Causes, Symptoms, and Treatment of Epilepsy in Children


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Epilepsy is a brain condition that causes recurring seizures. It affects about 470,000 children and 3 million adults in the United States.

Seizures are episodes of neurological symptoms caused by changes in your brain’s electrical activity. Tonic-colonic seizures, previously known as grand mal seizures, cause a change of consciousness and full-body convulsions. Some other types of seizures cause symptoms that are not as noticeable.

According to the Epilepsy Foundation, children with certain types of epilepsy are at a heightened risk of developing learning problems and underachieving academically. A proper diagnosis and treatment plan are important for helping your child navigate potential difficulties caused by epilepsy.

Keep reading to learn what causes epilepsy in children. We’ll also cover its symptoms and your treatment options.

What causes epilepsy in children

About 40 percent of epilepsies have no known cause and are attributed to genetic factors. Epilepsy is thought to be more common in people with close family members who also had epilepsy. Twin studies suggest that the heritability of epilepsy is somewhere between 25 and 70 percent.

The other 60 percent of epilepsies are often attributed to brain damage caused by one of the following factors:

Head trauma

A traumatic injury to your head can potentially lead to brain damage and epilepsy. Car crashes, sports injuries, and physical abuse are some potential causes.

Stroke

A stroke occurs when impaired blood flow in a blood vessel leads to brain damage.

Brain conditions

Brain tumors, meningitis, and other conditions that lead to brain damage can potentially cause epilepsy.

Prenatal injury

Factors like developmental brain abnormalities or an oxygen deficit before birth can potentially lead to brain damage.

Types and symptoms of epilepsy in children

Epilepsy can cause many types of seizures. Here are some of the common types of seizures children who have epilepsy can experience.

Focal seizures

Focal seizures are also known as partial seizures. They only affect one side of your child’s brain and are often preceded by an aura. An aura is a sudden unusual feeling, such as déjà vu or changes in hearing, sight, or smell.

Focal seizures can be further categorized depending on the specific symptoms.

Focal aware seizures

Focal aware seizures typically only affect a specific part of your child’s body, like a leg, and don’t cause a loss of consciousness. A person often becomes unable to respond but can hear and understand their surroundings. These seizures generally last less than 2 minutes.

Focal impaired awareness seizures

Focal impaired awareness seizures cause a change of consciousness. They typically last for less than 2 minutes, and your child will likely seem awake to other people during the seizure. They will have involuntary movement or stiffening of part of the body and may make noises, but they will not interact or respond normally. They will often appear to fall asleep or faint for a period of several minutes to a few hours after the episode.

Focal to bilateral tonic-clonic seizures

Focal to bilateral tonic-clonic seizures start on one side of your child’s brain and spread to both sides. During the first phase, your child will have impaired consciousness and their muscles will stiffen. If standing, they might fall to the floor and their muscles may spasm or jerk.

These seizures usually last between 30 seconds and 3 minutes.

Gelastic and dacrystic seizures

These two types of seizures start in your child’s hypothalamus. Gelastic seizures cause uncontrollable laughter. Dacrystic seizures cause uncontrollable crying. Your child won’t lose consciousness during either type.

Generalized seizures

Generalized seizures affect both sides of your child’s brain. They can be subdivided into many categories.

Generalized tonic-clonic seizures

Generalized tonic-clonic seizures cause similar symptoms as the focal to bilateral tonic-clonic seizure. The difference is that this seizure starts with both sides of your child’s brain, whereas the bilateral tonic-clonic starts on one side and spreads.

Tonic seizures

Tonic seizures cause muscle stiffing but don’t cause muscle spasms. They typically affect your child’s back, legs, or arms. They can also occur due to certain medical conditions in people who don’t have epilepsy.

Clonic seizures

Clonic seizures cause muscle jerking motions. This type of seizure is relatively rare. According to the Epilepsy Foundation, they occur most often in babies.

Absence seizures

Absence seizures can be mistaken for daydreaming and cause symptoms such as blank staring and eyelid fluttering with impairment of consciousness. Most kids who have absence seizures do not have other types of seizures.

Myoclonic seizures

Myoclonic seizures cause muscle jerking but don’t affect your child’s consciousness. They usually last less than 2 seconds. They are often one of several types of seizures that occur as part of a childhood epilepsy syndrome.

Atonic seizures

An atonic seizure causes a sudden loss of muscle tone. This can cause your child to fall if they’re standing. You may also notice their head drop. Atonic seizures can occur as part of a childhood epilepsy syndrome.

Epileptic spasms

Epileptic spasms are brief muscle spasms that last for 1 to 3 seconds. They often occur several times throughout the day.

They’re referred to as infantile spasms when they occur in children under the age of 2 years, and they can be an indication of severe brain damage in infants.

Childhood epilepsy syndromes

If your child has a specific group of symptoms, they may be diagnosed with a particular epilepsy syndrome. Each syndrome causes a specific pattern of brain activity when measured on an electroencephalogram (EEG). These syndromes also usually occur within certain age ranges.

Benign rolandic epilepsy of childhood

Benign rolandic epilepsy is the most common epilepsy syndrome in children. It occurs in about 15 percent of children with epilepsy and arises between the ages of 3 and 10. With benign rolandic epilepsy:

  • Your child may be seizure-free by the age of 16.
  • They may have focal aware seizures, usually at night.
  • Focal aware seizures can develop into a generalized tonic-clonic seizure.

Childhood absence epilepsy

Childhood absence epilepsy affects about 2 to 8 percent of people with epilepsy. It typically begins between the ages of 4 and 8 years. With childhood absence epilepsy:

  • Most children grow out of it by the time they turn 12.
  • It causes absence seizures that only last several seconds.
  • Seizures respond well to medication.

Infantile spasms (West syndrome)

Infantile spasms start in your child’s first year. They appear as brief muscle spasms that occur in clusters.

  • They can occur in children with brain injuries.
  • Many children have learning and behavior difficulties.
  • It may be an early symptom of Lennox-Gastaut syndrome.

Lennox-Gastaut syndrome

Lennox-Gastaut syndrome typically begins between the ages of 3 and 5 years, but it can develop as late as adolescence.

  • It may cause tonic, atonic, myoclonic, tonic-clonic, and absence seizures.
  • Many children have learning and behavioral problems.
  • It’s difficult to treat with antiepileptic drugs.

Juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy starts between the ages of 12 and 18. Children often experience myoclonic, tonic-clonic, and absence seizures.

  • Your child may experience seizures shortly after waking.
  • Seizures often persist into adulthood but can be treated well with medication.
  • Tiredness, stress, and alcohol can trigger seizures.

Landau-Kleffner syndrome

Landau-Kleffner syndrome is a rare condition that typically arises between the ages of 3 and 7.

  • This syndrome leads to problems with verbal expression and understanding language.
  • It usually causes focal seizures.

Temporal lobe epilepsy

About 60 percent of people with focal epilepsy have temporal lobe epilepsy. Symptoms typically start between the ages of 10 and 20 but can also develop earlier or later.

  • It leads to focal aware and focal impaired awareness seizures.
  • Seizures usually last less than 2 minutes.

Is there a link between autism and epilepsy in children?

Autism spectrum disorder and epilepsy are both caused by changes in brain activity. Epilepsy is more common in children with autism, but the link still isn’t fully understood.

About 20 to 30 percent of children with autism spectrum disorder develop epilepsy before they turn 18.

What to do if your child is having a seizure

It can be scary watching your child have a seizure. But often, the best thing you can do is wait it out.

According to the Epilepsy Foundation, the following are the dos and don’ts of helping a child who’s having a generalized seizure.

Do

  • Move anything that could hurt your child.
  • Put something soft under their head.
  • Turn them gently to the side to prevent them from choking on their tongue.
  • Keep track of how long the seizure lasts.
  • Loosen anything around their neck.
  • Comfort your child once the seizure is over.

Don’t

  • Hold your child.
  • Try to stop their movements or tongue biting.
  • Open or put something in their mouth.

When to seek medical help

  • if it’s your child’s first seizure
  • if their seizure lasts more than 5 minutes
  • if it happens while swimming or in water
  • if your child has a high fever or diabetes
  • if they may have injured their head
  • if they’re having trouble breathing after their seizure

How is epilepsy diagnosed in children?

If your child has recurrent seizures, their doctor may diagnosis them with epilepsy.

A doctor will likely use a variety of tests to make the diagnosis. These may include:

  • Medical history. They will collect information about relatives with epilepsy and make a detailed list of your child’s symptoms.
  • Neurological exam. A doctor will test your child’s mental function and behavior to determine what type of epilepsy your child has.
  • Blood test. They may order a blood test to rule out infections or other conditions that may cause seizures.
  • EEG. Electrodes are placed on your child’s scalp, and your child may be asked to perform specific tasks while the EEG measures brain activity.
  • Imaging tests. The doctor may order a number of imaging tests to examine your child’s brain for abnormalities. These tests include:

    • computerized tomography scan (CT or CAT scan)
    • magnetic resonance imaging (MRI)
    • functional MRI (fMRI)
    • positron emission tomography (PET)
    • single-photon emission computerized tomography

Is there a cure for epilepsy in children?

At this time, there’s no known cure for epilepsy. However, getting proper treatment can help keep seizures under control and lessen potential complications.

How are seizures treated in children?

The most common treatment for epilepsy is medication, but a number of other treatments may also be used.

Medication

Epilepsy is commonly treated with antiepileptic drugs that help control symptoms. There are dozens of types of antiepileptic drugs available, and your child’s doctor can help you determine which one is best for them.

If your child has been seizure free for several years, the doctor may recommend reducing the amount of medication they’re taking.

Ketogenic diet

A ketogenic diet is a diet that drastically restricts carbs. This type of diet causes your body to produce a substance called decanoic acid that may reduce convulsive activity in some people.

Surgery

For children with frequent and severe seizures, a doctor may recommend surgery to cut or remove part of the brain. Brain surgery can be effective for certain types of epilepsy, but it’s usually not performed unless noninvasive treatments have failed.

Neurostimulation may be an option if your child doesn’t respond to medications. During neurostimulation, an implanted device delivers a small amount of electricity to your child’s nervous system.

Currently, the three types of neurostimulation available include:

  • vagal nerve stimulation
  • responsive neurostimulation
  • deep brain stimulation

How to help children live with seizures

Here are some ways that you can help support a child with epilepsy:

  • Learn as much as you can about epilepsy, especially the specific type your child has.
  • Avoid making your child feel like a burden.
  • Help your child understand the dosage of all their medications as well as potential side effects.
  • Talk to your child’s doctor before giving them medications that may interact with their epilepsy medications.
  • Encourage your child to get enough sleep and develop healthy habits.
  • Take your child to see a doctor for regular checkups.
  • Make sure your child wears a helmet when playing sports with a high risk of head injury.

Takeaway

Genetic factors or brain damage can lead to epilepsy in children. Epilepsy can cause a wide range of symptoms that can vary in severity from barely noticeable to severe.

If you think your child may have epilepsy, it’s critical to see a doctor as soon as possible for a proper diagnosis. Epilepsy can often be well managed with medication or other treatments.


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