Epilepsy is a brain condition that causes a child to have seizures. It is one of the most common disorders of the nervous system. It affects children and adults of all races and ethnic backgrounds.
The brain consists of nerve cells that communicate with each other through electrical activity. A seizure occurs when one or more parts of the brain has a burst of abnormal electrical signals that interrupt normal brain signals. Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion. But when a child has 2 or more seizures with no known cause, this is diagnosed as epilepsy.
There are different types of seizures. The type of seizure depends on which part and how much of the brain is affected and what happens during the seizure. The 2 main categories of epileptic seizures are focal (partial) seizure and generalized seizure.
Focal seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. Before a focal seizure, your child may have an aura, or signs that a seizure is about to occur. This is more common with a complex focal seizure. The most common aura involves feelings, such as deja vu, impending doom, fear, or euphoria. Or your child may have visual changes, hearing abnormalities, or changes in sense of smell. The 2 types of focal seizures are:
A generalized seizure occurs in both sides of the brain. Your child will lose consciousness and be tired after the seizure (postictal state). Types of generalized seizures include:
A seizure can be caused by many things. These can include:
A seizure may be caused by a combination of these. In most cases, the cause of a seizure can’t be found.
Your child’s symptoms depend on the type of seizure. General symptoms or warning signs of a seizure can include:
During the seizure, your child’s lips may become tinted blue and his or her breathing may not be normal. After the seizure, your child may be sleepy or confused.
The symptoms of a seizure may be like those of other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. You’ll be asked about other factors that may have caused your child’s seizure, such as:
Your child may also have:
The goal of treatment is to control, stop, or reduce how often seizures occur. Treatment is most often done with medicine. Many types of medicines used to treat seizures and epilepsy. Your child’s healthcare provider will need to identify the type of seizure your child is having. Medicines are selected based on the type of seizure, age of the child, side effects, cost, and ease of use. Medicines used at home are usually taken by mouth as capsules, tablets, sprinkles, or syrup. Some medicines can be given into the rectum or in the nose. If your child is in the hospital with seizures, medicine may be given by injection or intravenously by vein (IV).
It is important to give your child medicine on time and as prescribed. The dose may need to be adjusted for the best seizure control. All medicines can have side effects. Talk with your child’s healthcare provider about possible side effects. If your child has side effects, talk to the healthcare provider. Do not stop giving medicine to your child. This can cause more or worse seizures.
While your child is taking medicine, he or she may need tests to see how well the medicine is working. You may have:
Your child may not need medicine for life. Some children are taken off medicine if they have had no seizures for 1 to 2 years. This will be determined by your child's healthcare provider.
If medicine doesn’t work well enough for your child to control seizures or your child has problems with side effects, the healthcare provider may advise other types of treatment. Your child may be treated with any of the below:
A ketogenic diet is a type of diet is very high in fat, and very low in carbohydrates. Enough protein is included to help promote growth. The diet causes the body to make ketones. These are chemicals made from the breakdown of body fat. The brain and heart work normally with ketones as an energy source. This special diet must be strictly followed. Too many carbohydrates can stop ketosis. Researchers aren’t sure why the diet works. But some children become seizure-free when put on the diet. The diet doesn’t work for every child.
This treatment sends small pulses of energy to the brain from one of the vagus nerves. This is a pair of large nerves in the neck. If your child is age 12 or older and has partial seizures that are not controlled well with medicine, VNS may be an option. VNS is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around one of the vagus nerves. The battery is then programmed to send energy impulses every few minutes to the brain. When your child feels a seizure coming on, he or she may activate the impulses by holding a small magnet over the battery. In many cases, this will help to stop the seizure. VNS can have side effects such as hoarse voice, pain in the throat, or change in voice.
Surgery may be done to remove the part of the brain where the seizures are occurring. Or the surgery helps to stop the spread of the bad electrical currents through the brain. Surgery may be an option if your child’s seizures are hard to control and always start in one part of the brain that doesn’t affect speech, memory, or vision. Surgery for epilepsy seizures is very complex. It is done by a specialized surgical team. Your child may be awake during the surgery. The brain itself does not feel pain. If your child is awake and able to follow commands, the surgeons are better able to check areas of his or her brain during the procedure. Surgery is not an option for everyone with seizures.
You can help your child with epilepsy manage his or her health. Make sure to:
Keep in mind that your child may not need medicine for life. Talk with the healthcare provider if your child has had no seizures for 1 to 2 years.
If your child’s seizures are controlled well, you may not need many restrictions on activities. Make sure your child wears a helmet for sports such as skating, hockey, and bike riding. Make sure your child has adult supervision while swimming.
Call the healthcare provider if:
Tips to help you get the most from a visit to your child’s healthcare provider: