Did you notice muscle twitching in your child? If yes, then your child might have epilepsy. It is common in children and people older than 65. This can be of many different types and its severity varies accordingly. It has no cure but with treatment, it can be manageable. Learn what causes epilepsy in children and treatment options in this article. Log on to www.doralhw.org for a consultation.

Causes and triggers

Epilepsy has no definite cause in children. It causes uncontrolled electrical activity between different brain cells, which causes irregular and temporary changes in the messages sent between brain cells. This irregularity causes seizure symptoms in the child’s brain until it’s gone, and the right messages start to be sent to the brain cells.

The potential causes or triggers that cause epilepsy in children are:

• Head trauma or a brain injury.
• Developmental disorders such as autism.
• Genetic issues that run in families.
• Infectious diseases like meningitis and encephalitis.
• Abnormal way of brain formation in the womb due to maternal infections or poor nutrition during pregnancy or any other cause.
• Tumors or cysts in the brain
• High fevers in childhood that lead to seizures such as febrile seizures.
• Oxygen deficiency before or during birth.

Types

Epilepsy varies in children and adults, but seizures are divided into two main types, including:

1. Focal seizures:

This type of seizure involves one spot or one side of the brain. Before a focal seizure, a child experiences an aura that signals a seizure is coming. This aura works as warning signs like changes in hearing, vision, or smell or unusual feelings, such as fear, euphoria, or a sense of Deja vu. This type of seizure affects a child’s consciousness, responsiveness, and memory. Its symptoms may include changes in behavior, thinking, or movement.

As an individual doesn’t lose consciousness in this type of seizure (like generalized seizures) they can hear or understand things around them but are not able to respond to them. It may be caused by structural abnormality in the brain; however, MRI scans are not able to pick this up, which sometimes doctors may conclude that something is wrong with the neuron, brain cell, or connections in that area.

A child may have cortical dysplasia, which is a region of the brain that is not developed properly and causes brain cells to fail to form proper connections with each other. Focal seizures also occur due to head trauma, stroke, infection, or tumors. Focal seizure symptoms are typically related to the area or lobes of the brain where the seizures start.

2. Generalized seizures:

This type of seizure occurs on both sides of the brain and causes widespread excessive electrical discharge at the same time. Its symptoms may include blinking and staring, muscle tone loss, stiffening of limbs, and full-body jerking. Children often become sleepy and tired after a seizure. This effect is called the postictal state.

According to the Epilepsy Foundation, common types of generalized seizures in children are:

• Absence seizures: It is also known as petit mal seizures, and it causes a very brief loss of consciousness. Your child may stare, blink rapidly, or have a facial twitch. It mostly occurs in ages between 4 to 14 and usually lasts less than 10 seconds. Children with absence seizures do not cause a postictal state.
• Atonic seizure: This type of seizure causes a child to experience a loss of muscle tone that occurs suddenly. They may fall or their body goes limp and stops responding, which typically lasts less than 15 seconds. It is also known as drop seizures.
• Generalized tonic-clonic seizure (GTC): This is also known as a grand mal seizure, which occurs in phases. Your child’s limbs will first contract, then straighten and then shake. The muscles will then contract and relax and lastly, the child gets tired and confused. It usually occurs in childhood and lasts 1 to 3 minutes.
• Myoclonic seizure: This type of seizure causes sudden muscle jerking which lasts for 1 to 2 seconds and may last for a short time. People with this seizure usually don’t lose consciousness.

The common types of epilepsy in children that common under these 2 types of seizures are:

1. Absence seizures/epilepsy:

This epilepsy causes short moments of confusion in children between 4 to 10 years of age. Up to 90% of children with this epilepsy get cured by the age of 12. During this epilepsy, your child may have a sudden cessation of movement, with staring and blinking, or a mild loss of body tone that makes them lean forward or backward slightly. Your child may not be able to respond to you during its episode. It occurs without an aura or warning.

2. Infantile spasms:

This is a severe type of epilepsy that occurs in infants when they fall asleep or wake up. It is also known as West syndrome and is very rare. It mostly occurs in children who are 3 to 12 months old. During the seizure episode, your child does a sudden jerking movement followed by stiffening. Sometimes a child with infantile spasms flings their arms out to bend forward. Its episodes last only for a few seconds but your baby may experience many seizures back-to-back with short breaks between them. It may occur due to a brain disorder or injury like birth trauma with oxygen deprivation, which is common in 60% of infants who have this condition and 40% of the cause is unknown. Sometimes children may also develop another epilepsy syndrome known as Lennox-Gastaut syndrome.

3. Juvenile myoclonic epilepsy:

This occurs during puberty between 12 to 18 years of age and causes different types of seizures, including myoclonic seizures, tonic-clonic seizures, and absence seizures. Its episodes get triggered by flashing lights or shortly after waking up. This is the most common generalized epilepsy syndrome, which continues into adulthood but becomes less severe and manageable with medication in up to 90% of cases.

4. Lennox-gastaut syndrome:

This is an uncommon form of epilepsy that causes a child’s muscles to stiffen up and relax suddenly. Your child may experience moments of nonawareness and confusion and are unable to respond to you during a seizure. It occurs between 3 to 5 years of age, but some people may experience it in adolescence. It may cause some different types of seizures like tonic, atonic, prolonged absences, and generalized convulsions. This is often difficult to treat and continues into adulthood.

5. Rolandic epilepsy:

Around 15% of children are diagnosed with this epilepsy; it occurs when you fall asleep or wake up. It causes uncontrolled movements, often to one side of your child’s body or also the child’s speech. It mostly affects 2 to 13-year-old children. Rarely, children may have seizures during wakefulness involving twitching of the face and tongue. These seizures stop when a child is 19 years old.

6. Landau-Kheffner syndrome:

It is a rare childhood disorder occurring in children 3 to 7 years old. It causes difficulties in language and verbal expression. Some children also have behavior problems as well. Around 70% of children with this epilepsy have obvious seizures usually focal, mainly during sleep.

7. Temporal lobe epilepsy:

This is the most common form of focal epilepsy, which affects 6 out of 10 of those focal epilepsy. Symptoms typically occur between 10 to 20 years of age but can develop at any time.

Diagnosis

To diagnose epilepsy in children, your doctor may ask about the child’s symptoms and health history. Sometimes doctors ask for a detailed description of the child’s symptoms by taking a video recording, if possible. Some forms of epilepsy are difficult to diagnose in infants and young children. Your doctor usually diagnoses epilepsy when more than one seizure occurs or when there are no other factors involved that cause a child’s seizure, such as:

• Recent fever or infection
• Head injury
• Congenital health conditions
• Preterm birth
• Recent medicines

For diagnosis, the doctor may perform these tests, including:

• Physical exam: During this exam, your doctor will check your child’s symptoms and investigate the complete medical history and biological family history.
• Neurological exam: During this exam, your doctor will evaluate your child’s brain and nervous system functions.
• Blood tests: Blood tests are used to check if there’s any underlying condition caused by a child’s symptoms.
• Imaging tests: This includes an MRI or CT scan to check brain activity.
• Electroencephalogram: This test is used to measure your child’s brain electrical activity.

Treatment

There are several treatment options used to treat epilepsy in children, including:

1. Medications:

Your doctor may prescribe antiepileptic drugs to manage their symptoms. While it may stop seizures from happening, it’s not a cure, and it doesn’t stop seizures once it’s begun. Many children may not need this medication for the rest of their lives. Parents whose children have been seizure-free for several years should talk with the doctor about lowering or coming off medication. However, don’t stop treatment without consulting with the doctor because seizures may come back or get worse. It may not control seizures in all children, in those

cases, other treatments are necessary.

2. Ketogenic diet:

In case medications are not sufficient, the doctor may recommend trying a ketogenic diet to manage their seizures. Make sure you work with a doctor and dietician when you put your child on a keto diet.

3. Neurostimulation:

If epilepsy doesn’t respond to drugs, the doctors may recommend neurostimulation. In this therapy, the doctor uses a device to send small electric currents to the nervous system. Currently, there are 3 types of neurostimulation for epilepsy treatment.

• Vagus nerve stimulation
• Responsive neurostimulation
• Deep brain stimulation

4. Surgery:

In some cases, specific children may need to go through surgery to remove a portion of the brain to prevent or lower seizures.

Epilepsy in children is different from adults; it can be severe or mild depending on the type of epilepsy your child has. However, with treatment, most children and adults can live better with epilepsy. Recent medical advancements make epilepsy more manageable than ever. It is essential to notice the symptoms earlier and seek medical help to manage the condition earlier to prevent complications and improve life quality.

Is your child showing epilepsy symptoms? Visit our clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!!

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