Pediatric Epilepsy

Epilepsy Information 2012

Pediatric Epilepsy

Pediatric epilepsy is a type of childhood seizure disorder that can be quite serious. Epilepsy is a condition, not a disease that is characterized by seizures. The seizures must occur more than twice for a child to be considered to have epilepsy. It is quite possible for children to experience only one seizure for their entire lives. Single seizures may be caused by a metabolic problem or a serious brain trauma.

There are several suggested causes of pediatric epilepsy and these include brain infections (meningitis, encephalitis or cerebral abscess), brain tumors (ganglioglioma, glioma or ganglioneuroma), malformations during brain development (hemimegalencephaly, arteriovenous malformation or focal cortical dysplasia), and high fevers. Fevers may cause febrile seizures which may not re-occur. Other causes of pediatric epilepsy include brain hemorrhage, brain injury, lack of oxygen to the brain, genetics, hydrocephalus and cerebral palsy.

The most common cause of pediatric epilepsy is thought to be cortical dysplasia, which is poor development of the cerebral cortex. The cerebral cortex contains a significant percentage of brain cells and controls thoughts and actions.

There are 2 main types of seizures in pediatric epilepsy; generalized seizures and partial seizures which are also referred to as focal seizures. Generalized seizures involve the whole brain while partial seizures involve a part of the brain. Focal or partial seizures may spread out and involve the entire brain. When this happens, the partial seizure is referred to as a secondary generalized seizure. During generalized seizures, the child loses consciousness but this is not necessarily the case during partial seizures. When consciousness is lost during a partial seizure, it is called a complex partial seizure (also called psychomotor or temporal lobe seizures) while a simple partial seizure has no loss of consciousness.

The symptoms of epilepsy, which include loss of consciousness, will depend on the type of seizure. For generalized seizures, symptoms are elevated heart rate, high blood pressure, pupil dilation and blue lips and skin (cyanosis). Generalized seizures are of different types which are grand mal seizure (tonic clonic seizure), petit mal seizure (absence seizure), myoclonic seizures, atonic seizures and tonic seizures.

Symptoms of partial seizures will depend on the area of the brain involved in the seizure. Some symptoms include feeling of de ja vu, pallor, flushed skin, sweating, anger or fear and epigastric pain.

In pediatric epilepsy, it is crucial to make a correct diagnosis as this enables a suitable treatment plan to be drawn up. Treatment is usually in the form of anti-epileptic medication. If the drugs do not control the seizures, surgery is considered a viable option. There are 3 types of surgeries that may be performed. These are corpus collosotomy, respective surgery which are both performed on the brain, and vagal nerve stimulation in which a stimulator is implanted on the vagus nerve.