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About Pediatric Epilepsy

Epilepsy is a disorder of repeated, unprovoked seizures more common in young children than in adults. Most children’s seizures will be controlled without surgery; however, when medication is not enough to manage a child’s seizures, our caring and experienced pediatric neurosurgeons at Columbia University Medical Center/NewYork-Presbyterian Hospital may be able to offer surgical options to treat epilepsy that include resection, corpus callosotomy, and more.

At our Comprehensive Epilepsy Center, experts use the latest technology to diagnose epilepsy, determine the location of the seizures’ origin in each patient’s brain, and tailor individualized treatment plans. Our pediatric neurosurgeons work as part of a team that includes pediatric epileptologists, pediatric neurologists, neuroradiologists, psychologists, and more.

PEDIATRIC SEIZURES

A pediatric seizure can be an alarming event, and a suspected seizure should be investigated by a medical team. There are many potential causes of pediatric seizures besides epilepsy, including fever, meningitis, a metabolic imbalance, exposure to a toxin, head injury, or a tumor or other lesion. Sometimes no cause is ever determined. It is estimated that 10 percent of people will have a seizure during their lifetimes. Only one to three percent of people have epilepsy.

PEDIATRIC EPILEPSY

Epilepsy is a disorder of repeated seizures. There are many different types of epilepsy, with different causes, extents, and effects. In general, there are two major types: generalized epilepsy, in which seizures affect the entire brain, and partial (or focal) epilepsy, in which seizures begin in a specific portion of the brain.

Generalized epilepsies have no defined area in the brain from which the seizures originate. There are two varieties of generalized epilepsies. One is idiopathic, in which the brain behaves normally between seizures. The other variety of generalized epilepsy is symptomatic, in which a clear structural abnormality contributes to the seizures.

Types of seizures caused by generalized epilepsy include:

  • Absence, or petit mal, seizures: These seizures are characterized by a brief lapse in awareness that lasts a few seconds and causes the person to stare or have twitches in the eyelids or face muscles. These seizures, which may occur up to hundreds of times a day, commonly begin before age two and end after childhood.
  • Tonic-clonic, or grand mal, seizures: These seizures are characterized by a sudden and complete loss of consciousness and a stiffening of the arms and legs that causes the person to fall (called the tonic phase) before a rhythmic jerking (called the clonic phase) begins. When the seizing does not stop, it may become a status epilepticus seizure. This uncontrolled seizing requires immediate medical attention to prevent brain damage or death.
  • Tonic seizures: These seizures are similar to tonic-clonic seizures, but are not followed by the rhythmic jerking of the clonic phase.
  • Myoclonic seizures: These generalized seizures involve very brief, lightning-like jerks of any part of the body without a loss of consciousness.
  • Atonic seizures: People with these seizures experience a sudden loss of muscle tone resulting in collapse, sometimes head first, into the ground.

In partial (focal) epilepsy, seizures begin at a specific point in the most highly developed parts of the brain. Often defined by their point of origin, types of partial epilepsy include frontal lobe epilepsy, occipital lobe epilepsy, temporal lobe epilepsy,  and parietal lobe epilepsy.

While the electrical activity of a focal seizure begins in a localized area, the seizure can spread and become a generalized seizure. Seizures caused by partial (focal) epilepsy include:

  • Complex partial seizures (psychomotor attacks): These seizures often begin with an aura, or a neurological warning, such as a sense of fear, an unpleasant smell, or change in perception. After the aura, consciousness may be altered; speech may stop and the person may perform automatic repetitive movements such as chewing, swallowing, hand fidgeting, or purposeless movement from place to place.
  • Simple partial seizures: These seizures typically affect the motor or sensory areas of the brain, causing jerking movements in the hand or facial muscles, or sensory symptoms such as flashing lights or a buzzing sound–but not an alteration in consciousness.

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