What are the symptoms of epilepsy in children?

Written by Yan Xin Liang
Pediatrics
Updated on September 24, 2024
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Common symptoms of epilepsy in children generally include sudden convulsions. During a convulsion, the typical manifestations are tightly closed or staring eyes, rolled-up eyeballs, clenched teeth, twitching at the corners of the mouth, frothing at the mouth, head and neck thrown back, and repetitive flexing or rigid shaking of the limbs. Generally, these can last for a few minutes, or vary from several seconds to ten minutes. Of course, there are also focal seizures, such as twitching of one side of the body, or absence seizures. Some infantile spasms are characterized by jackknife movements, occurring in clusters, with each display being different. The symptoms described earlier are typical of a generalized tonic-clonic seizure.

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Written by Liu Shi Xiang
Neurology
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What can severe epilepsy lead to?

Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.

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Written by Tang Bo
Neurology
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What causes epilepsy relapses?

Epilepsy is a clinical syndrome caused by highly synchronized abnormal discharges of brain neurons due to various reasons. Clinically, it is characterized by episodic, transient, repetitive, and stereotyped manifestations, making recurrence a characteristic of the disease itself. The location of the neurons with abnormal discharges and the range of the abnormal discharge waves vary, leading to different forms of seizure symptoms in patients. These can manifest in various ways, including sensory, motor, consciousness, psychiatric, behavioral, and autonomic nervous system dysfunctions, and may occur simultaneously. Each seizure and each type of seizure process is referred to as an epileptic seizure. Of course, a patient can experience one or several types of epileptic seizures, thus, recurrence is a characteristic of epilepsy itself.

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Written by Yan Xin Liang
Pediatrics
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Precursors to epileptic seizures in children

The majority of childhood epilepsy seizures occur without any precursors, as they arise and cease suddenly with stereotyped movements. However, some seizures are preceded by prodromes, such as sudden onset of consciousness disturbances, or fainting symptoms. Other seizures can present with motor dysfunctions, displaying sudden weakness or fatigue in certain limbs, followed by an epileptic attack. Additionally, some may experience abnormal sensations, such as numbness in a specific area or visual disturbances, including sudden flashes or even visual distortions, leading to convulsive seizures.

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Written by Yan Xin Liang
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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Written by Shi De Quan
Neurology
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What is an effective treatment for epilepsy?

To effectively treat epilepsy, it is crucial to adhere to the principles of medication use and cessation. First, epilepsy medication should generally be administered for one to two years without seizures before gradually reducing the dose. If seizures reoccur after dose reduction, or if there is significant worsening on electroencephalography (EEG), the dosage should be restored. If switching medications, take both medications concurrently for about a week, then gradually reduce the original medication to cessation while increasing the new medication to an effective dose. These are the principles of medication exchange and use. Then, consider the principles for attempting medication cessation. Generally, medication should not be ceased any earlier than one year and abrupt cessation should be avoided to prevent epilepticus status. If there is clear organic brain disease, persistent positive neurological signs, or continuous mental disorders with abnormal EEG readings, lifelong medication may be necessary. Some suggest that individuals older than 30 should be cautious about stopping medication. Since the recurrence rate upon cessation can exceed 50%, lifelong medication may be necessary.