Epilepsy in Children: Growing, Thriving and Living Beyond Seizures

One sunny afternoon in school, a 7-year-old boy was reciting a poem in front of his classmates when suddenly, his body stiffened, his eyes rolled back and he fell to the ground with jerky movements.

Of course, the class froze, and while some children screamed, the teacher panicked and rushed for help, thinking maybe he was possessed or had fainted.

Later, at the hospital, the doctors explained this could be epilepsy.

Epilepsy is more common than you think. In fact, according to the World Health Organization (WHO), over 50 million people globally live with epilepsy, and nearly half of them started showing symptoms in childhood. If you keep reading, you'll learn what epilepsy is, what can put one at risk of having it and what the outlook is.

What Is Epilepsy in Children?

Epilepsy is a disorder where nerve cells of the brain send abnormal signals, causing repeated seizures (convulsions) [1]. These seizures can occur as fainting or shaking but they can also be brief staring spells, sudden falls or even excessive laughter.

Children are especially vulnerable because their brains are still developing, and seizures can affect their learning, growth and social life if not properly managed.

Types of Epilepsy and Their Symptoms

Children may experience different types of Epilepsy such as [2]:

1. Generalized seizures – This type affects the whole brain. It includes:

• Tonic-clonic seizures (the classic convulsions with jerking)
• Absence seizures (a child suddenly stares blankly for seconds, as if they are daydreaming)
• Myoclonic seizures (sudden, brief jerks of the muscles)
• Atonic Seizures (sudden loss of strength in muscles that makes the child fall)

2. Focal (partial) seizures – Involves one part of the brain, causing twitching, strange sensations, or odd behaviours.

3. Mixed type - Some children may have mixed epilepsy, experiencing more than one type at a time.

Epilepsy Types Specific To Children

These types of epilepsy also known as epilepsy syndromes are common to children [3]. Common ones are:

1. Benign Rolandic Epilepsy (BRE): Occurs at night between ages 3 and 13. Symptoms usually involve one side of the face and includes gurgling noises, grunting and dribbling of saliva.
2. Childhood Absence Epilepsy (CAE): Occurs in children between 4 and 10. Here the child has a blank stare and is unaware of what’s happening around them at the moment.
3. Infantile Spasms (West Syndrome): Happens in children around 6 months of age with symptoms of brief muscle jerks. These children may end up developing learning disorders.

Why Does Epilepsy Happen in Children?

Epilepsy as already described happens when the brain’s electrical activity misfires. Common causes include [4]:

• Genetic factors – When a child inherits the tendency from their parents.
• Birth complications – Lack of oxygen at birth can lead to brain injury and increase the risk of having Epilepsy.
• Infections – Brain infections such as meningitis and encephalitis are risk factors for Epilepsy.
• Head injuries – Such as those from accidents or trauma could make a child have Epilepsy.
• Developmental disorders – Children with conditions like autism or cerebral palsy could be at risk of Epilepsy.

In many children, the exact cause remains unknown and doctors simply call it “Idiopathic Epilepsy.”

Complications of Epilepsy

Children with Epilepsy can develop several complications which parents should watch out for [5]. These include:

• Injuries/fractures from falls or accidents during seizures.
• Emotional struggles like stigma, bullying or low self-esteem.
• Learning difficulties due to frequent seizures or medication side effects.
• A rare but serious complication known as sudden unexpected death in epilepsy (SUDEP).

What Signs Should Parents and Teachers Watch Out For?

Seizures can look different from child to child. Here are signs parents, caregivers and teachers should never ignore:

• Sudden loss of awareness or staring blankly
• Jerking or stiffening of arms and legs
• Confusion or unresponsiveness after an episode
• Extreme tiredness after a seizure
• Repeated falls, strange movements, or unusual behaviours
• Sometimes, seizures are so subtle (like just blinking or lip smacking) that parents mistake them for “play” or “distraction.”

When you notice any of these symptoms, take the child to a doctor immediately.

How Do Doctors Find Out a Child Has Epilepsy?

Diagnosing epilepsy is important to get your child properly treated. Doctors do the following to find out if a child has Epilepsy or not:

● Detailed history from parents/teachers.

● Tests like an an Electroencephalogram (EEG) to check brain activity.

● Brain scans (MRI or CT) to detect structural problems may be done.

● Blood tests to rule out infections or metabolic causes.

Can Epilepsy Be Treated? What Options Are Available?

The good news is that many children outgrow seizures as they grow older. But generally, Epilepsy can be managed. Treatment options include:

• Anti-epileptic drugs (AEDs) – this is the mainstay of treatment. With proper use, most children can live seizure-free.
• Ketogenic diet – a special high-fat, low-carb diet that reduces seizures in some children [6].
• Surgery – depending on the cause of epilepsy, surgery can be done for children whose seizures don’t respond to drugs.
• Lifestyle support – enough sleep, reduced stress and avoiding seizure triggers (like flashing lights in some cases).

Support from schools and families is also crucial. No child should be stigmatized for having epilepsy.

Can Epilepsy Be Prevented in Children?

Not all cases can be prevented, but parents can reduce risks by:

• Ensuring safe delivery and antenatal care
• Vaccinating against brain infections (like meningitis)
• Preventing head injuries with helmets/seatbelts
• Seeking medical care early when seizures first appear

So, What's the Take-Home Message?

Epilepsy in children is not a curse, not witchcraft and definitely not something to hide. It is a medical condition that is treatable and not contagious. With awareness, early diagnosis and proper treatment, children with epilepsy can live normal, happy and successful lives.

So next time you see a child having a seizure, don’t panic or label it as spiritual. Instead, offer help and let’s fight stigma together.

References

1. NHS - Epilepsy
2. CDC - Types of Seizures
3. Epilepsy Society - Epilepsy Syndrome
4. NIH - Epilepsy and Seizures
5. Epilepsy Foundation - Complications and Risks
6. Epilepsy Society - Ketogenic Diet| Epilepsy