Precursors to epileptic seizures in children

Written by Yan Xin Liang
Pediatrics
Updated on October 29, 2024
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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 Tong Peng
Pediatrics
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What causes benign epilepsy in children?

There are multiple causes of benign epilepsy in children, with significant genetic factors often involved. It generally occurs during a specific developmental period in childhood due to localized diseases, and the prognosis is usually good. Such seizures in children may be caused by conditions like tuberous sclerosis, cerebral trigeminal angioma, and neurofibromatosis. Intracranial infections, such as viral encephalitis, bacterial meningitis, and tubercular meningitis, can also trigger benign epilepsy in children. Therefore, once diagnosed, early intervention treatments should be initiated to prevent the symptoms from worsening. Regular follow-ups with electroencephalograms are also necessary to understand the effects of epilepsy medications and treatments.

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Written by Liu Shi Xiang
Neurology
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How is epilepsy caused?

Epilepsy is generally caused by cerebrovascular diseases, brain trauma, intracranial tumors, and central nervous system infections, and some cases of epilepsy are due to congenital genetic factors. Patients with epilepsy need to undergo timely examinations and treatments in the department of neurology. Examination methods mainly include CT, MRI, EEG, transcranial Doppler ultrasonography, cerebral angiography, etc., among which video EEG or ambulatory EEG is the most important basis for diagnosing epilepsy. Once epilepsy is diagnosed, the treatment plan needs to be decided based on the individual condition of the patient. If it is the patient's first episode, medication may not be necessary initially, and regular follow-ups are sufficient. However, if the patient frequently experiences episodes, it is necessary to promptly administer antiepileptic drugs, commonly used drugs include carbamazepine, oxcarbazepine, gabapentin, levetiracetam, etc.

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Written by Li Jiao Yan
Neonatology
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What are the symptoms of epilepsy in children?

Seizures in children manifest in various forms, but they all share characteristics of sudden onset, sudden cessation, and periodic occurrence. Common types include grand mal seizures, absence seizures, and benign childhood epilepsy. During a grand mal seizure, the child suddenly loses consciousness, stops breathing, turns blue-purple, pupils dilate, limbs stiffen, hands clench into fists, followed by spasmodic convulsions, foaming at the mouth, with the episode generally lasting 1-5 minutes. Absence seizures in children present as sudden loss of consciousness, interruption of activity, staring or rolling of the eyes, but without falling down or convulsing, lasting 1-10 seconds, with consciousness quickly returning after the episode. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, or tongue, possibly accompanied by abnormal sensations in the area, inability to speak, drooling, generally with clear consciousness, with episodes occurring more frequently at night.

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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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What are the symptoms of epilepsy in children?

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.