About 300,000 American children under the age of 14 have epilepsy. It affects children at different ages, and in different ways. For some, it will be a temporary problem, easily controlled with medication, outgrown after a few years. For others, it may be a lifelong challenge affecting many areas of life. Medical treatment of childhood epilepsy is getting better and research towards a cure continues.
Some Facts About Epilepsy
- It may be time-limited or long-term.
- Early recognition and treatment are keys to the best possible outcome.
- It may be associated with serious, difficult-to-treat syndromes, including infantile spasms, Lennox-Gastaut syndrome, genetically related conditions and developmental disorders.
- Social impact in childhood is often severe, producing isolation and loss of self-esteem.
Causes of Childhood Epilepsy
Epilepsy is a disorder of the brain. A child’s brain contains billions of nerve cells. They communicate with each other through tiny electrical charges that fire on and off in random fashion. When some or all of these cells suddenly begin to fire together, a wave of electrical energy sweeps through the brain, causing a seizure.
Seizures interfere with the child’s normal brain functions.They produce sudden changes in consciousness, movement or sensation.
Some people use the term “seizure disorder” instead of “epilepsy” to describe this condition. Both mean the same thing— an underlying tendency to experience seizures.
Having a single seizure does not mean a child has epilepsy. Epilepsy is the name for seizures that happen more than once without a known treatable cause, such as fever or low-blood sugar.
Often Starts in Childhood
While epilepsy can begin at any time of life, 50 percent of all cases begin before the age of 25. Many start in early childhood. One reason is that immature brains are more susceptible to seizures.
Pinpointing the cause of epilepsy is difficult at any age. In seven out of every ten cases, there is no known cause and those having seizures are labeled as having idiopathic epilepsy. “Idiopathic” is a Latin word meaning “of unknown cause.”
There are many possible causes in children. These include problems with brain development before birth; lack of oxygen during or following birth; a head injury that leaves scaring on the brain; unusual structures in the brain; tumors; a prolonged seizure with fever, or the after-effects of severe brain infections such as meningitis or encephalitis. When a cause can be identified, these children are labeled as having symptomatic epilepsy. The seizures are believed to be a symptom of the underlying brain injury.
Epilepsy is a common disorder, and frequently within an extended family more than one person may have seizures.
In most cases, a specific pattern of epilepsy within the family cannot be determined. However, there does appear to be a slightly increased risk of epilepsy in close relatives of individuals with seizures compared to the risk in the general population.
Sometimes there’s a family history of seizures, including febrile (fever-caused) seizures, epilepsy or seizures in childhood that later went into remission.
Absence and juvenile myoclonic epilepsy are two types of epilepsy that tend to run in families and are thought to have a genetic basis.
A great deal of research is ongoing to find the genetic roots of some forms of epilepsy or the inherited conditions that have seizures as a primary symptom.
Informed, understanding relatives are a wonderful source of strength when a child has epilepsy. But some may have beliefs about this condition that hail from an earlier time. They may think it is somehow linked to mental illness (it isn’t), or someone’s fault (wrong), or is related to mental retardation (usually not), or is even a sign of spiritual possession (an old myth that still lingers). Helping family members understand the true nature of epilepsy as a medical condition affecting brain function will set these fears at rest.
Dealing With Risk
A seizure that ends normally after a minute or two is usually not hazardous to a child who has epilepsy.
However, risks increase when the seizure happens near water, at heights, near traffic or in any setting in which sudden loss of awareness could be dangerous.
Parents naturally want to protect a child who has this extra level of risk on top of all the other risks that accompany a normal childhood.
However, excessive concern about risk may isolate children with epilepsy from others and reduce social interaction.
Unless your child’s doctor recommends otherwise, sports activities and other exercise are as beneficial to a child with epilepsy as they are to any other child.
In general, school sports activities and gym should be open to all children, including children with seizures. Safety measures such as harnesses, shock absorbing mats and adult supervision should reduce risks.
Coaches and other officials should be aware that the child has seizures, and how the parents want them to be managed.
Wearing safety helmets when riding a bicycle, or for sports where head injury is possible, should reduce risk.
Seizures and School
Having seizures at school can be socially damaging to a child and frightening to others. However, it doesn’t have to be.
A well-informed, confident teacher and a supportive school nurse and school administration can make all the difference in the world.
Take time to meet with your child’s teacher before the beginning of each school year to discuss how epilepsy affects your child, what type of seizures he or she has, and how you would like the teacher to handle the seizures when they occur.
As seizures are a common problem, many teachers will have had other students with epilepsy. If your child’s teacher is unfamiliar with seizures and needs information, contact your local Epilepsy Foundation affiliate.
Videos, pamphlets and first aid presentations available from the Epilepsy Foundation have a basic message: that students with seizures belong in school and are in no way a threat to other children.
Treatment for Children
Childhood epilepsy is usually treated with seizure-preventing medicines called antiepileptic or anticonvulsant drugs. If the drugs don’t work, or the child has a lot of side effects, surgery or the ketogenic diet may be tried. If surgery is not an option, or the diet does not work, a new form of therapy called vagus nerve stimulation (VNS) may be tried.
Finding the Right Drug
The search for the best medication for any individual child may take a long time. Children, like adults, respond to medications in different ways. Several drugs and different combinations of drugs may have to be tried in an effort to get the seizures under control.
The goal of treatment is to achieve the greatest level of control and the lowest level of side effects, at the lowest possible dose.