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Causes of epilepsy in childhood

Epilepsy is a disorder of the central nervous system which affects the brain activity causing it to become abnormal. It leads to seizures or unusual behaviour, sensations, and even loss of awareness. Epilepsy can affect all genders and people across ages; however, it is more common in children. Though many children tend to outgrow the disease before the teen years, in other cases, effective treatments are easily available to ensure a healthy and normal life.

Epilepsy is a neurological condition, which causes seizures in the brains of the child. Often adults with epilepsy experience their first seizure episode in their childhood or adolescence. Epilepsy affects children differently and varies by age, type of seizure, treatment, response to treatment and also impact of any other existing health condition. In some cases, seizures are usually easily treatable with medications, but in other children, the seizures could be a life-long condition.

Types and Symptoms

There are two main types of seizures, such as below:

Focal Seizures: Also medically called partial seizures, these seizures only impact onepart of the brain. Before the seizures, the child experiences signals which indicate the oncoming of a seizure, the duration of the signals is also known as an aura which is a part of the entire epilepsy episode.

The auras can cause:

  • Modifications in hearing, smell or even vision
  • Abnormal feelings such as fear, euphoria, déjà vu, etc.

These seizures only affect a specific group of muscles such as the fingers or legs and often do not lead to unconsciousness. That said, a child experiencing a focal seizure might appear as frozen and is usually unable to respond but is hearing and understanding senses are functioning properly. Some other symptoms include nausea, pale skin, excessive sweating, etc. However, a type of focal seizures which affect the awareness can cause lack of consciousness or complete awareness of the surroundings. It could also lead the child to cry laugh, stare, or smack his or her lips.

Generalized Seizures

These seizures usually impact both sides of the brain and tend to cause a lack of consciousness. Children affected by generalized seizures usually feel sleepy and extremely tired after a seizure. A few types of generalized seizures include:

  • Absence Seizures which only cause a brief loss of consciousness and symptoms include staring, blinking rapidly, and facial twitching, among others. These seizures last for 10 seconds and are usually common in children between the ages of 4 to 14 years.
  • Atonic Seizures tend to cause a sudden loss of muscle tone, which can lead to a fall or the child limping or even stop responding. These usually last for 15 seconds and are known as drop seizures.
  • Generalized tonic-clonic seizure (GTC), impact a child in phases. Initially, these lead to contraction of the child’s body and limbs, followed by straightening of these affected muscles and a sudden shaking. These muscles contract and then relax, eventually leaving the child in an after-math of confusion and tiredness. GTCs typically last for 1-3 minutes.
  • Myoclonic Seizures commonly cause sudden jerking of the muscles and last for 1-2 seconds but do not cause a lack of consciousness.

Causes and Triggers

Epilepsy does not have a definitive cause in most children that tend to develop the condition. However, some factors that can potentially cause epilepsy include:

  • Autism or other developmental disorders
  • Genetics
  • High fever in childhood causing seizures. This is also known as febrile seizures
  • Meningitis or another type of infectious diseases
  • Infections during pregnancy
  • Poor nutrition or brain development during pregnancy
  • Deficiency of oxygen before or at the time of birth
  • Trauma especially to the head
  • Tumours or cysts in the brain

On the other hand, some factors that can trigger an epilepsy episode include:

  • Extreme excitement
  • Lack of sleep
  • Flickering or flashing lights
  • High or intense sounds
  • Skipping meals
  • Acute stress
  • Trauma or injury
  • Loud noises such as church bell
  • Missing a medication dose that controls seizures

Diagnosis of Epilepsy in Children

It can be difficult to diagnose epilepsy in children especially infants and very young ones. However, continuous monitoring of symptoms or a video recording can help the doctor understand the condition better. However, a diagnosis is made when the seizures occur more than once, or when there is no apparent cause of the problem.

Steps for diagnosis include:

  • Analyzing the family history
  • Assessing medical history
  • Physical examination
  • Blood test
  • Brain tests, scans and measurements such as CT scan, MRI, EEG, etc.

Once the child experience seizures, it is important to determine the cause, type and treatment fit for the seizures.

Treatment of Epilepsy in Children

Treatment options for epilepsy in children include:

Medications: These are directed to control the symptoms and prevent seizures from occurring. However, these medicines are preventive and cannot help if the seizure has already begun. In some cases, children do not require medications after a continuous course; but the decision needs to be made depending on the overall condition of the child and upon the recommendation of the medical professional. That said, in some children antiepileptic drugs do not help to control seizures and hence, other forms of treatment of a combines approach may be required.

Ketogenic Diet: Cases, where medications cannot successfully control seizures, the doctor might recommend a keto diet full of vitamins, minerals, etc. to minimize seizure episodes.

Neurostimulation: This treatment method involves sending small electric currents to the nervous system of the child to prevent the occurrence of seizures in cases where medications have proved unsuccessful. There are typically three types of neurostimulation for epilepsy treatment:

  • Vagus nerve stimulation
  • Responsive neurostimulation
  • Deep brain neurostimulation

Surgery: In some cases, where the seizures are intense, last for longer than usual durations and have severely impacted the child’s life, the doctor may recommend surgery to remove a part of the affected brain and reduce or minimize seizures. Surgery is also the last option for treatment in cases where all other forms of cure have failed to provide any result.

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