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Childhood epilepsy – diagnosis and treatments

Epilepsy is a relatively common neurological condition that can occur at any age. People affected have recurrent seizures, also known as epileptic attacks, or epileptic fits. Epilepsy often starts early in life but is not always life-long. Around a third of cases of childhood epilepsy resolve during adolescence and have disappeared by the early 20s.

 

Some common causes of childhood epilepsy are:

  • Congenital abnormalities in brain development

  • Being deprived of oxygen at birth

  • Infections affecting the brain such as meningitis or encephalitis

 

What are the symptoms of childhood epilepsy?

Epileptic attacks happen when an abnormal electrical discharge occurs in the brain. This may happen without warning or may be triggered by flashing lights or tiredness. Partial seizures, where only part of the brain is affected, may lead to muscle twitching, numbness/pins and needles, disturbance to sensations such as taste, smell or hearing. Generalised seizures, where all of the brain is affected, lead to stiffening followed by jerking of the muscles, breathing disturbance, and loss of consciousness.

 

How is childhood epilepsy diagnosed?

Your observations of your child’s seizures are one of the most important factors in diagnosing childhood epilepsy. Your doctor may perform tests including blood tests, an electroencephalogram (EEG) to assess the electrical activity of your child’s brain, or a brain scan. Your child may also be referred for behavioural and developmental checks to help with your child’s diagnosis. You can choose to be referred into the NHS or the private sector.

 

What treatments are available for childhood epilepsy?

Drug treatments

Childhood epilepsy has been treated with drugs such as sodium valproate and carbamazepine for several years. More recently, several newer drugs are suitable for the treatment of childhood epilepsy have become available, including gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate and vigabatrin. Having more drug therapies to choose from means that childhood epilepsy treatment can be better tailored to your child. Such individual treatment is more likely to achieve optimum benefit with minimal side-effects. More than one drug can be used in combination if required.

Brain surgery

In some cases of childhood epilepsy, drug treatment is not successful. If the specific area of brain causing the epilepsy can be identified, brain surgery may be an option. This delicate operation involves the cutting connections or removing a small part of the brain that is the source of the electrical disturbance that initiates attacks.

Vagus nerve stimulation

Another alternative to drug treatment for childhood epilepsy is vagus nerve stimulation (VNS). A small generator is implanted under the skin of the upper chest, just below the collar bone, and is connected via a lead and three coils to the vagus nerve in the neck. This device is then used to stimulate the vagus nerve at intervals to reduce the frequency and intensity of seizures. VNS can also be used if your child senses an attack is about to start.

Ketogenic diet

Some children with difficult-to-control childhood epilepsy benefit from a diet that is high in fat and low in carbohydrates. This diet was used successfully to treat childhood epilepsy for almost a century, but became less popular once drug treatments became available. It is now being used again in children whose epilepsy does not respond to drugs, and who are not suitable for surgery.