Overview
What is epilepsy?
An epileptic seizure is a sudden and transient occurrence of signs and/or symptoms that are the result of an abnormal activity of the brain. Epileptic seizures are the common and defining component of the disorder that is referred to as epilepsy. The diagnosis of epilepsy implies that there is an abnormality in the brain and that this abnormality will result in more epileptic seizures. That is, an individual that has an isolated seizure as a result of an acute transient insult to the brain, for example a metabolic disorder, or a seizure observed after an acute trauma to the brain, would not be diagnosed as having epilepsy. In other words, epilepsy is the tendency to have repeated spontaneous seizures.
Some possible causes of pediatric epilepsy:
- Fevers: Febrile seizures are one of the most common causes of seizures in pediatric patients. They typically occur during a high fever when the child is sick with a viral illness. However, this is generally not considered epilepsy as most of these seizures are benign and most of these patients do not go on to have a lasting epileptic disorder.
- Brain Malformations: Some malformations of the brain which occur during brain development can lead to epileptic conditions that present in childhood. For example, cortical dysplasia can present with pediatric epilepsy.
- Brain Tumors: Certain brain tumors which can occur in children, such as some low grade gliomas, ganglioglioma or ganglioneuroma, can be associated with pediatric epilepsy.
- Infection: Certain infections in or around the brain can lead to seizures. Some will only cause seizures during the infection but occasionally can lead to long-standing epileptic conditions. Examples include meningitis, cerebral abscess and encephalitis.
- Idiopathic: In idiopathic condition is one for which we do not know the cause. Some children who present with epilepsy do not have a known cause or the cause eludes detection until extensive work-up is performed.
- Other Causes: Other potential causes of seizures and epilepsy in children include traumatic brain injury, brain hemorrhage, arteriovenous malformation, Moyamoya disease, cerebral palsy or cerebral infarction.
What Are Some Common Treatments?
Treatment for epilepsy varies considerably from patient to patient. Treatment generally consists of medical treatments or surgical treatments. In general, patients with forms of epilepsy that are not due to a tumor or other surgical condition are started with medical treatment with anti-epileptic drugs. There are many such drugs which help to suppress seizure activity in the brain. If a patient's seizures are well controlled only with these medications then this may be the only treatment that is needed.
However, in cases where the seizures are not controlled adequately with medication, surgical treatments may be necessary. These vary but can include surgical removal of the part of the brain responsible for the onset of seizures, the seizure "focus". Likewise, if there is a known lesion in the brain such as a tumor or malformation, surgical removal of the lesion may be necessary both to treat the lesion itself as well as preventing further seizures.Some pediatric epilepsy is adequately treated with these various treatment options while other severe cases may be very difficult to control. Because there is such variability from patient to patient, each child with epilepsy or any history of seizures should be worked up fully by their own physician who can recommend the best diagnostic and treatment options for their specific condition.
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