Epilepsy in children
Seizure disorder - children; Convulsion - childhood epilepsy; Medically refractory childhood epilepsy; Anticonvulsant - childhood epilepsy; Antiepileptic drug - childhood epilepsy; AED - childhood epilepsyEpilepsy is a brain disorder in which a person has repeated seizures over time.
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
Read Article Now Book Mark ArticleA seizure is a sudden change in the electrical and chemical activity in the brain. A single seizure that does not happen again is not epilepsy.
Causes
Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown.
Common causes of epilepsy include:
- Traumatic brain injury
- Damage or scarring after infections of the brain
- Birth defects that involve the brain
- Brain injury that occurs during or near birth
- Metabolic disorders present at birth (such as phenylketonuria)
Phenylketonuria
Phenylketonuria (PKU) is a rare condition in which a baby is born without the ability to properly break down an amino acid called phenylalanine....
Read Article Now Book Mark Article - Benign or malignant brain tumor, often very small
- Abnormal blood vessels in the brain
Abnormal blood vessels in the brain
A cerebral arteriovenous malformation (AVM) is an abnormal connection between the arteries and veins in the brain that usually forms before birth....
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Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Hereditary conditions (run in families)
- Other illnesses that damage or destroy brain tissue
Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy.
A febrile seizure is a convulsion in a child triggered by a fever. Most of the time, a febrile seizure is not a sign that the child has epilepsy.
Febrile seizure
A febrile seizure is a convulsion in a child triggered by a fever.
Read Article Now Book Mark ArticleConvulsion
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
Read Article Now Book Mark ArticleSymptoms
Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected.
Your child's health care provider can tell you more about the specific type of seizure your child may have:
- Absence (petit mal) seizure: Staring spells
Absence (petit mal) seizure
An absence seizure is the term for a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) change...
Read Article Now Book Mark Article - Generalized tonic-clonic (grand mal) seizure: Involves the entire body, including aura (specific warning symptoms), rigid muscles, and loss of alertness
Generalized tonic-clonic (grand mal) se...
Bilateral tonic-clonic seizure is a type of seizure that involves the entire body. It is also called grand mal seizure. The terms generalized seizu...
Read Article Now Book Mark Article - Partial (focal) seizure: Can involve any of the symptoms described above, depending on where in the brain the seizure starts
Partial (focal) seizure
All seizures are caused by abnormal electrical disturbances in the brain. Focal seizures occur when this electrical activity is in a limited area of...
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Some children can have more than one type of seizure. Most of the time, the seizure is similar to the one before it, although that may change over time. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of déjà vu (feeling that something has happened before). This is called an aura.
Exams and Tests
The provider will:
- Ask about your child's medical and family history in detail
- Ask about the seizure episode
- Do a physical exam of your child, including a detailed look at the brain and nervous system
Your child's provider may order an electroencephalogram (EEG) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures.
Electroencephalogram
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.
Read Article Now Book Mark ArticleTo diagnose epilepsy or plan for epilepsy surgery, your child may need to:
- Wear an EEG recorder for few days during day-to-day activities
- Stay in the hospital where brain activity can be watched on video cameras (video EEG)
Your child's provider also may order other tests, including:
- Blood chemistry
- Blood sugar
Blood sugar
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the...
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Complete blood count (CBC)
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Kidney function tests
Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...
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Liver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
Read Article Now Book Mark Article - Lumbar puncture (spinal tap)
Lumbar puncture (spinal tap)
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
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Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery.
Head CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Read Article Now Book Mark ArticlePET scan of the brain
A brain positron emission tomography (PET) scan is an imaging test of the brain. It uses a radioactive substance called a tracer to look for disease...
Read Article Now Book Mark ArticleTreatment
Treatment for epilepsy includes:
- Medicines
- Lifestyle changes
- Surgery
If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed.
Medicines to prevent seizures are called antiseizure medicines. They are also known as anticonvulsants or antiepileptic medicines. These may reduce the number of future seizures.
- These medicines are taken by mouth, but some can be given by feeding tube, or intravenously (IV). The type of medicine prescribed depends on the type of seizure your child has.
- The dosage may need to be changed from time to time. Your provider may order regular blood tests to check for side effects.
- Always make sure your child takes the medicine on time and as directed. Missing a dose can cause your child to have a seizure. Do not stop or change medicines on your own. Talk to your child's provider first.
Other medicines are used to stop a seizure that doesn't stop on its own. These can be given under the tongue or by an injection into the muscle. They are called rescue medicines.
Many antiseizure medicines may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements.
Epilepsy that is not well controlled after trying a number of antiseizure medicines is called medically refractory epilepsy. In this case, your child's provider may recommend surgery to:
- Remove the abnormal brain cells causing the seizures.
- Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures.
Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, also may be helpful. Be sure to discuss these options with your child's provider before trying them.
Epilepsy is often a lifelong or chronic illness. Important management issues include:
- Taking medicines
- Staying safe, such as never swimming alone, fall-proofing your home and avoiding activities that could lead to a fall
- Managing stress and sleep
- Avoiding alcohol and medicine or illegal drug abuse
- Keeping up in school
- Managing other illnesses
Managing these lifestyle or medical issues at home can be a challenge. Be sure to talk with your child's provider if you have concerns.
Managing these lifestyle or medical iss...
Your child has epilepsy. People with epilepsy have seizures. A seizure is a sudden brief change in the electrical and chemical activity in the brai...
Read Article Now Book Mark ArticleSupport Groups
The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.
Support group
The following organizations are good resources for information on epilepsy:Centers for Disease Control and Prevention -- www. cdc. gov/epilepsy/index...
Read Article Now Book Mark ArticleOutlook (Prognosis)
Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, your provider may suggest stopping their medicines.
For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued.
Children who have developmental disorders in addition to epilepsy may face challenges throughout their life.
Knowing more about the condition will help you take better care of your child's epilepsy.
Knowing more about the condition
Your child has epilepsy. Children with epilepsy have recurrent seizures. A seizure is a sudden brief change in the electrical activity in the brain...
Read Article Now Book Mark ArticlePossible Complications
Complications may include:
- Difficulty learning
- Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia
Aspiration pneumonia
Pneumonia is inflammation (swelling) and infection of the lungs or large airways. Aspiration pneumonia occurs when food or liquid is breathed into th...
Read Article Now Book Mark Article - Irregular heartbeat
- Injury from falls, bumps, or self-caused bites during a seizure
- Permanent brain damage (stroke or other damage)
- Side effects of medicines
When to Contact a Medical Professional
Call 911 or the local emergency number if:
- This is the first time your child has a seizure
- A seizure occurs in a child who is not wearing a medical ID bracelet (which has instructions explaining what to do)
If your child has had seizures before, call 911 or the local emergency number for any of these emergency situations:
- The seizure is longer than the child normally has or the child has an unusual number of seizures
- The child has repeated seizures over a few minutes
- The child has repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus)
- The child gets injured during the seizure
- The child has difficulty breathing
Contact your child's provider if your child has new symptoms:
- Nausea or vomiting
- Rash
- Side effects of medicines, such as drowsiness, restlessness, or confusion
- Tremors or abnormal movements, or problems with coordination
Tremors
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...
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Contact your child's provider even if your child is normal after the seizure has stopped.
Prevention
There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy.
Reduce the risk of head injury during risky activities by wearing a helmet. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy.
References
Ghatan S. Pediatric epilepsy surgery. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 267.
Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs I: treatment of new-onset epilepsy: report of the American Epilepsy Society and the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Epilepsy Curr. 2018;18(4):260-268. PMID: 30254527 pubmed.ncbi.nlm.nih.gov/30254527/.
Mikati MA, Tchapyjnikov D, Rathke KM. Seizures in childhood. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 633.
Pearl PL. Overview of seizures and epilepsy in children. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 61.
Review Date: 6/13/2024
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.