What causes childhood epilepsy?
Childhood epilepsy is due to uncontrolled electrical activity in the brain, which disrupts communication between brain cells. This irregular activity causes temporary interruptions in message transmission, causing seizure symptoms. Contributing factors include head trauma, birth complications, infections such as meningitis or encephalitis, brain abnormalities from birth and genetic predisposition. All of these factors can alter brain function and cause epilepsy in children.
Symptoms of epilepsy
Epilepsy manifests differently in children than in adults, often presenting subtle symptoms that can be confused with other conditions. Epileptic seizures result from abnormal bursts of electrical activity in the brain. Although they are usually brief, they can be distressing for families.
Signs that your child may be experiencing seizures may vary, but may include:
• Staring and lack of response
• Loss of consciousness or consciousness.
• Sudden or rhythmic movements of arms and legs.
• Stiffness of the body, arms or legs.
• Altered breathing
• Unexpected falls
• Nod your head
• Fast flashing
• Unusual behaviors such as murmuring, chewing, or wandering
Seizures can also cause challenges related to muscle control, movement, speech and language, vision and other senses, consciousness, as well as memory and learning.
Several risk factors and causes contribute to the development of pediatric epilepsy. These may include genetic predisposition, prenatal or perinatal factors, brain injuries, infections, and metabolic disorders. Understanding these risk factors can help healthcare providers tailor diagnosis and treatment strategies to each child’s unique circumstances.
Diagnosis of pediatric epilepsy
Accurate diagnosis is the crucial first step in the treatment of pediatric epilepsy. During the initial evaluation, the health care professional will perform a physical examination and collect a complete medical history, focusing on the child’s seizure experiences. Diagnostic tests may include:
• Electroencephalogram (EEG) to monitor brain activity during or between seizures
• Imaging scans such as magnetic resonance imaging (MRI), positron emission tomography (PET), functional MRI, computed tomography (CT), or single photon emission computed tomography (SPECT) to detect any brain abnormalities associated with seizures.
• Blood tests, including routine labs and potentially genetic or metabolic testing.
• Lumbar puncture (spinal tap) if there is concern about an infection or to rule out other underlying problems.
Treatment Options and Management Strategies
Treatment of childhood epilepsy involves several approaches aimed at controlling seizures and improving quality of life. Antiepileptic medications are commonly prescribed to control seizures and their effectiveness may vary depending on individual response. In some cases, dietary modifications, such as the ketogenic diet, may be recommended as complementary therapy.
Surgical interventions may be considered for children with drug-resistant epilepsy or specific types of seizures that originate from a focal point in the brain. These procedures aim to eliminate or disconnect the area of the brain responsible for generating seizures, reducing the frequency or severity of seizures.
For parents managing a child’s epilepsy, several tips can help relieve symptoms and improve well-being:
1. Maintain a consistent medication schedule: Administer antiepileptic medications as prescribed by the healthcare provider to ensure optimal seizure control.
2. Establish a healthy lifestyle: Encourage regular exercise, adequate sleep, and a balanced diet to promote overall health and well-being.
3. Minimize triggers: Identify and avoid factors that may trigger seizures, such as stress, lack of sleep, or certain foods.
4. Create a safe environment: Take precautions to avoid accidents during seizures, such as protecting sharp corners and securing furniture.
5. Educate caregivers and teachers: Make sure caregivers, family members, and school staff know the child’s epilepsy diagnosis and understand how to respond during a seizure.
6. Monitor and track seizures: Keep a seizure diary to record the frequency, duration, and characteristics of seizures, which can help healthcare providers adjust treatment plans as necessary.
Innovative approaches in the treatment of epilepsy
Traditional antiseizure medications (AEDs) remain essential in the treatment of epilepsy, but their limitations have prompted research into alternative strategies. These advances offer new hope for those suffering from drug-resistant epilepsy. There are several treatment options for these patients. For example, epilepsy surgery involves removing a particular point in the brain responsible for epilepsy, which is very useful and effective in such scenarios. Stimulation therapies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS), modulate brain activity to reduce seizure frequency without the need to remove brain tissue. Gene therapies and optogenetics target specific genetic mutations or neural circuits to address the underlying causes of seizures. Additionally, cannabidiol (CBD) and the ketogenic diet show promise as complementary therapies.
By staying informed about these new developments and collaborating closely with healthcare providers, parents can explore innovative treatment options and advocate for the best possible care for their child’s epilepsy.
(Article courtesy of: Dr. Atma Ram Bansal, Associate Director, Neurology, Neurosciences, Medanta, Gurugram)
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