Epilepsy in Children: Symptoms & Diagnosis

Epilepsy isa neurological condition (affecting the brain and nervous system) where a person has a tendency to have seizures that start in the brain. The brain is made up of millions of nerve cells that use electrical signals to control the body’s functions, senses and thoughts. If the signals are disrupted, the person may have an epileptic seizure (sometimes called a ‘fit’ or ‘attack’). Not all seizures are epileptic.Other conditions that can look like epilepsy include fainting (syncope) due to a drop in blood pressure, and febrile convulsions due to a sudden rise in body temperature when a young child is ill. These are not epileptic seizures because they are not caused by disrupted brain activity.

What Causes Epilepsy?

Epilepsy can be caused by infections, genetic mutations, brain injury or a tumor, abnormal blood vessels, or bleeding in the brain. Kids with Down syndrome, autism, and some metabolic disorders also may have epilepsy. Some types of epilepsy run in families. More than half of epilepsy cases are idiopathic, meaning there's no clear cause, but this is changing as more genetic mutations are found.

Symptoms

Seizures are not always recognised in children when they first occur. Seizures can be subtle and short, such as an ‘absence seizure’ in which the child has brief episodes of decreased awareness and responsiveness.Some childhood events that may be confused with seizures are:

• Fainting spells
• Breath-holding spells
• Normal sleep jerks
• Daydreaming
• Night terrors in young children
• Migraine
• Heart and gastrointestinal problems
• Psychological problems.

Diagnosing a Seizure in a Child

Diagnosing a seizure can be tricky. Seizures are over so quickly that your doctor probably will never see your child having one. The first thing a doctor needs to do is rule out other conditions, such as nonepileptic seizures. These may resemble seizures, but are often caused by other factors such as drops in blood sugar or pressure, changes in heart rhythm, or emotional stress. Your description of the seizure is important to help your doctor with the diagnosis. You should also consider bringing the entire family into the doctor's office. The siblings of children with epilepsy, even very young kids, may notice things about the seizures that parents may not. Also, you may want to keep a video camera handy so that you can tape your child during a seizure. This may sound like an insensitive suggestion, but a video can help the doctor enormously in making an accurate diagnosis.

Caring for a Child During a Seizure

During a simple or complex partial seizure, the child should be placed facing the side (recovery position) and no objects should be put into his/her mouth. Forcing spoons, sticks or fingers into the mouth of a child during a seizure can break teeth or injure his/her mouth. Saliva should be wiped away from the outside of the mouth. The seizure should be timed and medical help sought if the seizure lasts more than 5 minutes and is not stopping. A seizure doesn’t always mean a child has epilepsy. Fever, blow to the head or an illness can also cause a seizure. In these children, once the cause of the seizure is removed, the child usually does not need medication to prevent seizures from occurring again.

Try to keep the epilepsy in perspective for the child and for the rest of the family, including grandparents. Siblings can feel overlooked when one child has additional needs. Epilepsy is sometimes related to family genetics. If you are planning a baby and you are concerned about the potential risks of epilepsy, ask your doctor to explain any risks in your case. Genetic risks do not apply to all epilepsies and, in most cases, are fairly low.