Pediatric Epilepsy

Symptoms

Causes

Many different disorders of the brain may be associated with epilepsy. For some patients the epileptic disorder is congenital, that is, the child is born with the predisposition to have epilepsy. In other patients, the epileptic disorder is acquired because of brain damage that occurred after birth. The congenital epilepsies could be the result of the child having a gene that is responsible for the epileptic disorder; these are the genetic types of epilepsy. Alternatively, congenital epilepsy may be the result of factors that interfere with the development of the brain during gestation, resulting in brain malformations. In acquired epileptic disorders, the damage might occur at the time of birth, for example the case of newborns that have oxygen deprivation during labor and delivery; or intracranial bleeding, as seen in some children born prematurely. Also, the brain damage may occur any time after birth. For example, epilepsy could be a complication of infections in the brain (meningitis, encephalitis), head injuries with brain damage, brain tumors, or intracranial bleeding.

Diagnosis

Making a diagnosis involves identifying a condition or disease based on signs and symptoms. An epilepsy diagnosis is generally made when seizures occur more than once without an identifiable reason, such as fever or injury. Any child without a known diagnosis of epilepsy who experiences an unprovoked seizure needs immediate emergency medical attention and then have follow-up with her primary care pediatrician soon thereafter. If seizures reoccur, children should see a pediatric neurologist, a specialist who manages seizures and epilepsy.

While every child's diagnostic process will vary, the major steps in the process typically include:

After the exam, tests, and a period of observation, a doctor determines whether a child has epilepsy.

Treatment

The main line of treatment is with anti-epileptic drugs, which are effective in controlling seizures in 70%-80% of patients with epilepsy. There are several anti-epileptic medications. Since certain medications are much better for some seizures, the choice of the medication should be made by a physician who is familiar with these medications. If possible, the child should be evaluated in a center specializing in epilepsy. If this is not feasible, usually pediatric neurologists have training in epileptic disorders and are a good source for a referral.

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