CHILDHOOD EPILEPSY: TYPES, CAUSES, AND TREATMENTS - NEUROPSYCHOLOGY - 2025

The childhood epilepsy appears due to an exaggerated increase in the activity of neurons that is not related to a fever or other acute disorders affecting brain function as infections or trauma.

Epilepsy is a brain disorder characterized by repeated epileptic seizures or convulsions. The seizure of epilepsy is produced by excessive and sudden electrical discharges in the cells of the brain, that is, in the neurons.

During seizures, people do not control their movements, what they feel or what they do, so that, in some way, in those moments they are totally governed by the electrical discharges that are produced in their brain.

It should be noted that having a single seizure does not imply suffering from epilepsy, since this disease is characterized by having attacks repeatedly and due to a brain condition or condition.

Likewise, it must be borne in mind that epilepsy is not a psychiatric disorder nor does it respond to a mental disorder, but rather it is a neurological disorder that has little to do with the psychological functioning of the person.

The electrical discharges from the brain that produce seizures can occur in a specific region of the brain (focal seizure) or throughout the brain simultaneously (generalized seizure).

Crises typically last a few seconds or minutes, and are often accompanied by a loss of consciousness.

In order to diagnose this disease, different tests must be carried out, such as the electroencephalogram that measures the electrical activity of the brain, the CT scan if a brain abnormality is suspected and, in some cases, blood tests and genetic studies.

Types of childhood epilepsy

Epilepsy is a disease that can be classified into the two types that have been discussed above: focal or partial seizures, and generalized seizures.

Focal seizures are usually much weaker than general seizures and can proceed without a seizure, while generalized seizures tend to be more severe.

These two types of seizures can be divided into two more types: idiopathic epilepsies and cryptogenic epilepsies.

Idiopathic epilepsies are the most common and are characterized by not having a known cause, while cryptogenic epilepsies are much less prevalent and are characterized by having a specific organic origin.

Causes

epilepsy is a disease characterized by generalized and disordered impulse discharges from neurons. These brain discharges are not produced by external agents, that is, it is the brain's own functioning that produces them.

The first doubt that opens this disease is clear, what causes the brain to make these discharges?

The electrical discharges that characterize epileptic seizures are produced by alterations in the balance of neurotransmitters, that is, in the chemical substances that connect neurons.

This imbalance may be due to excess excitatory neurotransmitters, a decrease in modulators or alterations in the receptors of neurons that capture these chemicals.

It seems to be quite clear what are the processes that are verified in the brain when a person suffers an epileptic seizure, however, knowing why this happens is a more complex task.

Hereditary factor

First, a hereditary component in epilepsy is postulated. In fact, some cases of epilepsy with a very clear inheritance have been described, however they have been very rare.

As with most diseases, the diversity of genetic factors that can induce the appearance of an epileptic seizure makes the heritability of this disease not so evident.

In this way, it is postulated that the hereditary factor may be present in all epileptic seizures but only in a few cases this factor is clearly observable.

Many epileptic patients have a family history, so this hypothesis gains strength, however, today the hereditary components of epilepsy have not yet been discovered.

Feverish convulsions

Apart from this, there is a small percentage of epilepsies that occur with febrile seizures. This type of seizure produced by fever is not considered epileptic, that is, having this type of seizure does not imply epilepsy.

However, it has been shown that febrile seizures can be a predictive factor of epilepsy, since some children who present febrile seizures may suffer from epilepsy during adulthood (although this percentage is very small).

As we can see, epilepsy is a neurological disease with quite unknown causes and origins, so it is difficult to predict its appearance.

Evolution of childhood epilepsies

The main factor that determines the course and evolution of epilepsy is early care for this disease. In general, epilepsies that are controlled and treated early, that is, as soon as the first seizures appear, they are usually cured effectively.

Less malignant are idiopathic epilepsies, that is, the type of epilepsies that are not accompanied by lesions in the nervous system.

Children with idiopathic epilepsy who receive immediate treatment can lead a totally normal life and will not suffer alterations in their psychomotor or mental development.

Cryptogenic epilepsies, on the other hand, have a much worse prognosis, since they are produced by processes that affect brain function.

In these cases, antiepileptic drugs are less effective and the evolution of the disease will depend on the disease causing the epilepsy and the treatment that is given to this pathology.

In addition, in these cases, each crisis that is suffered damages some region of the brain, so that with the passage of time and the suffering of crisis, the child may see his nervous system progressively affected.

Thus, cryptogenic epilepsy can cause damage to the child's brain that results in psychomotor or intellectual disorders.

In all cases of epilepsy and especially in cryptogenic epilepsies, medical monitoring is essential to prevent damage and repercussions on the development and life of the child.

How to act in a crisis

Epileptic seizures are often highly unpleasant and stressful moments for family members or people who are with the child during the crisis.

The spectacular nature of the symptoms that epileptic seizures produce can alarm the child's family members and they can become very distressed by not knowing what to do.

The first thing to keep in mind is that, despite the fact that the state in which the child is during the crisis is usually very shocking, epileptic seizures almost never cause injuries.

In this way, at this time it is necessary to try to remain calm and be aware that the child's state during the crisis can be very alarming but that this fact does not have to mean an injury or highly negative consequences.

The seizures subside on their own after a few seconds or minutes, so no attempt should be made to do anything to interrupt the attack or to bring the child back to a normal state.

The most important thing to do in these situations is to lay the child on a safe surface and place him on his side so that the seizure does not obstruct the airway.

Likewise, it is important not to introduce any object into the child's mouth, to notify an emergency service and wait for the crisis to subside in order to transfer him to a health center where medical monitoring of his condition can be carried out.

Treatments

The main treatment for this disease is the administration of antiepileptic drugs.

These drugs must be received by a neurologist, who will indicate the most appropriate dose and medication in each case.

Currently there are many antiepileptic drugs, however, most of them are equally effective in eliminating seizures as soon as possible without producing significant side effects. The choice of drug and dose will be made based on the age and characteristics of the child.

Only some cases of epilepsy (the minority) are difficult to control and require the administration of several drugs. Epilepsy can usually be adequately treated with the administration of a single antiepileptic drug.

Can crises be prevented?

Although the causes that originate the seizures are little known today, some patterns have been established that can reduce the risk of having seizures in a child with epilepsy.

In general, it is recommended that the child sleeps a sufficient number of hours (between 8 and 10), and that he / she follows a regular sleep pattern, going to bed and getting up each day at the same time.

It is not recommended that children with epilepsy watch television at a distance of less than two meters and it is important to try to avoid viewing electronic devices in the dark.

On the other hand, despite the fact that watching television or playing computer games and video consoles are not prohibited activities for children with epilepsy, it is recommended that these activities be made healthy and the time spent in doing them is limited.

Finally, the consumption of stimulant drinks should also be limited and only taken occasionally, since these substances can increase the risk of having a crisis.

In young people with epilepsy, the intake of alcohol, stimulants and other drugs that act on the nervous system is contraindicated, so they must be very cautious with the consumption of these substances.

Similarly, places that can cause overstimulation of the nervous system, such as discos or rooms with invasive lights and noise, can also increase the risk of having a seizure, so it is not recommended that people with epilepsy attend regularly. these spaces.

References

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3. Gómez-Alonso J, Muñoz D, Sánchez-Herrero J, Gómara S. The classification of epilepsies: an invitation to disorder. Neurology 2005; 20: 156-7.
4. Leutmezer F, Lurger S, Baumgartner C. Focal features in patients with idiopathic generalized epilepsy. Epilepsy Res 2002; 50: 293-300
5. Medina-Malo C. Epilepsy: classification for a diagnostic approach according to etiology and complexities. Rev Neurol 2010; 50 (Suppl 3): S25-30.