What Is Epilepsy?
Epilepsy is a condition involving the brain that makes people more likely to have seizures. It is one of the most common problems of the nervous system and affects people of all ages, races, and ethnic backgrounds.
When your child has two or more seizures, he or she is considered to have epilepsy.
There are many possible causes of epilepsy, including tumors, strokes, and brain damage from illness or injury. It can also occur if the brain did not develop normally (called cortical dysplasia). In many cases, no clear cause is found—this may mean the condition is genetic and runs in families.
What Is a Seizure?
The brain controls all responses in the body and communicates through electrical activity. A seizure occurs when there is abnormal electrical activity in the brain, causing a sudden change in awareness, movement, or behavior.
Seizures may look different for each child and do not always involve shaking.
Common seizure signs include:
- Recurring shaking of all or part of the body
- Blank staring
- Falling to the ground
- Brief, sudden muscle spasms
- Repeating movements such as blinking, pulling at clothes, or lip smacking
What Causes a Seizure?
Provoked Seizures
Caused by short-term conditions affecting the brain, such as:
- Fever
- Low blood sugar
- Brain infection or injury
- Poisoning or exposure to toxins
Unprovoked Seizures
Caused by changes in brain electrical activity. These may be:
- Genetic (run in families)
- Related to brain development
- Of unknown cause
What Are the Different Types of Seizures?
Seizures fall into two main groups: partial and generalized.
- Partial seizures affect one side of the brain
- Generalized seizures affect both sides of the brain
Partial Seizures
Simple Partial Seizures
- Child remains awake and alert
- No loss of consciousness
- May experience an aura (changes in smell, vision, or hearing)
- Usually last less than one minute
Symptoms depend on the brain area involved:
- Back of brain: visual changes
- Muscles: small or large muscle group movements
Complex Partial Seizures
- Most common type of partial seizure
- Starts in one area and spreads
- Child may be awake but not alert
- Last 1–2 minutes
Common features:
- Repetitive behaviors (lip smacking, running, screaming, laughing, swallowing)
- Confusion or sleepiness after the seizure
Generalized Seizures
Tonic-Clonic Seizures
Previously called grand mal seizures.
Tonic phase:
- Loss of consciousness
- Body stiffening
- Cry or yell may occur
- Lasts 10–30 seconds
Clonic phase:
- Rhythmic jerking of arms and legs
- Drooling, sweating, color changes
- Possible loss of bladder or bowel control
After the seizure, your child may be sleepy, confused, or upset. Temporary weakness on one side (Todd’s paralysis) may occur.
Absence Seizures
Previously called petit mal seizures.
- Blank staring
- Minimal movement (eye blinking or facial movement)
- Last less than 30 seconds
- Occur many times daily
- Child resumes activity without awareness of the seizure
Other Generalized Seizure Types
- Myoclonic seizures: Sudden jerks of head, arms, or legs
- Tonic seizures: Sudden body stiffening
- Atonic seizures: Sudden loss of muscle tone (“drop attacks”)
- Infantile spasms: Occur in infants 2–12 months; urgent treatment needed
- Febrile seizures: Occur with fever, typically ages 6 months–5 years
Understanding Childhood Epilepsy
Recurrence After a First Seizure
- Less than half of children have a second seizure
- Risk increases after a second seizure
Starting Medication
Medication is usually started after two unprovoked seizures, not after the first.
Long-Term Remission
Epilepsy may resolve with age, especially in children who have:
- Normal intelligence
- Normal neurological exams
- Few seizures
- First seizure before age 12
Stopping Medication
Over half of seizure-free children for two years may stop medication with doctor guidance.
Never stop medication without speaking to your doctor.
Cognitive and Behavioral Disorders
Learning and Cognitive Challenges
Some children may experience difficulties with:
- Attention and memory
- Reading, writing, or math
Children with epilepsy should be screened for learning disabilities.
Emotional and Behavioral Health
Children with epilepsy may have higher rates of:
- Anxiety and depression
- Behavioral and conduct disorders
How Are Seizures Diagnosed?
Common tests include:
- EEG: Records brain electrical activity
- MRI: Provides detailed brain images
- Blood tests: Check for infections or metabolic issues
- Lumbar puncture: Tests spinal fluid when infection is suspected
How Are Seizures Treated?
Medications
Anti-epileptic drugs (AEDs) are used to control seizures.
Treatment goals include:
- Identifying seizure type
- Using the correct medication
- Using the lowest effective dose
- Monitoring medication levels
Other Treatment Options
- Vagal nerve stimulation (VNS)
- Ketogenic diet
- Epilepsy surgery (for select cases)
Seizure Preparedness Plan
What To Do During a Seizure
- Stay calm
- Do not restrain movements
- Clear surrounding hazards
- Place child on their side during tonic-clonic seizures
- Stay until the child is fully alert
When to Call 911
- Seizure lasts longer than 5–7 minutes
- Multiple seizures occur without recovery
- Breathing difficulty or injury occurs
Living With Epilepsy
Common Seizure Triggers
Avoidable:
- Lack of sleep
- Missed medications
- Alcohol
Unavoidable:
- Illness
- Hormonal changes
Frequently Asked Questions
Can My Child Be Active?
Yes, with safety precautions. Swimming and biking require supervision and protective gear.
Can My Child Play Video Games?
Most children can, unless they have photosensitive seizures.
Traveling With a Child Who Has Epilepsy
Before You Go
- Refill medications
- Carry emergency care plans
- Bring medical contacts
During Travel
- Keep medicines in carry-on bags
- Ensure all caregivers know seizure first aid
