Epilepsy - children
Epilepsy is a brain disorder in which a person has repeated seizures over time.
A seizure is a sudden change in the electrical and chemical activity in the brain. A single seizure that does not happen again is NOT epilepsy.
Seizure disorder - children; Convulsion - childhood epilepsy; Medically refractory childhood epilepsy; Anticonvulsant - childhood epilepsy; Antiepileptic drug - childhood epilepsy; AED - childhood epilepsy
Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown.
Common causes of epilepsy include:
Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy.
Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected.
Your child's health care provider can tell you more about the specific type of seizure your child may have:
Most of the time, the seizure is similar to the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of déjà vu (feeling that something has happened before). This is called an aura.
Exams and Tests
The provider will:
The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures.
To diagnose epilepsy or plan for epilepsy surgery, your child may need to:
The provider also may order other tests, including:
Treatment for epilepsy includes:
If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed.
Medicines to prevent seizures are called anticonvulsants or antiepileptic drugs. These may reduce the number of future seizures.
Many epilepsy drugs may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements.
Epilepsy that is not well controlled after trying a number of antiseizure drugs is called "medically refractory epilepsy." In this case, the doctor may recommend surgery to:
Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, also may be helpful. Be sure to discuss these options with your child's provider before trying them.
Epilepsy is often a lifelong or chronic illness. Important management issues include:
Managing these lifestyle or medical issues at home can be a challenge.
The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.
Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, the provider may stop medicines.
For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued.
Children who have developmental disorders that also cause epilepsy may face challenges throughout their life.
Knowing more about the condition will help you take better care of your child's epilepsy.
Complications may include:
When to Contact a Medical Professional
Call your local emergency number (such as 911) if:
If your child has had seizures before, call 911 for any of these emergency situations:
Call the provider if your child has new symptoms:
Contact the provider even if your child is normal after the seizure has stopped.
There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy.
Reduce the risk of head injury during risky activities. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy.
Camfield PR, Camfield CS. Pediatric epilepsy: an overview. In: Swaiman KF, Ashwal S, Ferriero DM, Schor NF, eds. Swaiman's Pediatric Neurology: Principles and Practice. 5th ed. Philadelphia, PA: Elsevier; 2012:chap 50.
Freeman J, Harvey S. Seizures and epilepsies. In: South M, Ashwal S, Isaacs D, eds. Practical Paediatrics. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2012:part 17.1.
Mikati MA, Hani AJ. Seizures in childhood. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 593.
Morris GL III, Gloss D, Buchhalter J, Mack KJ, Nickels K, Harden C. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;81(16):1453-1459. PMID: 23986299 www.ncbi.nlm.nih.gov/pubmed/23986299.
Review Date: 5/21/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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