Epileptic seizures

Childhood epilepsy is a brain disease that can cause repeated seizures in children. The prognosis of epilepsy has radically changed and, today, most epileptic children can and should lead a completely normal life since there are drugs capable of controlling seizures and curing epilepsy.

Epileptic seizures

Seizures are the manifestation of excessive activity of a group or of all neurons, which are produced by discharges of generalized and disordered neuronal impulses, and which appear to be caused by alterations in the balance of neurotransmitters (chemicals that transmit signals between neurons).

Epileptic seizures usually last seconds or a few minutes. In some cases they can be difficult to perceive if their symptoms are not very evident and their duration is very short. Many seizures usually end with a period of postcritical drowsiness, which can last more than an hour, and in which the child is drowsy and with an abnormal response to stimuli. On many occasions, he does not remember what happened to him, nor is he aware of the minutes before and after the crisis (post-critical amnesia).

What to do about a seizure

The highest recommendation is to stay calm. Although the crisis is very spectacular, it almost never causes injuries and tends to subside on its own in a few minutes, although afterwards it is usually followed by a post-critical state that can lengthen the apparent duration.

Subsequently, the child should be laid on a safe surface and placed on his side, to avoid airway obstruction. No object should be put into the mouth and it is advisable to notify an emergency service or take the child to the nearest health center.

Types of epileptic seizures

There are different types of epileptic seizures, which can be classified into two large groups:

1. Partial or focal seizures: they affect a group of neurons and the manifestations of the crisis are related to the area where the problem is located.

• Simple: without loss of consciousness.
• Complex: with loss of consciousness.

2. Generalized seizures: affect all brain neurons.

• Absences: it is the loss of consciousness together with the stop of the child's activity.
• Atonic: sudden fall due to loss of muscle tone.
• Generalized tonic: general muscle contraction.
• Generalized tonic-clonic: body stiffness together with generalized muscle jerks.

DO NOT CONFUSE WITH FEBRILE SEIZURES

They are not considered epilepsy. Less than 5% of children with febrile seizures may have epilepsy. Predictive factors such as frequent recurrence of febrile seizures, type of seizure, family history of epilepsy, and changes in neurological examination may indicate which children are most at risk.

Diagnosis

The fundamental test for the diagnosis of epilepsy is the (EEG). It is a painless test without side effects, which does not require sedation or anesthesia. It is done by applying electrodes to the surface of the scalp that record the electrical activity of the brain. Thus, the specialist can show the discharges (irritative foci) that cause the seizures, their intensity and location. In cases where the existence of a specific cause (symptomatic epilepsy) is suspected, other tests may be performed, such as CT, MRI, other analyzes, genetic studies, etc.

Treatment

Epilepsy is one of the diseases of the central nervous system of children with a more effective treatment, approximately 75% of patients are controlled with medication. There are a wide variety of antiepileptic drugs and it will be the neurologist who has to indicate the most appropriate for the age of the patient and the type of epilepsy. In general, doses are administered that vary according to the child's weight and are divided into two or three doses a day. Most treatments meet the general objective of eliminating seizures as quickly as possible, with a single drug, without notable side effects and without interfering with activities of daily living. During the duration of the treatment, the neurologist carries out regular check-ups, usually a couple of times a year if the epilepsy is well controlled. A control EEG is performed, as well as one to assess tolerance to medication and drug levels in the blood. Doses are progressively adjusted according to results and response to treatment. Parents should inform the doctor about any incident that may appear as poor seizure control, possible side effects, etc.

Most epilepsies not due to brain injury are controlled and cured with medication. This process can last a few years, time that will depend closely on several factors, such as the type of epilepsy, the age of onset of the seizures and the response to antiepileptic treatment. If the seizures are controlled early and there are no previous lesions in the nervous system, children can lead a completely normal life and there are no alterations in their psychomotor or intellectual development.

In the event of not being able to control epilepsy with medication, as occurs in 5% of patients, today epilepsy surgery can be performed, a technique with which up to 75% of patients with drug-resistant focal epilepsy can remain crisis free if you are a good candidate for the operation.

Can crises be prevented?

The best way to prevent an epileptic seizure is to take the medication prescribed by the neurologist, carry out routine check-ups of the child and, in some cases, monitor the drug levels in the blood. In addition, as prevention, exciting drinks should be taken in moderation and the child should sleep and rest at night, without abusing screens or video consoles.

• It is a brain disease that can produce repeated epileptic seizures that last seconds or a few minutes and usually end with post-critical drowsiness.
• Epileptic children must lead a completely normal life since there are drugs capable of controlling seizures and curing epilepsy.
• Prevention: drink exciting drinks in moderation and get a good night's rest, without overusing screens or game consoles.

Dra. Esther Martínez GarcíaPediatric Specialist