Epilepsy is a central nervous system condition in which clusters of nerve cells (neurons) in the brain misfire and send abnormal electrical signals that cause the body to respond in unusual ways. Neurons normally send electric and chemical signals to muscles, glands and other nerve cells to produce needed thoughts and actions.
A seizure can be caused when a group of neurons repeatedly misfires all at once. Seizures involve different involuntarily actions in the body such as:
Epilepsy is a common condition with the highest incidence of diagnosis occurring in early childhood. More than 450,000 children and adolescents in the United States are living with epilepsy.
In nearly half of all people with epilepsy and seizures, the cause is unknown (idiopathic). In other cases, epilepsy and seizures can be linked to specific causes or other conditions, including:
While many children may experience one seizure during childhood, an epilepsy diagnosis requires two or more unprovoked seizures that occur at least 24 hours apart.
There are different types of seizures, which can be mild to severe and can happen frequently or infrequently.
This type of seizure starts in a specific part of the brain. Children with focal seizures may experience sudden feelings of sadness or joy, or they may hear, taste, smell and see things that are not there. They may feel like they are in a dreamlike state and show repeated facial movements such as blinking. Focal seizures usually only affect one part of the brain, but they can become generalized, involving the entire brain.
These seizures impact the whole brain all at once. The abnormal nerve activity happens quickly, causing a variety of symptoms, from loss of consciousness to major muscle contractions. There are different kinds of generalized seizures:
Seizures can happen at any time, day or night. They can last for a few seconds or a few minutes. A child may recover quickly after a seizure, or it may take several hours for him or her to recover. Children may experience certain symptoms after a seizure, including:
Many forms of epilepsy require lifelong treatment to control the seizures, but some children do outgrow the seizures. For most children diagnosed with epilepsy, medicines and surgery control and reduce seizures.
Most children with epilepsy lead normal and productive lives. They can participate in the same activities as other children but may need closer supervision, such as not riding a bicycle or swimming without an adult nearby.
Doctors at Riley at IU Health perform the following exams and tests to diagnose epilepsy and seizures:
The goal of epilepsy treatment is to reduce and control the number and frequency of seizures. Medicines work to manage seizures in most children, but about 25 percent of children have epilepsy that is resistant to medicine. These children often respond to surgery and implantable devices.
There are more than 20 antiepileptic medicines now available to control seizures. Some children require more than one medicine or a combination of medicine and other treatments.
When seizures do not respond to medicines or are difficult to control, a highly specialized type of diet may be used. The ketogenic diet is often initiated in the hospital by your child’s neurologist, pediatrician and dietician. The modified Atkins diet is similar to the ketogenic diet, but it can be started at home. Children following these diets are monitored every three months. Changes may be made to the diet in between visits in consultation with your child’s neurologist and dietician.
Seizure surgery is a good option for children with a specific and identifiable area in the brain that causes their seizures. This means there is a specific, localized group of abnormal brain cells that send abnormal signals and cause irregular brain activity at random. The neurologist can see the exact spot or focus of seizure activity in the brain on an EEG or MRI scan. If the seizure focus can be safely removed, surgery may be the best treatment to stop your child’s seizures. Surgery may also involve breaking the connection between different brain tissues that are causing seizures.
Patients with frequent generalized seizures that are resistant to medicines may respond well to a surgically implanted device that helps control seizure activity. A vagal nerve stimulator uses a generator that is implanted in the fatty tissue under the skin in the left chest, as well as an electrode array (wire) that is wrapped around the left vagus nerve and connected to the generator. The stimulator controls seizure activity by sending electrical impulses to the brain from the vagus nerve in the neck.
It is important to find treatments that work to control the seizures to reduce the possible risk of more serious complications. In rare cases, some children with epilepsy may be at risk for sudden unexplained death in epilepsy (SUDEP). Researchers believe gene abnormalities that impact epilepsy and heart function may be the cause of SUDEP. Genes tied to specific types of epilepsy have been identified as well as biological links between epilepsy and heart dysfunction. This knowledge is aiding researchers as they look for potential risk factors and new treatments.
View these links to discover support groups and more resources for epilepsy and seizures.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This organization advocates for families living with epilepsy, funds research for new treatments and provides resources and support to patients.
This nonprofit organization raises funds for epilepsy research. The site includes educational information about epilepsy and research updates.
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