What is childhood epilepsy?

Written by Yan Xin Liang

Pediatrics

Updated on September 04, 2024

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Epilepsy is a persistent brain disease characterized by recurrent epileptic seizures, abnormal perceptions, and associated neurological, cognitive, psychological, and social issues. An epileptic seizure refers to sudden, brief symptoms and signs caused by excessive and abnormal discharges of brain neurons. Depending on the affected brain functional areas, clinical manifestations can vary, including disturbances in consciousness, motor functions, sensory abnormalities, as well as psychiatric and autonomic nervous system dysfunctions. It is important to note that epileptic seizures and epilepsy are two distinct concepts.

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What are the initial symptoms of epilepsy?

The initial symptoms of epilepsy mainly manifest as localized neurological symptoms, including sudden weakness of one limb, numbness, or sudden loss of consciousness, limb convulsions, upward staring of the eyes, incontinence, and more. Therefore, when patients exhibit the above symptoms, the possibility of epilepsy should be considered. It is essential for patients to visit the neurology department of a hospital promptly to undergo examinations such as video EEG, dynamic EEG, and MRI of the head to confirm the diagnosis. Once the diagnosis is confirmed, appropriate medications should be administered promptly to terminate the epileptic episodes. When a patient experiences a major epileptic seizure, medications such as diazepam and sodium valproate should be administered to stop the seizure and prevent the development of a continuous epileptic state. Additionally, patients should regularly take anti-epileptic drugs as part of their treatment. Common medications include levetiracetam, carbamazepine, and gabapentin.

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Pediatrics

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Can children's epilepsy be effectively treated?

Can childhood epilepsy be cured? Firstly, it depends on the type of epilepsy. If the symptoms are not very severe, the frequency of convulsions is low, and comprehensive exams such as brain MRI and genetic testing show no problems, and the child's intellectual development is normal, then this type of epilepsy might be curable. Generally, after 2 to 3 years of effective antiepileptic drug treatment and then gradually discontinuing the medication if there are no further seizures, the condition can usually be controlled. However, some types of epilepsy are associated with underlying diseases, such as cerebral palsy, inherent metabolic genetic disorders, poor brain development, or organic brain lesions. The treatment outcomes for these types of epilepsy are not good, and they are generally difficult to control.

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Best treatment time for childhood epilepsy

The best time to treat pediatric epilepsy is as early as possible; the earlier the child's condition is discovered, the better the treatment outcome will be. Especially when the child has their first seizure, such as with febrile convulsions or afebrile convulsions, if epilepsy appears for the first time, it is crucial to promptly check the child with a head CT scan or MRI and an electroencephalogram (EEG). If a specific cause is identified, treatment should be tailored to the child's specific condition. It is essential to bring the child to the hospital for a thorough examination as soon as possible, ensure a timely diagnosis, and administer medications promptly, as this is critically important for the child's future prognosis.

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Neurology

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Why does epilepsy occur at night?

Epilepsy that occurs at night is called sleep-related epilepsy. There are many reasons for this phenomenon, such as excessive fatigue, irregular sleep, menstrual onset, anxiety, depression, and more. Additionally, some patients exhale more carbon dioxide during sleep, causing hyperventilation and internal environmental imbalances, which can easily lead to abnormal discharges of brain neurons. When some patients experience symptoms of epilepsy at night, timely intervention and treatment are needed. First, patients should develop a good lifestyle, go to bed on time, get up on time, avoid staying up late, and avoid excessive fatigue. Furthermore, targeted medication should be given to prevent the onset of the condition. Common medications include lamotrigine, levetiracetam, carbamazepine, and sodium valproate. Besides, patients also need to maintain a good mindset and avoid tense and anxious emotions that could exacerbate symptoms.

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Can mild epilepsy be treated?

Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.