What is childhood epilepsy?
Epilepsy is a disease characterized by convulsive seizures or repeated crises, caused by an exaggerated activity of neurons, and which are not related to fever or processes affecting the brain. In other words, the seizures are produced by changes in the electrical and chemical activity of the brain. They are usually benign and 70% of them are controlled or cured with drugs.
Epilepsy is usually not a single disease but comprises several pathologies, with different treatments and prognoses.
Basically there are two main types of epilepsy, those with focal or partial seizures and those that cause generalized seizures. Within each group, they are divided into idiopathic (with no known cause) and symptomatic or cryptogenetic (of confirmed or suspected organic origin). In most children epilepsy is idiopathic in origin.
Prognosis of the disease
Most epilepsies can be controlled and cured with medication. This may take a few years, but the time will depend on other related factors, such as the age at onset of seizures, the type of epilepsy and the patient’s response to treatment.
If the seizures are controlled early and there are no previous lesions in the nervous system, children will be able to lead a normal life, without alterations in their intellectual and/or psychomotor development.
Symptomatic epilepsies have the worst prognosis because they are related to processes that affect the brain and their evolution will depend on the disease that causes them. Repeated seizures in this type of epilepsy tend to damage the nervous system and lead to greater psychomotor retardation.
In any case, the specialist will inform the patient and his relatives about the characteristics of each epilepsy, the one suffered by the child in particular, and will offer them the best possible treatment.
Symptoms of childhood epilepsy
The most common symptoms of childhood epilepsy can be classified into partial seizures or generalized seizures. Partial seizures can be simple (without loss of consciousness) or complex, with loss of consciousness. Generalized seizures can be:
- Atonic, with a sudden drop as a result of loss of muscle tone.
- Absent, with loss of consciousness together with a stoppage of the child’s activity.
- Generalized tonic, with a general muscle contraction.
- Generalized tonic-clonic, with body rigidity and muscle twitching.
Medical tests for childhood epilepsy
For childhood epilepsy the main test for diagnosis and follow-up is the electroencephalogram (EEG). It is a completely painless test that does not require anesthesia. Electrodes are applied to the scalp to record the electrical activity of the brain. In this way the specialist will be able to record the discharges (focal points of irritation) that cause the seizures, how intense they are and where they are located. Sometimes these alterations are difficult to observe, so sometimes the specialist will need an EEG in sleep deprivation (without the child sleeping), or to record the brain activity during nighttime sleep.
If a specific cause of epilepsy is suspected (symptomatic epilepsy) other tests can be done, such as a Magnetic Resonance Imaging (MRI), a CAT scan, tests and even genetic studies.
What are the causes of childhood epilepsy?
There are several factors that may indicate epilepsy. However, it will be the neuropediatrician who will determine the relationship with the symptoms suffered by the child, and thus establish the cause. In 7 out of 10 cases of childhood epilepsy, the causes cannot be identified but, among other factors, there are:
- Problems with brain development during pregnancy.
- Traumatic brain injury.
- Lack of oxygen during or after childbirth.
- Brain tumors, although this is rare in children.
- Very prolonged febrile seizures.
- Meningitis or encephalitis.
- Family history of epileptic seizures or febrile convulsions.
Can it be prevented?
It is difficult to prevent epilepsy itself. But, in general, habits of life should be adopted that can diminish the risk of epileptic seizures. Some recommendations for children are:
- Sleep between 8 and 10 hours, depending on age.
- To respect the schedules of getting up and going to bed.
- Watching television at a distance of more than 2 meters, with ambient light.
- Do not abuse video games and consoles, being convenient to limit them in time, with rest intervals.
- Limit stimulant drinks.
- In young epileptics, alcohol, stimulants and drugs that act on the nervous system are contraindicated.
- In young people, regular attendance to places where there is an overstimulation of the nervous system, such as nightclubs, discotheques, etc., is also not recommended.
- An alteration of the usual sleep schedule is not recommended.
On the other hand, it is important that the diagnosis and treatment of the child is known at school, as well as in any extracurricular activity, especially in sports activities that may involve some risk (swimming, etc.), and that the child should not do them alone.
Treatments for childhood epilepsy
Treatment for childhood epilepsy is usually pharmacological, and there are multiple antiepileptic drugs. The type and dosage is usually administered according to the child’s weight, age and type of epilepsy, as well as possible adverse effects or interactions with other drugs.
Most treatments perfectly fulfill their objective: to eliminate seizures as soon as possible, with a single drug, without interfering with the child’s daily life activities and without side effects.
Only some epilepsies (mainly symptomatic) are difficult to control, so more than one medication will be necessary. However, there are now many new substances that better control seizures in these types of epilepsies, also improving tolerance.
Epilepsy surgery is possible in very specific cases that do not respond well to pharmacological treatment. The Neurology and Child Neurology specialist should assess you very well.
Which specialist treats it?
The specialists who treat childhood epilepsy are neurologists and child neurologists.