Childhood Epilepsy

Epilepsy is one of the most common conditions that affect the central nervous system. It can affect anyone of any age or gender but is particularly prevalent in children and the elderly. Currently, rates of epilepsy are at around 0.5–1% of the worldwide population. Epilepsy is a condition that can have an effect on childhood development, both in terms of knowledge acquisition and social interaction. If the condition is left untreated, it can cause the child to regress in terms of neurocognitive development.

If parents or guardians suspect that their child may be suffering from epilepsy, it’s vital they see doctor urgently in order to get an early diagnosis and the proper treatment.

Causes of Epilepsy
Epilepsy occurs due to an abnormality in the electrical impulses of the brain which causes seizures. Often, epilepsy is found in children who are otherwise of good health, are developing normally, and do not display any outward signs of a medical issue, but unfortunately, have a brain abnormality brought upon by various underlying factors. However, suffering from a seizure does not always mean that the child is epileptic.

Differential diagnosis:
  • Seizures which occur when there is a temporary irregularity in the brain’s electrical impulses, leading to symptoms that temporarily affect the central nervous system. Symptoms may last for seconds or minutes. This type of seizure can be treated if the causes are targeted, such as a low glucose level or brain tumor.
  • Epilepsy occurs because of a permanent disruption to the electrical impulses in the brain. The condition leads to repeated seizures which do not require any stimulus to occur.
  • Convulsions are when the muscles contract and relax repeatedly and rapidly. Epileptic seizures are often the cause of convulsions, but not all seizures lead to convulsions and not all convulsions are due to seizures.
There are various symptoms of epilepsy, depending on the area of the brain which is affected. Some symptoms are difficult to observe, which means that many parents and guardians are often unaware that their child is suffering from epilepsy. That being said, parents and guardians should be particularly observant of their child; if their child’s behavior and learning worsens with no clear explanation, or if their child displays strange or repetitive behaviors such as absent mindedness, not responding to their name being called, laughing without reason, or show signs of hallucination.

The types of seizures most commonly found in children are:
  • Absence Seizures – Children will have an absent look in their eyes or become unusually still during conversation. They may also fail to respond to their name being called. There are generally no muscular symptoms, however, if there are, they are generally limited to a rapid blinking of the eyes. These seizures usually occur in children between the ages of 5-10 years.
  • Full Body Seizures – These seizures cause the child’s body to spasm uncontrollably and leave them with no memory of the episode.
Finding out the exact cause of the condition will have a great effect on the effectiveness of treatment, as well as in determining which treatment route to take. In addition to a detailed evaluation of the patient’s medical history, doctors have equipment available to help them accurately target the site of the abnormality in the patient’s brain responsible for the epilepsy, such as:
  • Electroencephalogram (EEG) – This helps diagnose epilepsy and identify the location in the brain which is causing the seizures, as well as identify the type of seizure.
  • CT scan and MRI scans – These help doctors by giving them a clear picture of what is causing the seizures.
Medication is the main form of treatment for epilepsy, which prevents seizures from occurring. Medication is usually administered for a period of 2 years or more. Treatment may also include targeting the cause(s) of the epilepsy itself. Epilepsy sufferers can usually be cured of their condition, but for some epileptics, it is only possible to restrict the number of seizures they may suffer from through continuous courses of medication. Currently, there are numerous types of medications that are able to safely and efficiently control seizures.
Approximately 70% of epileptics are able to treat or control the symptoms by taking medication and avoiding situations that can stimulate a seizure. Furthermore, doctors may advise a ketogenic dietwhich has been shown to help to reduce seizures. For the most part, dietary restrictions such as this can be used for children in whom seizures are more difficult to regulate and when medication is not producing the desired effect. For groups of patients who are not responding to medication, doctors may offer an alternative choice in the form of surgery.

Bumrungrad International Hospital currently offers an innovative, modern surgical technique called SEEG. The hospital was the first private hospital in Thailand to offer such a method to its patients. The surgery involves inserting electrodes into the brain to locate the exact site from which the seizure emanated before operating on that site. This type of surgery has produced satisfactory results.
Quickly and efficiently treating the pathology in the brain which is causing the seizures can reduce the risks of brain injury for the child suffering from epilepsy. Parents and guardians can also help to treat their epileptic child by making sure they take their medication as prescribed by their doctor, seeing that they get sufficient rest, not allowing them to climb high-up on the playground, making sure they don’t swim alone, and making sure they do not leave designated routes when cycling.

Moreover, parents and guardians should be aware of the following first aid procedures that can be administered to epileptics:
  • Ensure the child is in the recovery position during a seizure: they should be laying on their side with their head facing to one side.
  • Do not put anything in their mouth or try to pull at their mouth to prevent them biting their tongue, as this will risk them chipping their teeth or choking on the object.
  • Be sure to observe and record the amount of time the seizure episode lasts. If the child’s seizure ends before 5 minutes, they may not require medical attention straight away. However, if the child’s seizure lasts longer than 5 minutes, or they suffer more than one seizure in a day, first aid should be correctly administered before heading to the hospital immediately.

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