What are the causes of childhood epilepsy? Discover the underlying factors behind this neurological condition, including inherited and acquired factors, in this detailed article.

Understanding the Causes of Childhood Epilepsy

Childhood epilepsy is a complex neurological disorder that affects the brain’s normal function, leading to recurring seizures. When a child is diagnosed with epilepsy, parents often wonder about the underlying cause. While in some cases the cause remains unknown, identifying the cause can be crucial in determining the appropriate course of treatment.

Inherited Epilepsy: The Role of Genetics

Current research indicates that many types of epilepsy have a genetic component. It has been observed that epilepsy tends to run in families, and it is estimated that up to 20% of childhood cases are inherited. Studies have shown that the risk of epilepsy in siblings and children of individuals with the disorder ranges from 4 to 8 percent, compared to 1 to 2 percent in the general population. This increased risk suggests that genes play an important role in some cases of epilepsy.

Researchers have identified more than 70 genes that have been linked to disorders that can lead to epilepsy. While the exact role of many of these genes is still unknown, scientists believe that the alteration of any one of them can increase an individual’s risk of developing epilepsy. Some researchers estimate that more than 500 genes may ultimately be linked to epilepsy.

Certain rare epilepsy syndromes are caused by the mutation of a single gene, resulting in abnormal protein function and leading to seizures. Examples include benign familial neonatal convulsions and generalized epilepsy with febrile seizures plus (GEFS+).

Acquired Epilepsy: External Factors and Brain Injuries

In addition to inherited factors, there are also various acquired causes of epilepsy. These include:

• Abnormal brain development
• Brain injuries, such as traumatic brain injury or stroke
• Infections, such as meningitis or encephalitis
• Inflammation of the brain

These factors can all lead to seizures and the development of epilepsy.

Idiopathic Epilepsy: When the Cause is Unknown

Despite advancements in epilepsy research and clinical care, a significant percentage of epilepsy cases (65 to 70%) remain idiopathic, meaning the cause is unknown. This does not necessarily mean that these cases have no underlying cause, but rather that a specific cause cannot be determined with the available diagnostic tools and tests.

Even in cases where the cause is unknown, effective treatments can still be found. Many children with idiopathic epilepsy may even outgrow their seizures entirely.

Diagnostic Tools and Determining the Cause

To determine the cause of a child’s epilepsy, physicians rely on various diagnostic tools and techniques, including:

• Eyewitness accounts of the seizures
• Electroencephalogram (EEG) analysis to identify abnormal brain activity
• Neuroimaging technologies, such as computed tomography (CT) and magnetic resonance imaging (MRI), to detect structural abnormalities in the brain
• Genetic tests to identify gene mutations that may be contributing to the seizures

By using these tools, doctors can often determine the type of seizure and gain clues about the underlying cause, which can inform the appropriate course of treatment.

The Importance of Understanding Epilepsy Causes

Identifying the cause of a child’s epilepsy can be helpful in several ways:

1. It can provide insights into the prognosis and the risk of seizures recurring or worsening over time.
2. It can guide the selection of the most appropriate treatment options, potentially leading to more effective management of the condition.
3. It can help families understand the nature of their child’s epilepsy and plan for the future.

While the cause may remain unknown in a significant number of cases, the continued advancement of research and diagnostic tools is helping to uncover the underlying factors behind childhood epilepsy.

Conclusion

Childhood epilepsy is a complex neurological disorder with a wide range of potential causes, both inherited and acquired. While in many cases the cause remains unknown, identifying the underlying factors can be crucial in determining the appropriate course of treatment and management. Through continued research and advancements in diagnostic techniques, the understanding of the causes of childhood epilepsy continues to evolve, ultimately leading to improved care and outcomes for those affected by this condition.

Childhood Epilepsy: Causes

When a child is diagnosed with epilepsy, parents often ask, “Why did this occur?” They may wonder if their child’s epilepsy resulted from something they did or failed to do. They may also hope that identifying a cause will lead to a way to prevent future seizures.

Although cases of epilepsy in which cause remains unknown can often be managed effectively, determining a cause can sometimes point to a particular course of treatment. To determine the cause, or causes, of a child’s epilepsy, physicians rely, in part, on information from parents and other family members. Some of the content in this section may help with those conversations.

Cause Identification May Lead to Improved Care

Epilepsy is a neurological disorder in which events called seizures disrupt normal brain function. These sudden surges of abnormal electrical activity can have a wide range of effects. Depending upon which brain regions are involved, seizures may influence behavior, sensory perception, motor function, or all of the above. In fact, physicians can often determine the location and extent of abnormal brain activity based solely upon the seizure type and its observed clinical effects.

Accurate diagnosis of seizure type often provides clues about the underlying cause of an individual’s seizures. This information may be helpful in determining the risk of seizures recurring and worsening over time, and may also reveal an appropriate course of treatment.

One of the most difficult aspects of epilepsy diagnosis is that seizures are symptoms that can result from many different causes. Abnormal brain development and/or brain injuries, infection, inflammation, or specific gene mutations can all lead to seizures. Collectively, all cases of epilepsy that have a known cause are called symptomatic.

However, cause is not always easy to identify and remains unknown in 65 to 70 percent of epilepsy cases. These cases are called idiopathic.

Idiopathic Epilepsy

Physicians use the term idiopathic to describe medical conditions for which there is no known cause. Despite marked advances in epilepsy research and clinical care in recent decades, idiopathic cases of epilepsy still make up the largest percentage (65 to 70 percent) of epilepsy diagnoses. This does not mean that such cases have no underlying cause, but rather that a cause cannot be determined. Often this is because a diagnostic test sensitive or specific enough to determine the cause does not yet exist.

Although determining the cause of seizures can serve an important role in diagnosis, prognosis, and treatment, it is not essential to finding effective treatments. In fact, idiopathic epilepsies can be successfully treated, and it is common for children with this diagnosis to grow out of their seizures entirely.

Even so, determining the cause of an individual’s seizures can be helpful in identifying an appropriate course of treatment. As described in the Diagnosis section, neurologists rely on eyewitness accounts of the seizures and electroencephalogram (EEG) analysis to determine seizure type, and neuroimaging technologies such as computed tomography (CT) and magnetic resonance imaging (MRI) to identify structural abnormalities in the brain. Also, physicians increasingly rely on genetic tests to determine the role that gene mutations might play in an individual’s seizures.

How epilepsy is diagnosed

Of the many known causes of epilepsy all fit into two broad categories: inherited and acquired.

Inherited Epilepsy

Current research is revealing that many types of epilepsy have a genetic component. It has been recognized for some time that epilepsy tends to run in families, and it is now thought that up to 20 percent of childhood cases are inherited. Studies have found that the risk of epilepsy in siblings and children of individuals with the disorder ranges from 4 to 8 percent, compared to 1 to 2 percent in the general population. This increased risk does not imply that genes alone predetermine epilepsy but suggests that genes play an important role in some cases.

To date, researchers have linked more than 70 genes to disorders that can lead to epilepsy. Although the exact role many of these genes play is unknown, scientists believe that the alteration of any one of them increases an individual’s risk of developing epilepsy. Some researchers estimate that more than 500 genes may ultimately be linked to epilepsy.

Scientists have identified some epilepsy types that are caused by the mutation of a single gene. These relatively rare epilepsy syndromes are caused by mutations that result in abnormal protein function, leading to seizures. A few examples include:

• benign familial neonatal convulsions—a type of epilepsy that usually begins prior to the third day of life and typically goes into remission after two or three weeks
• generalized epilepsy with febrile seizures plus (GEFS+)—an epilepsy type that arises in childhood, with seizures occurring during episodes of fever, and then progresses to generalized seizures
• autosomal dominant nocturnal frontal lobe epilepsy—a seizure type that is caused by a mutation in one of three genes and produces shaking movements mostly during sleep

Learn about kinds of seizures

In addition to these epilepsy syndromes, a number of other genetic disorders with wide-ranging manifestations can also give rise to epilepsy. Some of these disorders are:

• tuberous sclerosis complex—a disorder that can affect most major organs, including the brain, and causes seizures in approximately 80 percent of patients
• Sturge-Weber syndrome—a disorder characterized by a port wine birthmark on one side of the face, glaucoma, and seizures
• Aicardi syndrome—a rare disorder characterized by eye abnormalities, infantile spasms, and the partial or complete absence of the corpus callosum, the structure that links the two hemispheres of the brain
• Angelman syndrome—a disorder characterized by seizures, ataxia, language problems, and cognitive impairment

Although some of the disorders described above are uncommon, the identification of gene or chromosome abnormalities associated with many of them has enabled physicians to use relatively simple genetic tests and diagnostic criteria to diagnose patients and family members suspected of having a given disorder. Having identified some of the genes associated with these epilepsy syndromes, scientists can apply this knowledge in their search for similar genes involved in other types of epilepsy.

The search for genetic causes of epilepsy has not been straightforward. Even in cases where genes have been linked to specific types of epilepsy, they may only be part of the explanation. Researchers believe that the most common types of epilepsy are almost certainly caused or influenced by more than one gene, as well as by a number of environmental factors. Researchers hope that identifying the genetic causes of epilepsy may one day lead to better treatments and potentially a cure for some types of the disorder.

In addition to the role gene mutations play in causing epilepsy, it is also thought that genes may influence the effectiveness of treatment options for some people. A recent study demonstrated that many people with epilepsy have an abnormally active version of a gene that increases their resistance to drugs. This may explain why some individuals develop intractable or refractory epilepsy.

Acquired Epilepsy

Some of the most common non-idiopathic causes of seizures in children are acquired, as opposed to being present at birth or developing as the result of genetic abnormalities. Acquired causes include, for example, lack of oxygen (hypoxia), head injuries, and infections of the central nervous system. Brain tumors and degenerative disorders are not as common in children as they are in older adults, but in rare cases they can also cause childhood epilepsy. Whatever the cause, it is important, especially with regard to treatment and follow-up, to distinguish between factors and conditions that cause isolated seizures and those that cause the recurrent seizures characteristic of epilepsy.

Lack of Oxygen (Hypoxia)

An insufficient supply of oxygen to the brain can cause seizures. Brain cells are extremely sensitive to oxygen deprivation and begin to function abnormally or die just minutes after oxygen supply has been cut off. Drowning, choking, suffocation, cardiac arrest, head trauma, and complications during birth can all lead to hypoxia and seizures. Treatment depends on the underlying cause of the hypoxia but typically involves basic life-support procedures, including ventilation, medications to support blood pressure and heart rate, and medications to suppress seizures.

Head Injuries

Seizures resulting from head injuries are uncommon among infants and children. Because the skull offers a great deal of protection, these incidents seldom result in brain injury and subsequent epilepsy. Studies suggest that head injuries resulting in hematomas, wherein blood collects in a mass on the surface of the brain, are more likely to result in seizures and epilepsy.

Infections of the Central Nervous System

Brain infections can cause seizures during acute stages of the infection. In some cases, infections cause injury to the brain significant enough to cause recurrent seizures. The most common central nervous system infections are encephalitis and meningitis. Encephalitis is a brain inflammation often caused by a viral infection. Meningitis is an inflammation or infection of membranes covering the brain or spinal cord.

Brain Tumors

Both cancerous and benign brain tumors and other lesions can cause seizures. Researchers are unsure exactly why such growths cause seizures. It may be that they are made up of abnormal cells that affect the neuronal network and cause abnormal neuronal firing.

Seizure Threshold, Neurons, and Cell Membranes

A seizure can potentially occur in any individual. However, the conditions that lead to seizures vary from one individual to another. For example, a fever of 104 degrees Fahrenheit that leads to seizures in one child may not have that effect on another child. This is because of variability from one person to another in what doctors call seizure threshold, defined as the minimal conditions required to produce a seizure.

Key elements in understanding seizure threshold, and therefore finding good treatments, are the neurons themselves—in particular, the membranes of these neurons. Research has shown that neuronal cell membranes play a critical role in epilepsy, as they regulate the flow of electrical impulses between neurons. For this reason, researchers are investigating details of the membrane structure, focusing on how molecules cross these membranes and how the cell nourishes and repairs this semi-permeable boundary. A disruption in either of these processes may lead to epilepsy.

Normal brain activity relies on communication between networks of neurons and other types of cells in the body. This communication takes place via electrochemical signals. In essence, chemical messages passed from one neuron to another either turn on or turn off electrical activity in the target neuron. More specifically, these chemicals, including neurotransmitters and ions, either stimulate or inhibit the target neuron to fire its own electrochemical signals. Thus, neurons do their work by exciting or inhibiting the activity of other neurons.

Normal brain function generally requires a balance between excitation and inhibition. A balance of these influences enables the brain to send coordinated messages along networks of neurons that control behavior, learning, primary senses, motor function, and other vital functions.

One of the most studied epilepsy-related neurotransmitters is an inhibitory neurotransmitter called GABA, or gamma-aminobutyric acid. Research has led to drugs that alter the amount of GABA in the brain or change how the brain responds to it. Researchers also are studying excitatory neurotransmitters, such as glutamate.

Some environmental and metabolic conditions can trigger seizures by effectively lowering seizure threshold. These conditions include fever, stress, sleep deprivation, and others. The lower an individual’s seizure threshold, the fewer the stimuli required to cause neurons in the brain to misfire.

Scientists think that many of the genes linked to epilepsy are involved in mechanisms that regulate the flow of electrical charges into and out of nerve cells, thereby affecting their electrical excitability and overall seizure threshold. A likely place for a gene mutation to affect neuron function in such a way as to cause epilepsy is at the level of the neurotransmitters, chemicals that act as messengers between nerve cells, as well as the ion channels that maintain the neuron’s firing threshold.

An understanding of these regulatory mechanisms in the brain and how they malfunction in people with epilepsy has led to the development of medications that can help restore electrochemical balance and greatly reduce or eliminate seizures.

About treatments for epilepsy

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What are the causes and treatments for childhood epilepsy?

Epilepsy can be a life changing diagnosis for anyone, especially a child. About 470,000 children in the U.S. had active epilepsy in 2015, according to the U.S. Centers for Disease Control and Prevention. However, with proper care and treatment, childhood epilepsy can be controlled or it may even be cured.

What is pediatric epilepsy?

Pediatric epilepsy is when a child has two or more seizures. A seizure is a sudden electrical surge in the brain that causes a change in behavior, movements or feelings. When a seizure is not caused by fever, infection or trauma and occurs seemingly out of the blue repeatedly, we may diagnose the child with epilepsy. At any given time about 1% of children may be suffering from epilepsy.

What is the cause of pediatric epilepsy?

The causes fall into two main categories, acquired and inherited. Acquired pediatric epilepsy happens to children who started out with a normal brain, but then suffered a brain infection, stroke or some sort of traumatic injury. Genetic or inherited epilepsy refers to a family history of seizures, although not all genetic epilepsies will necessarily stem from a positive family history.

What should a caregiver do if their child suffers a seizure?

It’s extremely stressful, but they should try to stay calm. Next, it’s important not to do too much. Most seizures last no more than two minutes. Parents should avoid putting anything in the child’s mouth; the child will not swallow their tongue. They should also avoid physically restraining the child because this could cause joint damage if the child is moving. If possible, caregivers should record the seizure on video because the video will give doctors the best data to analyze the event to formulate the best treatment plan.

What are the treatments for pediatric epilepsy?

Together with the caregivers, our multidisciplinary team will work to develop an individualized treatment plan to control seizures with as few side effects as possible. Medication is the most common treatment but we may also recommend a medical diet, like a ketogenic diet. If medication and diet are not effective, we may explore surgical treatments like responsive neurostimulation.

At UChicago Medicine, one of our latest treatment initiatives is our New Onset Seizure Clinic. Our goal is for every child who has a seizure that is not caused by an infection or trauma to the brain, to quickly see a professional team that has expertise in epilepsy. We call it a “reverse referral.” When patients come to our Pediatric Epilepsy Center, patients will get an EEG and, many times, a definitive diagnosis. Depending on the diagnosis, we may direct them back to their primary doctor for continuing care.

What’s new in pediatric epilepsy research?

As leaders in pediatric neuroscience research, our experts are aggressively exploring new strategies to optimize and individualize care. One of the biggest areas of research is in genetics. In the past, we had a very limited knowledge of the genetics that were underlying epilepsy, but now we literally know hundreds of genetic causes. Genetics is also exciting because it holds the promise of precision medicine where we can figure out the problem causing the seizure and target it.

Convulsions, causes, treatment, appointment with a neurologist in Maryino

Contents:

• Causes
• Diagnostics
• Treatment

Cramps are uncontrolled muscle spasms that usually come on suddenly. Spasms are caused by electrical activity in the brain. The strength of convulsions can be different: weak ones are manifested by slight discomfort, strong ones often lead to loss of consciousness.

Seizures last from a few seconds to three minutes, and in some cases longer. If a person has lost consciousness during convulsions, and they last more than 2 minutes, this condition is called status epilepticus. With prolonged convulsions, a person can injure himself.

Convulsions differ in the nature of muscle contractions:

• clonic – rapid muscle contractions that occur when the cerebral cortex is excited;
• tonic – prolonged spasms that occur when the subcortical structures are excited;
• tonic-clonic, combined, often occur with organic brain lesions and epilepsy.

Causes

This condition is much more common in children than in adults. In children, they are most often caused by:

• general immaturity of the brain;
• weakness of braking mechanisms;
• insufficient myelination of nerve fibers;
• highly hydrophilic brain tissues;
• chronic diseases of the mother;
• severe toxicosis during pregnancy, fetal metabolic disorders, asphyxia;
• a severe course of childbirth, as a result of which the child received a brain injury.

In adulthood, seizures are caused by epilepsy; traumatic brain injury; neuroinfections.

Main symptoms of convulsions:

• darkening of the eyes;
• the appearance of confusion;
• nausea;
• dizziness;
• tingling in limbs;
• severe salivation;
• syncope;
• deviation of the position of the eyes and head.

Diagnosis

Convulsive readiness in childhood can proceed almost imperceptibly, and be detected only during diagnostic examinations.

If it is necessary to identify the cause of seizures, it is necessary: ​​

• perform an MRI or CT scan of the brain;
• take an electroencephalogram;
• x-ray the extremities;
• lumbar spinal tap.

Complete blood count is mandatory.

Treatment

Seizures are treatable, but the regimen depends on their nature and cause. Treatment depends on the underlying disease.

• Prescribe anticonvulsants, massage.
• Compliance with the regime of work and rest is strictly recommended.

If you experience leg cramps, you should consult a doctor: he will prescribe a complex of medicines and vitamins: such cramps respond well to drug treatment.

Primary hazard

Untreated or inadequately treated seizures may develop into epileptic seizures.

Prevention

A person suffering from epilepsy should wear a special tag so that others in a critical situation can provide him with adequate assistance.

When a child’s temperature rises above critical values ​​(usually above 38.5 degrees), it is necessary to bring it down to prevent seizures.

Information verified by an expert

Prokaeva Tatyana Alexandrovna

Chief physician, K.M.N., Neurologist
Work experience — 20 years

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Episyndrome (convulsions in a child): causes, symptoms, episyndrome treatment

Why does a child have seizures with or without fever? How do seizures manifest in a child? What to do with seizures in a child? – in this article we will help you find answers to these and similar questions, namely, we will talk about an effective and safe method of treating episyndrome (convulsions in a child), about the causes and symptoms of this disease, as well as about the most popular myths associated with it.

what is episyndrome

episyndrome – sudden and recurring seizures in a child, outwardly similar to epilepsy.

Episyndrome is always a consequence of some disease. Attacks stop as soon as the root cause of which they were a symptom is cured.

If an epileptic focus (a group of brain cells with increased electrical activity) is needed for the development of an attack of true epilepsy, then there is no such focus in episyndrome, therefore, it is not found during examination on an electroencephalogram (EEG).

causes and symptoms of episyndrome

The main cause of episyndrome is oxygen starvation of brain cells, as well as changes in their chemical state.

Such processes develop as a result of birth injuries of the cervical spine, causing a decrease in cerebral blood flow and an increase in intracranial pressure, as well as after various brain injuries (injuries, previous diseases, chemical poisoning).

The development of seizures occurs from irritation of the cerebral cortex or its deep structures and is accompanied by a flash of increased electrical activity of nerve cells (a kind of “short circuit” in the brain).

Quite often, the first attack of convulsions in a child develops at elevated temperature or after vaccination, since in such conditions intracranial pressure increases and oxygen starvation of brain cells increases.

More rare causes of episyndrome are tumors, cysts, parasites, infectious processes of the brain, toxic poisoning, underdevelopment of the brain in cerebral palsy, metabolic disorders.

Outwardly, an episyndrome attack is manifested by a sudden increase in tone in the limbs, muscle spasms and twitches both in sleep and in the waking state, trembling of the limbs, tics, nods, swaying movements of the body, fading, eye rolling, twisting of the body, respiratory arrest. These attacks are usually not accompanied by a lack of consciousness.

debunking myths about episyndrome

Today, there are a number of misconceptions about the problem of episyndrome, generated mainly by the lack of objective information from parents who have encountered this problem about the causes of episyndrome and the proposed treatment. We will try to clarify this issue and debunk the most popular myths.

Convulsions at high temperature are not an abnormality

With normal functioning of the brain, convulsions do not develop even at high temperatures. Convulsions against the background of high temperature indicate a malfunction of the central nervous system.

Seizures are indicative of epilepsy

Epilepsy always presents with different types of seizures, but not all seizures are indicative of epilepsy. In particular, with episyndrome, convulsions develop against the background of oxygen starvation of brain cells.

Seizures are treated with anticonvulsants

Anticonvulsants are used when there is an epileptic focus in the brain. With episyndrome, this focus is absent and the drugs do not have the expected effect – the frequency of seizures does not decrease, and sometimes even increases.

Seizures are hereditary

Most seizures are not hereditary, but evidence of brain dysfunction. It is extremely rare for seizures to be traced in several generations of relatives.

Seizures are incurable and require lifelong medication

Only a rare hereditary form of epilepsy, in which seizures occur throughout life, and the patient is prescribed symptomatic treatment with anticonvulsants, cannot be treated. Other forms of epilepsy and episyndromes are effectively treated. In each case, it is necessary to select an individual treatment depending on the cause of the seizures.

As can be seen from the examples described above, an objective look at the problem of episyndrome in terms of its causes and solutions helps the parents of a child who has this disease to timely and deliberately choose an effective and safe method of treatment.

about our treatment of episyndrome

If an electroencephalogram (EEG) examination does not reveal an epileptic focus in a child, then we do not see the need to prescribe anticonvulsants. When using such drugs, there is no improvement, since the cause of the development of seizures is different.

For the treatment of episyndrome, we offer an effective and safe method of traction therapy aimed at restoring cerebral blood flow and reducing intracranial pressure, which eliminates the main cause of episyndrome – oxygen starvation of brain cells

Treatment is carried out on an outpatient basis (outside the hospital) and involves the child traction collar of the original design (Patent No. 2587960) in combination with natural preparations to normalize brain activity.

Our treatment solves episyndrome quickly and effectively, while being safe and reliable.

Thus, the traction therapy we offer, due to its obvious advantages, is an excellent and often the only alternative not only to taking anticonvulsants, but also to other methods of treating episyndrome.

we begin the treatment of episyndrome

The treatment of episyndrome in our center begins with an appointment with a neurologist. The reception is conducted by the chief physician and leading specialist of our center, neurologist (vertebroneurologist), candidate of medical sciences Mazheiko Lyudmila Ivanovna.