Weill Medical College of Cornell University

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Pediatric Epilepsy

• Epilepsy Overview
• Epilepsy, types
• Mesial Temporal Sclerosis
• Neocortical Epilepsy
• Pediatric Epilepsy and Seizures
• Temporal Lobe Epilepsy

Epilepsy is a neurological disorder that affects people of all ages; however, the incidence of seizures is higher in young children (estimated to occur in as many as 4 percent of all children) than in adults. It is unknown why the developing brain is more prone to seizures than the adult brain. When they occur repeatedly and are not provoked, a child is said to have epilepsy.

Causes

In most cases there is no specific acute cause of epilepsy. Some individuals may have minor brain injury present since birth or an inherited tendency towards having seizures. Sometimes, head trauma or a brain infection (meningitis or encephalitis) at an early age produces scarring of the brain that can cause seizures.

Symptoms

Seizures can cause a wide variety of symptoms such as strange sensations, changes in behavior or emotions, muscle spasms, convulsions, or a sudden loss of awareness or consciousness. When children have intractable epilepsy, they are at increased risk of physical injury during a seizure, adverse effects from antiepileptic drugs, disruption of family life, and impairment of learning and attention. Any or all of these reasons, accompanied by concerns about quality of life and future development, may lead a family to consider surgery.

Diagnosis

Diagnostic techniques, such as electroencephalograms (EEGs), video-EEG telemetry (vEEG), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon-emission computerized tomography (SPECT) are used to assess and visualize abnormalities and structural problems associated with epilepsy that may be targets for surgery. Functional testing, including neuropsychological testing, functional magnetic resonance imaging (fMRI), and WADA testing, may be used prior to surgery to define vital regions of the brain and limit risks associated with removal of the epileptic zone.

Treatment

Most children with epilepsy are well controlled with medication and develop normally with few limitations. However, some children experience uncontrolled seizures or intractable epilepsy despite aggressive treatment with antiepileptic therapy. In these children, epilepsy surgery or surgical removal of the "epileptic zone" of brain tissue is often considered.

Although in the past, surgical treatment for epilepsy was considered only after a long period of seizures and multiple medication trials, individuals who will develop intractable epilepsy can now be identified earlier. A surgical evaluation will often be considered when a child has not responded to two or three antiepileptic medications.

This page was last updated on 11/23/04.