Childhood Epilepsy: Types, Symptoms, Causes and Treatment

Childhood epilepsy is a neurological disorder that causes a malfunction of neuronal activity of the brain. This disease stands out for the epileptic seizures it causes in children, giving rise to strong convulsions that affect the muscles in one or several areas of the body and that, sometimes, cause loss of consciousness and blows due to falls.

Next, we explain what childhood epilepsy consists of, what types of epileptic seizures exist and what their symptoms are, as well as the causes and available treatment.

What is childhood epilepsy?

Childhood epilepsy is a disease of the nervous system characterized by an abnormal discharge of electrical impulses in certain areas of the brain and cerebral cortex Children who suffer from this chronic disorder have recurrent attacks or convulsions, called epileptic seizures.

This disease usually manifests itself in various ways, depending on the brain structure affected and the region where the epileptic seizure originates. These crises can be simple, without the child losing consciousness, or complex, in which a loss of consciousness does occur. Seizures may be short and last just a few seconds, or they may be long and last several minutes.

The effects of childhood epilepsy on the child and his or her environment also vary depending on factors such as age, types of seizures, the child’s response to treatment, or whether there are other concomitant health problems.

The incidence of childhood epilepsy is estimated between 40 and 100 cases per 100,000 boys and girls, and affects more than 10 million children worldwide. 40% of the total new cases are detected in children under 15 years of age.

Types of epileptic seizures (and their symptoms)

Epileptic seizures that occur in a disease such as childhood epilepsy can be classified into two large groups: those that cause focal or partial seizures and those that cause generalized seizures. Within each category, up to 30 types of epileptic seizures have been described.

Focal or partial

Around 60% of childhood epilepsies present with focal or partial seizures These originate on only one side of the brain and are described based on the brain area in which they originate (e.g., frontal lobe or medial temporal lobe). Its duration ranges between 1 and 2 minutes.

During this type of crisis, the child does not lose consciousness and may have strange sensations, such as intense memories, which can be expressed in different ways. Motor symptoms include various automatisms, blinking, tics, mouth movements, etc. The child may also experience intense emotions (joy, anger, sadness, etc.) and sensory-perceptive alterations.

In focal crises there may be some alteration in the level of consciousness, which generates in the patient a sensation of being in a cloud or in a dream. In some cases, children feel an “aura” or prodrome, a sensation that allows them to anticipate the occurrence of an imminent epileptic seizure.

The characteristic symptoms of focal seizures can confuse clinicians and be misinterpreted as signs of other illnesses, such as narcolepsy, fainting, or even some mental illnesses. That is why a good differential diagnosis and the application of different tests are required.

Generalized

In generalized epileptic seizures, abnormal electrical discharges occur on both sides of the brain These types of seizures can cause loss of consciousness, leading to falls and generalized muscle spasms. There are different types:

Causes

The most common causes of childhood epilepsy may be genetic and hereditary, due to trauma, brain development anomalies, infections and diseases, metabolic disorders, tumors and other problems. In fact, any phenomenon that disrupts a normal pattern of brain activity can cause epilepsy.

Genetic factors, such as mutations, play an important role in some types of epilepsy that have a strong hereditary component. In some cases, alterations in genes can occur spontaneously and without a family history. For example, mutations that affect ion channels have been described, such as those in the SCN1A gene, responsible for the epileptic seizures that occur in severe myoclonic epilepsy of childhood or Dravet syndrome.

Brain damage may also be a determining factor in the onset of childhood epilepsy. This It can originate at different stages of growth: during pregnancy, early childhood or adolescence Malformations in blood vessels and cerebrovascular diseases can also be factors responsible for producing an epileptic disorder.

Other diseases such as cerebral palsy or metabolic disorders such as phenylketonuria may be related to childhood epilepsy. It is believed that 20% of epileptic seizures have their origin in neurological development disorders and the most common ones tend to occur in children with autism spectrum disorders and severe intellectual deficiency.

Treatment

To treat childhood epilepsy, doses of antiepileptic drugs are used that are usually administered depending on the type of epilepsy, the age and weight of the affected child, divided into two or three daily doses. The neurologist is in charge of monitoring the pharmacological treatment, taking into account possible side effects and interactions with other medications. A correct diagnosis is also essential.

Most single-drug treatments (known as monotherapy) are effective in reducing and eliminating the incidence of seizures, without significant unwanted effects. However, periodic controls are usually carried out with tests such as electroencephalography, to collect data on the functioning of brain activity; and blood tests, to assess tolerance and levels of the drug in the blood plasma.

Sometimes, a small number of epilepsies can be difficult to control and it is necessary to introduce several drugs at the same time, with the consequent increase in the risk of interactions and side effects. In cases where pharmacological treatment does not work and the child is resistant to its effects, surgery can be considered as an alternative.

The surgical intervention is planned taking into account the area of ​​the brain where the seizures originate (epileptic focus). An excision of this area can be performed; section several brain areas so that the seizures do not spread; A callosotomy can be carried out, which involves sectioning the network of neuronal connections between hemispheres; or perform a hemispherectomy, in which half of the cerebral cortex or hemisphere is removed, a drastic technique used only as a last resort.