Learning your child experiences multiple seizures can be a scary thing at first. Childhood epilepsy tends to be associated with a lot of general fear and anxiety, as the child’s family is often caught unprepared. In this blog, we will explore practical insights and guidance to help families manage childhood epilepsy with confidence and support.
What is Epilepsy?
The condition known as epilepsy is characterized by seizures, which are frequently brought on by uncontrolled electrical activity in the brain.
Childhood epilepsy
Childhood epilepsy is a neurological disease that is indicated by repeated seizures in children. The seizures range from mild to severe and could impact daily living. Parents have to collaborate closely with the professionals to properly identify the type of epilepsy their child is suffering from. Early identification and proper intervention are important to control symptoms and enhance the quality of life.
Due to its many intricacies and uncertainties, childhood epilepsy may be an overwhelming and daunting diagnosis for parents. To provide the best care for your child, you must be aware of the many types of childhood epilepsy. Every type of seizure, from absence seizures to focal onset seizures, has unique problems and requires different approaches to treatment.
Types and symptoms
The two main types of seizures are focal seizures and generalized seizures.
Focal seizures
Focal seizures, also referred to as partial seizures, impact only one side of the brain. Prior to a focal seizure, a child may experience an aura, which acts as a warning sign that a seizure is about to occur. The aura marks the onset of the seizure.
Auras may include: changes in hearing, vision, or smell, unusual feelings, such as fear or euphoria
Focal aware seizures affect just one area or side of the brain, usually involving a specific muscle group like the fingers or legs, and do not cause a loss of consciousness. During these seizures,
the individual may seem “frozen” or unable to respond but can typically still hear and comprehend their surroundings. Additional symptoms may include nausea, pale skin, and sweating.
On the other hand, focal impaired awareness seizures lead to a loss of awareness or consciousness. Symptoms can include crying, laughing, staring, and lip-smacking.
Generalized seizures
Generalized seizures affect both sides of the brain and usually cause a loss of consciousness. Children are typically sleepy and tired after the seizure. This latter effect is called the postictal state.
According to the Epilepsy Foundation, types of generalized seizures include:
Petit mal seizures, another name for absence seizures, result in a very brief loss of consciousness. The child may twitch their face, blink quickly, or gaze. They typically last fewer than 10 seconds and are more prevalent in those aged 4 to 14. Postictal states are uncommon in children with absence seizures.
During an atonic seizure, a child experiences a loss of muscle tone that comes on suddenly. They may fall down or become limp and stop responding. They usually last less than 15 seconds.
These are also called drop seizures.
A Generalized tonic-clonic seizure (GTC) or grand mal seizure, has phases. A child’s body and limbs will first contract, then straighten, and then shake. The muscles will then contract and relax. The final stage is the postictal period, where the child will be tired and confused.
GTCs usually begin in childhood and last 1–3 minutes.
Myoclonic seizure is a type of seizure that causes sudden jerking of the muscles. Myoclonic seizures usually last 1 or 2 seconds, and many can occur in a short time. People with brief myoclonic seizures do not lose consciousness.
Childhood epilepsy syndrome
If a child displays specific signs and symptoms, a doctor may diagnose them with childhood epilepsy syndrome.
The different kinds of epilepsy syndromes include:
Benign Rolandic Epilepsy of Childhood
This condition typically occurs in children between the ages of 3 and 10, affecting about 15% of children with epilepsy. It often presents with focal seizures at night, which may progress into generalized tonic-clonic (GTC) seizures. Rarely, children may experience seizures while awake,
usually manifesting as facial and tongue twitching. These seizures typically stop by the time the child reaches 16 years of age.
Infantile Spasms
Also referred to as West syndrome, infantile spasms usually begin before the child turns 1 year old. This syndrome is characterized by brief jerks or spasms in one or more parts of the body, typically occurring in clusters. It may affect infants with brain injuries, and many children with infantile spasms experience learning or behavioral difficulties. They are also at risk of developing Lennox-Gastaut syndrome.
Juvenile Myoclonic Epilepsy
This condition typically begins between the ages of 12 and 18, and it includes various types of seizures, such as myoclonic, tonic-clonic, and absence seizures. Seizures may be triggered by flashing lights or occur shortly after waking up. Juvenile myoclonic epilepsy is the most common form of generalized epilepsy and often persists into adulthood. However, symptoms may lessen over time, and seizures can usually be controlled with medication in up to 90% of cases.
Landau-Kleffner Syndrome (LKS)
Landau-Kleffner syndrome is a rare disorder that typically develops in children between the ages of 3 and 7. It primarily causes difficulties with language comprehension and verbal expression, along with behavioral challenges. Approximately 70% of children with LKS experience seizures, often focal in nature.
Lennox-Gastaut Syndrome
The typical onset of Lennox-Gastaut syndrome occurs between the ages of 3 and 5, although it can appear during adolescence. It is characterized by various types of seizures, and many children with this syndrome experience learning and behavioral problems. Treatment can be difficult, and seizures often continue into adulthood.
Temporal Lobe Epilepsy
According to the Epilepsy Foundation, temporal lobe epilepsy is the most common form of focal epilepsy, affecting 6 in 10 people with focal epilepsy. Symptoms usually appear between the ages of 10 and 20, although it can develop at any age.
Temporal lobe epilepsy symptoms may involve an epileptic aura, which is a unique sensation felt before a seizure, as well as the seizure itself. The symptoms of an epileptic aura can include experiences like déjà vu (the feeling that something is familiar) or jamais vu (the feeling that something is unfamiliar).
Risk Factors of Epilepsy in Children
- A family history of Epilepsy
- History of traumatic head injury affecting the brain
- History of brain infections like meningitis
- History of adverse issues affecting the brain at the time of birth
Treatment of Epilepsy
Anti-seizure medications
These medications form the first-line treatment of Epilepsy. Two-thirds of affected children may benefit from medical treatment, while the others may require other modes like surgery, vagus nerve stimulation, and dietary therapies.
Dietary changes
When the child does not respond well to medical therapy, dietary therapies may be an option in some epilepsy. Dietary therapies must be administered and supervised by a medical practitioner and a certified dietitian.
Family support in Epilepsy
Despite having a challenging health condition that demands various safety measures to prevent seizures, children with epilepsy still need to engage in social activities and physical exercise just like other children. Therefore, it’s important for parents and family members to create an enjoyable childhood experience for them while ensuring a safe environment that promotes happiness and good mental well-being.
Support groups and learning programs
There are many support groups and workshops available for parents and families of children with epilepsy, where you can ask questions and connect with others who have valuable experience and knowledge. Speaking with other families facing similar challenges can provide comfort, understanding, and practical advice.
Additionally, there are numerous awareness camps, educational seminars, and workshops where expert doctors and specialists share insights about the condition and guide families on how to support a child living with epilepsy. This is crucial for creating a healthy and supportive home environment for the child.
Conclusion
Caring for a child can be tough, and it may be even more challenging when your child is diagnosed with epilepsy. It’s natural to feel frustrated, uncertain, and worried about what your child is experiencing. However, your child’s healthcare team will collaborate with you to help you better understand the condition and guide you on how to support your child as they grow.
Author: Dr. Amol Kumar Jadhav
Consultant Pediatric Neurologist and Epileptologist
