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Epilepsy is a seizure disorder and neurological disease, and one of the most common disorders of the nervous system that affects people of all ages, races and ethnic backgrounds. It happens when a person experiences sudden, reoccurring seizures.

What causes epilepsy in kids?

There are many possible causes of epilepsy, including tumors, genetic mutations, strokes and brain damage from illness or injury. In many cases, there might be no detectable cause for epilepsy.

However, unlike adults, children and adolescents with epilepsy can undergo treatment during critical stages of their development.

The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with one another through electrical activity.

A seizure occurs when parts of the brain receive a burst of abnormal electrical signals that temporarily interrupt normal electrical brain function. During an epileptic seizure, the neurons may fire as many times as 500 times a second, compared to a normal rate of 80 times a second.

For some people, seizures only happen occasionally; for others, it may happen hundreds of times a day.

There are several different types of seizures in children, including:

Partial (focal) seizures

This type of seizure takes place when abnormal electrical brain function occurs in one or more areas of one side of the brain. About one-third of children with partial seizures experience an aura before the seizure occurs. An aura is a strange feeling, consisting of either visual changes, hearing abnormalities or changes in the sense of smell. Two types of partial seizures include:

  • Simple partial seizures: This type of seizure typically lasts less than one minute. A child might show different symptoms depending on which area of the brain is involved. If the abnormal electrical brain function is in the occipital lobe (the back part of the brain that is involved with vision), the child’s sight may be altered. A child’s muscles are typically more commonly affected. Seizure activity is limited to an isolated muscle group, such as fingers, or to larger muscles in the arms and legs. Consciousness is not lost in this type of seizure. A child might also experience sweating or nausea or become pale.
  • Complex partial seizures: This type of seizure commonly occurs in the temporal lobe of the brain (the area that controls emotion and memory function). These seizures usually last one to two minutes. Consciousness is usually lost during these seizures, and a variety of behaviors can occur, such as gagging, lip smacking, running, screaming, crying or laughing. When a child regains consciousness after the seizure, he or she might complain of being tired or sleepy. This is called the postictal period.

Generalized seizures

Generalized seizures involve both sides of the brain. There is loss of consciousness and a postictal state (sleepy or tired feeling) after the seizure occurs. Types of generalized seizures include:

  • Absence seizures (also called petit mal seizures): These seizures are characterized by a brief altered state of consciousness and staring episodes. Typically, a child’s posture is maintained during the seizure. The mouth or face may move, or the eyes may blink. These seizures usually last no longer than 30 seconds. When the seizure is over, a child might not recall what just occurred and might go on with activities, acting as though nothing happened. These seizures can occur several times a day. This type of seizure is sometimes mistaken for a learning or behavioral problem. Absence seizures almost always start between 4 and 12 years old.
  • Atonic (also called drop attacks): With atonic seizures, there is a sudden loss of muscle tone, and a child can fall from a standing position or suddenly drop the head. During the seizure, a child is limp and unresponsive.
  • Generalized tonic-clonic seizures (also called grand mal seizures): This type of seizure is characterized by five distinct phases. First, the body, arms and legs will flex (contract), extend (straighten out) and tremor (shake). This is followed by a clonic period when the muscles contract and relax. Then, the child will experience a postictal period which is distinguished by a sleepy or tired feeling. During the postictal period, the child might have problems with vision or speech and could have a bad headache, fatigue or body aches.
  • Myoclonic seizures: This type of seizure refers to quick movements or a sudden jerking of a group of muscles. These seizures tend to occur in clusters, meaning they may occur several times a day or for several days in a row.
  • Infantile spasms: This rare type of seizure disorder can occur in infants anytime within the first two years of age. This seizure has a high occurrence rate when the child is waking or trying to go to sleep. The infant usually has brief periods of movement of the neck, abdominal area or legs that last for a few seconds. Infants can have hundreds of these seizures a day. This can be a serious problem and can have long-term complications.
  • Febrile seizures: This type of seizure is associated with fever. These seizures are more commonly seen in children between 6 months old and 5 years old, and there might be a family history of this type of seizure. Febrile seizures that last less than 15 minutes are called “simple” and typically do not have long-term neurological effects. Seizures lasting more than 15 minutes are called “complex,” and there might be long-term neurological changes in a child.

A child might experience one or many seizures. While the exact cause of the seizure might be unclear, more common seizures are caused by certain identifiable factors.

In newborns and infants, a seizure may be caused by:

  • Birth trauma
  • Congenital (present at birth) problems
  • Fever
  • Metabolic or chemical imbalances in the body

In children, adolescents and young adults, a seizure may be caused by:

  • Alcohol or drugs
  • Trauma to the head
  • Infection

Other possible causes for seizures in children may include: 

  • Brain tumor
  • Neurological problems, such as drug withdrawal or medicine
  • Tuberous sclerosis complex
  • Genetic mutations

A seizure often changes how your child looks or acts. Seizures may cause your child to lose consciousness. Some children will not remember that a seizure even happened, while others will remember having a seizure.

Common signs of seizures in kids may include:

  • Falling
  • Shaking or jerking
  • Uncontrollable or involuntary muscle spasms
  • Drooling from the mouth
  • Loss of bladder or bowel control
  • Staring
  • Confusion

Learn More About Seizures and How These Conditions Can Be Treated at Children’s

The goal of seizure management is to control, stop or decrease the frequency of your child’s seizures without interfering with his normal growth and development.

Other goals of seizure management may include: 

  • Proper identification of the type of seizure
  • Using medication specific to the type of seizure your child has
  • Using the least amount of medicine to achieve adequate control
  • Maintaining good medication levels

How do we diagnose epilepsy?

At Children’s Healthcare of Atlanta, pediatric-trained doctors diagnose epilepsy with a physical examination and tests. A seizure might not be completely understood right away but tests can help our specialists find out more about the cause of your child’s condition. We use advanced diagnosis, treatment and neuroimaging technology to provide better outcomes for children, and our team provides unique treatment options based on each child’s condition and needs.

How do we treat seizures?

Specific treatment for a seizure will be determined by your child’s physician based on:

  • Your child’s age, overall health and medical history
  • Extent of the condition
  • Type of seizure
  • Your child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition
  • Your opinion or preference
  • Impact on cognitive functions and quality of life

Some treatments we offer include:

Some children who are having problems with medication, or whose seizures are not being well-controlled, might be placed on this special diet.

There are many types of medications used to treat seizures and epilepsy. Doctors select medication based on the type of seizure, age of your child, side effects, cost of medicine and adherence to the use of the medication.

Neuropsychology is a subspecialty of psychology concerned with the relationship between the brain and behavior, including the diagnosis of brain pathology through the use of psychological tests, assessment techniques and patient, parent, and teacher questionnaires. Neuropsychological evaluations typically include assessment of patients’ cognitive skills, as well as their emotional, behavioral, and social functioning. Findings inform treatment strategies and necessary supports for home and school, as well as transition to adulthood.

One possible treatment option for some types of seizures is surgery.

Surgery may be considered for a child who has:

  • Seizures that cannot be controlled with medication
  • Seizures that always start in one area of the brain
  • Seizures in a part of the brain that can be removed without disrupting important functions, such as speech, memory or vision

Surgery for epilepsy is a complicated process performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or in some cases, the surgery helps stop the spread of the bad electrical currents through the brain. Epilepsy surgery is not an option for everyone with seizures.

Epilepsy surgery at Children’s
We are a Level 4 pediatric epilepsy center, the highest designation by the National Association of Epilepsy Centers. This means our Comprehensive Epilepsy Center provides a complete spectrum of care for the most complex cases. Our pediatric-trained epileptologists, neuropsychologists and neurosurgeons collaborate on surgical procedures to deliver coordinated care and expertise to our patients. We offer the latest in robotic neurosurgery technology. The ROSA robotic surgical assistant has been added to our existing stereoelectroencephalography (SEEG) procedure to give us an integrated platform for surgical planning. We also offer laser ablation surgery using Visualase, an advanced, minimally invasive, MRI-guided technology used to treat patients with epilepsy. Lastly, responsive neurostimulation (RNS) device has been used to reduce seizure burden. Using epilepsy research, new techniques, advanced technology and diagnostic testing capabilities, we have helped our patients become free of disabling seizures after surgery.

Some children, whose seizures cannot be well-controlled with medication, may benefit from a procedure called vagus nerve stimulation (VNS).

VNS attempts to control seizures by sending small pulses of electrical current to the brain from a pulse generator attached to the vagus nerve. This is done by placing a small battery or generator into your child’s chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is programmed to send an electrical current to the brain every few minutes. When a child feels a seizure starting, the child or a caregiver may activate the device by holding a small magnet over the battery. In many people, this will help stop or shorten a seizure.

VNS does have some side effects. These are limited to the time of stimulation and may include:

  • Hoarseness
  • Pain or discomfort in the throat

Learn how the ketogenic diet can positively impact your child’s neurological treatment.

Children who are having problems with medicine, or whose seizures are not being well-controlled, may be placed on a special diet called the ketogenic diet.

LEARN MORE

Our pediatric neurologists in the Comprehensive Epilepsy Center recognize and treat the special needs of infants, children and adolescents who have epilepsy. Your child will be treated by specialists who care for hundreds of patients who have difficult-to-control epilepsy each year. Our team of specialists combines the latest diagnostic, treatment and neuroimaging technology with a caring, child-friendly approach to deliver unique treatment options based on each child’s condition and needs.

About our center

  • We specialize in diagnosis and treatment of children with difficult-to-control epilepsy (also known as refractory or intractable epilepsy).
  • Our physicians have completed extra certifications and training for epilepsy.
  • We offer advanced technology to help control epileptic seizures with minimal side effects.
  • We use medical and surgical evaluation, in addition to the ketogenic diet, based on the individual needs of each child.

National recognition

The National Association of Epilepsy Centers (NAEC) recognizes us as a Level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level of medical and surgical evaluation and treatment for patients with complex epilepsy.

We are an accredited EEG and EMG lab

Our EEG lab is accredited by the EEG Laboratory Accreditation Board of ABRET (LAB-EEG), which means we perform EEGs to the highest standards. We are the second hospital in Georgia and the 11th pediatric hospital in the country to achieve this accreditation.

Our electromyography (EMG) labs received Exemplary Status Accreditation from the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM). We are the only pediatric EMG lab in Georgia and are now one of three stand-alone EMG labs with this accreditation in the country.

Find comfort with people who are going through a similar diagnosis.

When a child is diagnosed with an illness, it affects every member of a family. Our Comprehensive Epilepsy Center offers support groups for parents and children who are dealing with epilepsy and seizures.

Get Support

Having a child diagnosed with epilepsy can be a stressful, overwhelming experience. At Children's, our top priority is to provide the most advanced treatment available to our patients, while also supporting their family. Family is a vital part of a child's healthcare team, fostering well-being, security and comfort. With this in mind, we prioritize educating families regarding a patient's unique medical history and treatment plan. Whether treating a toddler during an emergency or helping a teen through recovery after neurosurgery, we make it our mission to provide the best care—and best experience—for every child and their family.