes, coordination, and sensations are tested to evaluate any neurological issues.
  • Diagnostic Tests
    Advanced tests are utilized to identify the cause and type of seizures:
  • Electroencephalogram (EEG): This noninvasive technique records electrical activity in the brain, helping to identify abnormal patterns.
  • Magnetic Resonance Imaging (MRI): This imaging technique detects structural abnormalities within the brain, such as malformations, tumors, or scarring.
  • Genetic Testing: Patients with syndromic epilepsy may have genetic issues identified through DNA analysis.

Prompt diagnosis is a very important aspect of the management of seizure disorders in children. Parents should record any signs and symptoms to assist in the diagnosis.

Management of Seizure Disorders in Children

Seizure disorder in children does not have a one-size-fits-all cure, which means that children have to be treated individually. The intended goal is to control seizures without a consequence impairing the joy of living the child’s life. Below are the most common treatment modalities used for pediatric epilepsy:

1. Medications

Antiseizure medications are the initial, main treatment for epilepsy, so-called ASMs. While no single medication works for all types of epilepsy, doctors will prescribe a drug based on:

  • The nature of seizures the child has been diagnosed with.
  • Their age, weight, and general conditions of health.
  • The risks associated with the medicine.

Common ASMs include:

  • Carbamazepine for focal seizures
  • Ethosuximide is an effective drug for the treatment of absence seizures
  • Valproate is used for generalized seizure but is not preferred if a girl is soon to be of childbearing age because it has certain side effects on the reproductive system.
  • Ketogenic Diet: A dietary intervention that proved to be beneficial for drug-resistant epilepsy and consists of increased fat content and marginal absolute carbs.

ASMs need constant supervision, including changes in dosage or the need for cross-over to other ASMs in certain children over time.

2. Surgical Options

Failure of medications to prevent seizures makes surgery a possible solution. The goal of surgical management is to locate and resect the area of the brain that is responsible for the seizure. The most common types of surgery for epilepsy include:

  • Focal Resection: Surgical procedures for the removal of the section of the brain that is the source of the seizure.
  • Corpus Callosotomy: Surgery in which nerve connections in the brain are severed which helps to halt the spread of seizures.
  • Hemispherectomy: A rather unusual therapy for rather serious cases where one portion of the affected brain is removed.
  • Vagus Nerve Stimulation (VNS): A device is inserted beneath the skin to activate the vagal nerve thereby lowering the rates of seizures.

3. Emerging Therapies

New therapies for managing epilepsy are continually being developed, including:

  • Responsive Neurostimulation (RNS): An implant that monitors irregularities in the brain functioning and then sends an electric shock to the affected area so that a seizure does not occur.
  • Gene Therapy: Experimental therapies for the genetic abnormalities that lead to epilepsy.

4. Lifestyle Adjustments

Small adjustments in this kind of lifestyle are very effective in enhancing the lifestyle of the child. Key steps include:

  • Adequate Sleep: Make sure your child has adequate rest since sleep may be a seizure inducer.
  • Stress Management: Stress relief in the form of relaxation exercises or taking up other leisure activities.
  • Safety Precautions: Supervising the child during tasks like swimming or cycling by always being close to them and wearing appropriate protective gear.

Parents should explain to their child’s doctor about all the treatments available so that to select the most appropriate one.

Managing Epilepsy in Children

Epilepsy is not only treated with medications and other pharmaceutical products; it also requires a supportive environment, and caregiver capability to assist a child in their care.

Managing epilepsy in children can be challenging, but the points outlined below should help parents enhance their children’s quality of life.

  • Education and Awareness: Ensure that your child, other family members, and teachers understand what epilepsy is. Awareness of the condition reduces stigmatization and empowers everyone to manage or respond to a seizure appropriately.
  • Emergency Plans: Familiarize yourself with the specific guidelines on when to administer rescue medication or when to seek medical attention for a seizure.
  • Consistency in Treatment: Adhere to all prescribed medications and never discontinue any without first consulting your doctor.
  • Seizure Triggers: Some triggers should be avoided—such as lack of sleep, bright and flashing lights, or certain foods that might induce nausea. To track these triggers, a seizure diary should be maintained.
  • Psychological Support: Children living with epilepsy can experience varying degrees of emotional difficulties. Counseling or support groups can provide valuable emotional support.

The role of parents and caregivers is to make the child feel supported and empowered. Epilepsy is a serious condition; however, with proper guidance, children suffering from epilepsy do not have to lead diminished lives.

Final Thoughts

Epilepsy is a challenging but manageable condition in children, particularly with the right medical care. This site offers a step-by-step guide for parents, covering everything from understanding the different types of seizures to exploring various treatment options for this condition.

If your child has epilepsy, it is crucial to consult a qualified medical professional. Dr. Nikhil Pawar and his dedicated, knowledgeable team at Vidya Vikas Child Neuro Center specialize in diagnosing and managing seizure disorders in children. 

Connect with us at Vidya Vikas Child Neuro Center, Vidya Vikas Circle, Pumping Station Road, Bhavik Nagar, Nashik, Maharashtra 422 013 IND, or contact us at +91 820 816 4155 to know how we can assist your child to lead a productive, seizure-free life.

Start today, and make the first move – because your child’s future is worth every effort.