Epilepsy in children: from diagnosis to treatment

Epilepsy is a disorder of the brain wherein the affected individual becomes very susceptible to suffer from recurring seizures. A seizure occurs because the neurons or the nerve cells are unable to emit the appropriate signals that are needed to stimulate various parts of the body, creating an unmanaged state of uncontrolled body actions, often called ‘body-jerks’. The seizures can take a life-threatening form since they occur without any primary, notifying symptoms and are often accompanied by damaging symptoms of violent spasms and phases of complete loss of consciousness. There are no age limits for epilepsy and it is found among people of all ages. Nearly one-third of all new cases of epilepsy diagnosed each year are children. It can happen in early childhood or in adolescence.

It is largely believed that epilepsy occurs due to a range of factors, varying from a prolonged illness, a severe injury to the brain, along with other factors such as impaired brain development. However, these are just some commonly-speculated causes and many times, particularly among epileptic children, the cause is never diagnosed. In such cases, the diagnosis depends upon lots of medical tests that involve various brain scans and behavioral studies to identify typical epileptic patterns. It should be understood that there is no single cure or medical drug that can treat epilepsy-it is a sustained medical condition that can be limited by taking medications such as anti-seizure drugs. Among the more severe cases, a surgical route is taken wherein various implants are used to control the action of vital nerves like the Vagus nerve.

Understanding epileptic children

Epileptic seizures in children are often stimulated by an underlying illness or common causes such as high fever and even a state of low blood sugar level. During the examination of such children, the idea is to detail the ability of the child to control his actions during a seizure-like episode and decode the degree of vulnerability to have a seizure. Some commonly-discussed questions with children showing epilepsy-like symptoms include:

– Timing – the seizure occurred during the daytime or during the night and whether the child was asleep or awake?

– Relation of the seizure to mental conditioning – some seizures tends to begin after an argument or some days of emotional lows at the school or at home.

– Medical history – some children develop seizures due to a drug reaction induced by some medications they have been taking over a period of time. Similarly, the seizure-like tendency is often passed through genetic history.

– Tendency to harm themselves – many children report of injuries sustained due to suddenly falling on the ground and bruising themselves or typical symptoms like biting or swallowing their tongues.

When a child has seizures

After a child has seizures, he is given a comprehensive physical exam. Doctors will also look closely at the child’s complete medical history, including the child’s birth, to see if there might be any clues to what is causing the seizures. Some things the doctors will look for is a history of vomiting, diarrhea, dehydration, or altered consciousness.

Seizure symptoms in children

It is important for the family members are able to explain the kind of seizure that the child suffers from. This should include details about the movements of the eye, loss of consciousness, the extent of bodily twitching, intensive chewing, and strange movements of the hand or sudden loss of bladder control. Some children may not recall the seizure at all after recovering from the seizure. While some children may tend to sleep after having the seizure or ask questions about what had happened to them. Each of these features should be reported to ensure that the medical opinion is accurate and appropriate medications can be prescribed. In fact, many healthcare practitioners believe that the ability of the family to record and present the right kind of seizure history for medical evaluation is sometimes the most important step towards controlling the condition.

The need for visual diagnosis

This is why many epileptic children are placed in rooms with video recorders to ensure that their history of seizures is visually detailed. This is also because smaller children are unable to explain the kind of discomfort they are suffering from.

When seizures are accompanied by extensive disorientation, children cannot recall or explain what had happened, rendering the entire medical opinion-forming process to be based upon speculation rather than having a first-hand account for an accurate diagnosis. Some children also don’t report the events due to shyness or embarrassment.

This is typically explained by children who often report minor bruises on their bodies due to some playful activity whereas, in reality, the cause is often falling due to a mini-seizure. In such cases, parents are often advised to maintain stricter visual control on the child, along with preparing themselves with first-aid medications. This is why spotting epilepsy is the precursor to treating epilepsy and the entire family should be united in fighting this medical condition rather than ignore it or be embarrassed about it.

Your child’s health depends on the timely diagnosis of this disease. EEG is the most reliable modern diagnostic method. What happens to your child during electroencephalography? Is it scary or dangerous? There is no reason to wait, you can establish the correct diagnosis today!

Treatment of epilepsy in children: are there effective methods?

For the most part, children respond well to drug therapies, and their epilepsy can be controlled that way. In fact, it appears that many children who are diagnosed when young will outgrow epilepsy and can stop taking the medication.

Children who suffer from severe epileptic seizures with the cause of the seizures well-defined might be candidates for surgery, which removes the part of the brain causing the seizures but does not cause any impairment to overall brain function. Surgery has the best results when performed on young children who are still growing. This is because the brain can better rearrange and repair itself in growing children than it can in a child who has reached puberty.

If doctors are able to find the cause of the seizures and pinpoint the exact area of the brain that is affected, surgery is recommended to proceed as soon as possible. This is to help children avoid long-term drug treatment and reduce the risk of more seizures, which can impair a child’s social, physical, and intellectual development.

Children with epilepsy are able to live fairly normal lives, but parents do need to take a few precautions. Teachers, coaches, and other adults who will be supervising the child should be told about the possibility of seizures and the procedure for dealing with them. With proper supervision, children who have seizures are able to play sports and get involved in most activities. Parents should show caution to activities that trigger a seizure or if seizures cause the child to blackout, contact sports should be ruled out.

Epilepsy and pregnancy

There are a lot of concerns that a woman with epilepsy will have in regard to having a healthy pregnancy. Her biggest concern will most likely be whether the baby will be at risk from the medications she takes during the pregnancy and whether the baby will inherit epilepsy. Before pregnancy occurs, the woman should meet with her doctor to discuss the possible risks.

Whether the baby will inherit the mother’s epilepsy is determined by the mother’s own cause of the seizures. If the mother has a low threshold for seizures and the father does as well, the baby’s chance of inheriting epilepsy increases. If the reason for epilepsy has to do with an injury, the chances of passing along epilepsy are low.

Some medications can cause birth defects. A woman considering pregnancy is advised to check with her doctor to see if her medications can be adjusted to create a lower risk. This trial period should be done before pregnancy, if possible. Some women will need to be taken off the medications altogether. Women with epilepsy need to be well-informed about their own risk of seizures with the changes in drug therapy.

Dr. Ali Elahi

This article is written by Dr. Ali Elahi, a specialist in neuromuscular disorders, certified by the American Board of Psychiatry and Neurology (ABPN). His expertise includes evaluation and treatment of patients with epilepsy, stroke, headache, neuromuscular disease, and cerebral palsy.He also manages neurological emergencies in the Intensive Care Units.

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