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Epilepsy in Children: Diagnosis & Treatment

Epilepsy in Children: Diagnosis & Treatment Epilepsy in Children: Diagnosis & Treatment

​​Epilepsy is the most common childhood brain disorder in the United States – nearly 3 million Americans have this condition (450,000 of which are under age 17).

About two-thirds of all children with epilepsy outgrow their seizures by the time they are teenagers. However, it is important for parents to help their child maintain a healthy lifestyle and ensure regular medical visits.

About Epilepsy & Seizures

Epilepsy is a brain disorder where a person has recurring seizures. The seizures are triggered by changes in the electrical and chemical activity in the brain. Seizures can be caused by anything that injures the brain, including head injuries, infections, poisoning or even brain development problems prior to birth. Often a cause for the seizures and epilepsy cannot be found.

There are many different types of seizures. Some are very short, lasting only a few seconds, while others can last a few minutes. The type of seizure a person has depends on where the seizure occurs in the brain and how much of the brain is involved. A doctor will typically diagnose a child with epilepsy (also called a seizure disorder) if:

  • ​The child has one or more seizures
  • The doctor thinks the child is likely to have a seizure again

  • The seizure was not directly caused by another medical condition, like diabetes or a severe infection

​Epilepsy affects every child differently depending on:

Some people with seizures can easily control them with medication and eventually outgrow them all together. Others may have difficulties throughout their lives.

Improvements in epilepsy treatment in recent years have made the condition more manageable. Many new anti-seizure medications are available and more are being tested. Alternative treatments are also available for children who continue to have seizures while on medication.

How is Epilepsy Diagnosed?

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:

  • Detailed medical history: May include questions regarding the mother's pregnancy and delivery, any relatives with epilepsy, and if the child had a high fever, serious head injury and/or periods of staring, inattention or breath-holding.

  • Detailed account of the seizure: The person(s) who were present at the time of the child's seizure should communicate with the doctor.

  • Physical examination: Assessment of cardiac, neurological, and mental status.

  • Blood test: To identify potential causes and or other significant illnesses.

  • Computerized Axial Tomography (CAT) or CT Scan: Can be used to determine whether a seizure was caused by an acute neurological lesion or illness.

  • Electroencephalogram (EEG): Can be used to assess the risk of seizure recurrence and may help determine seizure type and epilepsy syndrome.

  • Magnetic Resonance Image (MRI): Preferred brain picture when evaluating children with new onset seizures or seizures that may have started in a particular part of the brain.

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

If a child is diagnosed with epilepsy:

After a diagnosis of epilepsy is made, it is important for parents to work with the doctor to classify what type(s) of seizures the child is having, and what type of epilepsy the child has, and discuss treatment options. As seizures do not often happen in the doctor's office, parents and caregivers must observe and track any unusual behavior and report it to their child's doctor.

These resources from the Epilepsy Foundation were designed to assist parents in record keeping:

Doctors will assess whether a child's symptoms and characteristics (age, seizure frequency, family history, etc.) fit a certain kind of epilepsy syndrome or pattern. Classifying the epilepsy syndromes depends on the type of seizure, test results, the child's behavior during the seizure, and the expectations for a child's response to treatment. Click here for a list of additional questions to ask the doctor to help take care of a child's epilepsy.

How is Epilepsy Treated?

Treatment for epilepsy usually begins with medication. However, it is important to remember that epilepsy is a complex condition and every child is different. Not every child responds to treatment in the same way, so there is no one "right treatment."

Seizure-prevention drugs

There are many seizure-prevention drugs, called anti-epilepsy drugs (AEDs) or anticonvulsant drugs, on the market and new ones in development. However, it sometimes takes a while to find the one that works best for each child.

These drugs do not change the brain's underlying susceptibility to produce seizures. They only treat the symptoms of epilepsy by reducing the frequency of seizures. The medication will not work properly until it reaches a certain level in the body, and that level has to be maintained. For this reason, it is especially important to follow the doctor's specific medication instructions.

If medication does not work, other options include:

How long a child needs to take medication for epilepsy:

If a child does not have a seizure for a few years while taking medication, it may be possible to stop taking it. This is different for every child. A child should never stop taking medication unless it is recommended and closely supervised by a doctor.

Risks for other medical issues:

Epilepsy can increase a child's chance of having a mood or learning disorder. Headaches, ulcers, and other physical conditions are also common. It is important for parents to know about possible "co-morbidities" and talk to their child's doctor about any concerns.

Additional Information & Resources:

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Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under grant U23MC08582 for Project Access. (Copyright © 2010 Epilepsy Foundation of America, Inc)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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