Epilepsy in Children

Epilepsy is a nervous system disorder that makes people susceptible to seizures. It can affect anyone at any age. Experts estimate that there are almost three million people in the United States who have been diagnosed with epilepsy, and approximately 400,000 of them are children under the age of 14. Not all seizures are due to epilepsy, but doctors will diagnose epilepsy if someone has more than one seizure. While some people have epilepsy for their entire life, others outgrow it and never have another seizure. Here are some statistics about epilepsy:

• Most children who have one seizure do not have epilepsy and will never have another seizure.Most children who are diagnosed with epilepsy will outgrow it.
• Epilepsy is manageable with medication in 70 to 80 percent of children, which means as long as they take their medication, they will not have seizures.
• Most children who have epilepsy are otherwise healthy.
• Most children with epilepsy can be effectively treated and live normal, healthy lives.

The best way to cope with your child’s epilepsy is to ensure he or she is getting good medical care and takes prescribed medications. It’s also important for parents to understand epilepsy and know what to do if their child has a seizure. Educating other caretakers, like family members, friends, or teachers, is important as well. When people know what epilepsy is and how to manage it, everyone can feel more confident.

Specialists at Beaumont’s Pediatric Comprehensive Epilepsy Center can diagnose and treat epilepsy and can help you and your child manage an epilepsy diagnosis.

Epilepsy overview

Despite what many people believe, epilepsy isn’t one disease. The term epilepsy is used to define many disorders that cause seizures. All people with epilepsy have had multiple seizures, but the causes of seizures and the types of seizures vary greatly. There are many types of epilepsy, and the different types require different treatment.

People who have epilepsy have varied experiences. Some people have very few seizures, and others have many seizures. Some people have obvious seizures, like grand mal seizures, and others have seizures that most people won’t even notice (absence seizures). 

If your child has been diagnosed with epilepsy, you will work closely with your child’s doctor to find an effective treatment. The first step in treatment is to control the seizures. Your child’s doctor will prescribe some type of epilepsy medication. After seizures are controlled, your doctor will work with a team of experts to address any psychological or cognitive effects of epilepsy. 

Difference between epilepsy and a seizure

People often ask what the difference is between epilepsy and a seizure. The simple rule is that a seizure is a single incidence, while epilepsy is only diagnosed after someone has more than one seizure without a known cause. So basically, all epilepsy involves seizures, but not all seizures are epilepsy.

Causes of epilepsy

Anyone can have a seizure. When someone has more than one seizure, they may be diagnosed with epilepsy. There are many causes of seizures and epilepsy in children, including genetic factors, brain changes, issues during pregnancy, brain tumors, and more. 
In about 70 percent of cases, doctors cannot identify a direct cause of a seizure. A seizure without an identifiable cause is called an idiopathic or cryptogenic seizure.

There is no medical evidence that immunizations/vaccines cause epilepsy, but some children do have seizures one or two days after receiving a vaccination – especially if they have a fever. To avoid febrile seizures after immunizations, give your child acetaminophen or ibuprofen shortly after the immunization is administered.

Signs and symptoms of epilepsy

Not all seizures are obvious and easy to recognize. For example, children who have what is called absence seizures may appear to be daydreaming or “spacing out.” And because these seizures may only last a few seconds, people may not even notice anything at all. 

Signs and symptoms of epilepsy vary depending upon the type and severity of the seizure. Grand mal seizures are what most people think about when they picture a seizure. Signs and symptoms of a grand mal seizure include:

• Loss of consciousness or unresponsiveness
• Sudden falling
• Muscle contractions or convulsions
• Loss of bowel or bladder control
• Screaming
• Confusion, extreme fatigue, and severe headache after the seizure
• Blackouts, gaps in memory, mumbling, or a lack of response when spoken to

Diagnosis and treatment of epilepsy

Unless your child has frequent and obvious seizures, getting an epilepsy diagnosis may be tricky. If you believe your child has had a seizure, talk to his or her doctor. Try writing down everything you witnessed so you can provide as many details as possible to the doctor. Keeping your phone with you is a good idea so you can record any potential seizure activity with the video camera on your phone.

When you take your child to his or her appointment, the doctor will perform exams and blood tests to attempt to rule out other conditions, such as non-epileptic seizures. The doctor may also have your child undergo an EEG to check electrical brain activity or an MRI or CT scan of the brain that specifically looks for signs of epilepsy.

If your child has epilepsy, he or she will need treatment. Fortunately, there are many different treatment options, and treatment tends to be quite effective at controlling seizures.

Pediatric epilepsy treatment usually begins with medication. Not all antiepileptic medications work the same way, so your child may need to try more than one medication before finding the best option to stop seizures. If the first medication doesn’t work or the side effects are too difficult to manage, your child’s doctor will prescribe a new medication. If you try multiple medications and none of them work well, there are other treatment options available, such as vagus nerve stimulation (VNS) and surgery. Some parents have reported that a ketogenic diet can be helpful in keeping seizures at bay.

At some point during treatment, you may want to take your child to an epilepsy specialist (an epileptologist). Beaumont Children’s has several pediatric epileptologists who work at the Pediatric Comprehensive Epilepsy Center. Call 248-551-6178 today to make an appointment for your child. 

What to do if your child has a seizure

Regardless of what type of seizure your child is having, you should watch him or her carefully and, if possible, have someone videotape the seizure. You can do the video recording if you don’t need to have your hands available to help your child. 

• If your child has a generalized, grand mal seizure
  • If your child cries or screams, falls, and experiences uncontrolled movements, there are some things you should do:
  • Move anything away from your child that could hurt him or her
  • If possible, place something soft and flat under his or her head
  • Turn your child to one side
  • Loosen any clothing or jewelry around the neck
  • Keep track of how long the seizure lasts, and remember all the signs and symptoms so you can report this to your child’s doctor
• If your child is having a seizure, there are things you should never do. For example:
  • Don’t try to hold or restrain your child
  • Don’t attempt to stop movements
  • Don’t put anything in your child’s mouth
  • Don’t try to open your child’s mouth
  • Don’t attempt mouth-to-mouth resuscitation until after the seizure stops
• Call 911 or get emergency medical care if:
  • Your child has never had a seizure before
  • The seizure lasts more than five minutes
  • Your child may have swallowed water or other fluid during the seizure
  • Your child has a high fever
  • Your child has diabetes
  • Your child may have injured his or her head (either during or prior to the seizure)
  • Your child is having trouble breathing after the seizure

If your child’s seizure doesn’t stop after five minutes or he or she has more than one seizure in a row, this is an emergency, and you need to call 911 right away.

• While you’re waiting for the ambulance to arrive, remember:
  • Do not try to move your child
  • Call the emergency room and tell them you’re coming (or call your doctor’s office and have them call the hospital)
  • If you have written instructions from your child’s doctor to give to the emergency personnel, make sure you bring them with you if possible

There are new medications available to treat prolonged, continuous seizures. Different options can be given orally, rectally, and through an injection. Ask the doctors if any of these options are available for your child.

Pediatric epilepsy care at Beaumont

The Comprehensive Epilepsy Center at Beaumont Children's offers a range of pediatric epilepsy treatment and monitoring services for infants, children, and teens who have epilepsy or have experienced seizures. Our clinic offers comprehensive seizure evaluations and diagnostic tests for all forms of epilepsy, including MRIs, PET scans, and EEGs.

Doctors Daniel Arndt, M.D. and Pramote Laoprasert, M.D. are pediatric epileptologists who lead the center, which specializes in helping young patients with drug-resistant epilepsy. About one-third of patients who have severe epilepsy will not respond to medication and will need additional treatment.

The multidisciplinary staff at the Comprehensive Epilepsy Center is made up of highly trained specialists, including pediatric neurologists, epileptologists, pediatric neuroscience nurses, pediatric EEG technologists, and a nurse coordinator. Using some of the most advanced EEG and imaging technologies available, our team works closely with Beaumont experts in several specialties, including pediatric neurosurgery, ophthalmology, radiology, and physical, occupational, and speech therapy.

The Comprehensive Epilepsy Center provides resources and guidance for parents and caregivers in a single location, giving them comfort and predictability during a challenging and sometimes unpredictable time.

The Pediatric Comprehensive Epilepsy Center at Beaumont Children’s is accredited by the National Association of Epilepsy Centers as a Level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy.

Call us today

If your child has had a seizure or has been diagnosed with epilepsy and you’d like to see one of our specialists, we’re here to help. We are located in the Neuroscience Center in Suite N120 on the campus of Corewell Health William Beaumont University Hospital. To schedule an appointment or learn about Beaumont's pediatric epilepsy services, call 248-551-6178.

For a referral to a Beaumont pediatric epilepsy specialist, call 855-480-KIDS (855-480-5437).