Epilepsy in children

Epilepsy in children: forms

Epilepsy in children can be very different, as in adults. The span of the Seizure types is big. Some children, for example, are mentally absent for only a few seconds during the seizure (Absence). Others faint, are stiff at first, and are then shaken by muscle twitching on the whole body for several minutes (grand mal seizure). If the epileptic seizure is confined to a limited brain region, it lies within focal seizure in front. If the whole brain is affected, it is one generalized seizure.

The seizures can seemingly out of nothing to emerge out. Often they are through trigger triggered as flickering light, but also lack of sleep.

As varied as the seizure types are the causes of epilepsy. In both children and adults, genetic predisposition, brain injury (such as birth or accident) and underlying illnesses (such as meningitis, metabolic disorders, etc.) may be responsible for epileptic seizures. Sometimes, however, no cause for epilepsy can be found.

Tip: For a description of the various seizure types and symptoms, see Epileptic seizure. To find out more about the possible causes of the condition, see Epilepsy: Causes.

Here are some specific forms of epilepsy in children. Some of them start in certain age groups.

Absence epilepsy of school age

One of the most common generalized forms of epilepsy in children is absentee epilepsy of school age (pyknolepsia). It is genetic and shows usually at the age of five to eight years, Girls are affected more often than boys.

The small patients experience up to 100 absence a day. Absences are short pauses in consciousness – The child is not unconscious, but does not perceive his environment for a short time. It stops suddenly in its current activity (play, talk, run, etc.) and continues after a few seconds, as if nothing had happened. Most of the time the child does not know that he had just “stepped out” for a short time.

This form of epilepsy in school-age children generally has a good prognosis. In about one third of the young patients, the absence periods come to a standstill, with a third remaining until adulthood. Finally, in the last third of the patients, major epileptic seizures are added.

Juvenile Absence Epilepsy

Absence epilepsy in children between the ages of 9 and 15 is called Juvenile Absence Epilepsy. Girls and boys are about equally affected. The patients only experience few absences during the day. But they are often with one tonic-clonic seizure (Grand times = “big attack”) connected. In other words, at first the child’s body suddenly becomes stiff (tonic phase), before it breaks out into rhythmic muscle twitches after a few seconds (clonic phase). After a few minutes the seizure is usually over.

The prognosis of Juvenile Absence Epilepsy is less favorable. This is especially true in patients who are not treated properly and lead an irregular lifestyle (frequent lack of sleep, etc.). With them it can come frequently to large attacks.

Rolando-epilepsy

The Rolando-epilepsy is one of the most common forms of childhood epilepsy. It is often seen as part of nocturnal seizures, with the children being woken up by sleep: there are discomfort and twitching, usually in one half of the face. The children have problems talking and swallowing and more saliva. Sometimes this focal attack spreads to other parts of the body. Less developed is a grand mal seizure (generalized tonic-clonic seizure).

The episodes of rolando epilepsy are sporadic. Treatment with medication is not always necessary. Often this form of epilepsy comes to a halt in children after the age of 15 years.

Primary reading epilepsy

Mostly at the age of 17 to 18 years, the primary reading epilepsy begins. In children before puberty, however, it is also possible. The epileptic seizures are going through here loud or quiet reading triggered: In those affected, tongue, jaw, lips, facial and neck muscles suddenly start to twitch briefly. This form of epilepsy has a good prognosis.

West syndrome (BNS epilepsy)

West Syndrome is a rare, serious epilepsy in children of infancy. It usually starts at the age of two to eight months. Boys are more affected than girls. The small patients usually suffer several epileptic seizures in a row (in series). Every single seizure lasts only a few seconds. There are three characteristic types of seizures that usually occur in combination. They also give the West Syndrome the second name Lightning Nick Salaam Epilepsy (BNS Epilepsy):

• When Lightning attacks It is called the sudden (lightning) muscle twitching of the entire body or individual limbs.
• Both Nick seizures Neck and neck muscles become tense. As a result, as with a pitching motion, the chin is pulled jerkily towards the chest.
• Both Salaam seizures The child bends his head and torso forward. At the same time it often opens the arms and rows with their hands or brings them together in front of the chest – which is reminiscent of the oriental greeting “Salaam”.

The seizures often occur shortly after waking up or before falling asleep. The measurement of the brain waves (EEG) in those affected shows a typical pattern (so-called hypsarrhythmia).

The West Syndrome is caused for example by a malformation or damage to the brain, an infection or metabolic disorder. The prognosis depends on this cause. Mostly it is unfavorable. Most of the affected children suffer from developmental disorders.

Lennox-Gastaut syndrome

The Lennox-Gastaut syndrome (LGS) is another rare form of epilepsy in children. It usually appears between the 3rd and 5th year of life for the first time. Boys are more affected than girls.

Patients often experience multiple seizures a day, sometimes at night. Typically, this occurs different seizure forms on: Sometimes the body suddenly tenses completely or partially for several seconds (tonic seizure). The muscles can also suddenly relax (atonic seizure). In both cases there is a risk of falling. A combined tonic-clonic seizure as well as other forms of seizure (such as absence of consciousness = absence) are also possible with Lennox-Gastaut syndrome.

Occasionally, LGS seizures are potentially lethal Status epilepticus above. This is a prolonged seizure or a series of multiple seizures in quick succession, between which the child does not come to consciousness.

This form of epilepsy often occurs in children with malformations or damage to the brain. Brain damage, for example, can be the result of birth complications. However, there are also LGS patients in whom the brain structure is normally developed and also shows no damage.

Lennox-Gastaut syndrome is difficult to treat. The development of affected children is usually more or less affected.

Juvenile myoclonic epilepsy

Typically, the Juvenile myoclonic epilepsy in children / adolescents aged 12 to 18 years for the first time. Characteristic feature are more or less pronounced muscle twitching (myoclonus). During the attack, the arms move violently and uncoordinated. In doing so, the patient can unwittingly throw away objects that he holds in his hand. Sometimes the legs buckle.

The seizures often occur after waking up, but also during sleep deprivation. Many sufferers develop generalized seizures or distraction (absence) during the course of the disease.

Juvenile myoclonic epilepsy can often be treated quite well with medication. This allows many patients to live without seizures. However, the medications often have to be taken for life.

Dravet syndrome

This is a very rare and severe form of epilepsy in children Dravet syndrome, It will also Myoclonic early cephalopathy or Early infantile epileptic encephalopathy called. Most children fall ill between the 3rd and 12th month of life, rarely later. Boys are more often affected than girls.

Initially, the little patients get tonic-clonic seizures in fever (at first the body stiffens briefly, then uncontrolled, slow muscle twitches begin). The seizures can turn into a dangerous status epilepticus! As the disease progresses, seizures occur without fever. Other types of seizures sometimes appear (in addition to tonic-clonic attacks), such as myoclonic seizures (rapid convulsions of individual muscle groups). Often the seizures are triggered by external stimuli, for example, by temperature changes, light stimuli or excitement.

The cause of Dravet syndrome is often a gene mutation (gene mutation): Affected is the so-called SCN1A gene, which provides the blueprint for a particular sodium channel in the brain. The function of these channels is crucial for the excitement of nerve cells.

Dravet syndrome is difficult to treat. Medications often do not work so well. With increasing age, epileptic seizures become less common. But because they often cause cognitive impairment and behavioral problems, this form of Epilepsy in children nevertheless an unfavorable prognosis. In addition, it may be related to sudden infant death (especially between the ages of 2 and 4).