Epilepsy disease in children

Epilepsy patients are frequently subjected to negative prejudice in the society and therefore are victimized. This situation makes the life of the patient and his family very difficult. However, epilepsy patients can continue their daily life with appropriate treatment like any diabetes and blood pressure patient.

Epilepsy, commonly known as epilepsy, is a disease that originates in the brain and manifests itself with recurrent seizures. A disorder in the normal functioning of the brain can cause a sudden and excessive electrical discharge, causing a change in a person’s behavior and consciousness. Saying that the recurrence of these seizures in attacks is called epilepsy disease, VM Medical Park Samsun Hospital Pediatric Neurology Specialist Dr. Hülya İnce states that attention should be paid to situations that are confused with epilepsy and that the disease is divided according to ages in childhood.



What are the symptoms of epilepsy in children?

The most common paroxysmal disorder of the neonatal period is seizures and it is seen in 1.8-3.5 percent of every 100 live born babies. Situations called febrile referrals are seen in 4 percent of children between the ages of 6 months and 5 years. It is observed that about half of these children develop epilepsy in the future. In infancy, it should be differentiated from pathological conditions such as breath-holding seizures (joining seizures), gastroesophageal reflux disease, infantile masturbation or startle disease, as well as physiological conditions such as shaddering attack, benign extraocular eye movements, and jitteriness. Differential diagnosis of psychogenic seizures, cardiac-induced syncope, tic disorder, daydream or migraine headache, which are defined as cyclic vomiting and benign paroxysmal vertigo, should be made in game and school age children.

In order for an event to be considered as an epileptic attack, there must be something different from the normal in the child at the time of the attack. There should be an “attack, period” in the form of “interruption” in the movements or consciousness of the child, the presence of movements, contractions, tremors or jumps in the body that are different from normal, or the inability to use or move the body unlike normal. Unconsciousness may not accompany some seizures. Psychogenic seizures, cardiac syncope, tic disorder, movement disorders and sleep disorders are often the first ones to come to mind in an adolescent patient. How is epilepsy diagnosed? In a situation where the list of differential diagnoses is so wide, the correct decision can only be reached by listening to the detailed history of the patient and performing a comprehensive physical examination. For this reason, what the person who saw the event will tell is very valuable for the physician. Epilepsy can be defined as having recurrent (two or more), sudden (not triggered by an event) seizures of epileptic character. Since the seizure interval is too long creates difficulties at the time of diagnosis, the presence of “two or more seizures in a year” is usually sought. Electroencephalography (EEG) method is used for diagnosis. However, the gold standard diagnostic value of EEG is only found during seizures. EEG made after the seizure may be normal. This situation does not exclude the disease. Therefore, 3-4 EEG records are requested from the patient at regular intervals. With each EEG, the rate of detection of the disease increases.


Is drug therapy suitable for children?

Antiepileptic drugs are used in the treatment of epilepsy. Ideally, a single drug treatment is preferred. The choice of these drugs is very important. Drug selection should be made according to the type of epileptic disease and seizure. Side effects that may be seen in the patient during the treatment should be followed. Epilepsy is a condition that can be treated at a rate of 60-70 percent in children with normal development. However, there is also a small group of patients called resistant epilepsy who have to use multiple drug therapy. While some epilepsy patients need to use drugs for life, in some epilepsies the drug should not be discontinued until adolescence. If it is in the group called symptomatic epilepsy, drug therapy often continues. Therefore, it is important to decide according to the patient.

Epilepsy classification should be made for each patient and treatment decision should be made accordingly. Two or more basic antiepileptic drugs must have been used for at least two years to conclude that drug therapy is not effective. The Ketogenic Diet method is very successful in specially selected patient groups. Some patients can undergo epilepsy surgery. Here, the epilepsy pacemaker that stimulates the vagus nerve can be used, as well as the surgical method in which the lesion is removed by surgically removing the brain region that causes epileptic discharge. Sometimes it is preferred to use methods called Callosotomy or Pial Resection. In order to make these decisions, different diagnostic examinations of the patient should be done.



A big task falls on families

First of all, it is important for the province to apply medication regularly. In addition, the child should not be sleep deprived, should not be hungry for a long time, and should be checked regularly. In addition, it is extremely important to avoid febrile illnesses. The contact with photosensitive stimuli such as computers, televisions and tablets should be reduced. Drugs and foods that can induce seizures should be avoided. Drug treatment should be reviewed frequently. Attention deficit and hyperactivity disorder are common with epilepsy. Therefore, if it is deemed necessary, it would be appropriate to evaluate it by a child psychiatrist. Since the main disease that causes epilepsy will also affect learning, it is necessary to make a special assessment for each patient.

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