What is Pediatric Epilepsy? Types, Symptoms, Causes, Diagnosis, and Treatment

Seeing your child have a seizure can be a scary and confusing experience. You may have a million questions—why did this happen? What does it mean? Will it happen again? If you’re feeling unsure, you’re not alone.

Epilepsy is a common neurological condition in kids, affecting about 1 in 100 worldwide. It causes recurring seizures, which happen when there’s a sudden surge of electrical activity in the brain.

While epilepsy can be challenging, many kids live healthy, active lives with the right care. In this blog, we’ll break down the signs, causes, and available treatments for pediatric epilepsy, so keep reading!

What is pediatric epilepsy?

Pediatric epilepsy simply means epilepsy that starts in childhood. It isn’t a single disease but a condition with different causes, types, and treatments. Some children outgrow it, while others may need long-term treatment.

To understand epilepsy, think of the brain as an electrical system. Neurons (brain cells) communicate using tiny electrical signals. But in epilepsy, these signals go haywire—like a sudden thunderstorm in a usually calm sky—causing a seizure.

Types of pediatric epilepsy

Pediatric epilepsy includes various types, each with unique symptoms and patterns. Let’s explore them:

Benign rolandic epilepsy (BRE)

A common childhood epilepsy that starts between ages 3 and 10. Seizures usually occur at night and cause twitching, numbness, or tingling in the face and tongue. Most children outgrow it by adolescence.

Childhood absence epilepsy (CAE)

Begins between ages 4 and 10 and is marked by frequent brief staring spells that can happen multiple times a day. These seizures are often mistaken for daydreaming but can affect learning and attention.

Juvenile myoclonic epilepsy (JME)

Usually appears between ages 12 and 18. It causes sudden muscle jerks, tonic-clonic seizures, and occasional staring spells. Seizures often happen shortly after waking up and may be triggered by a lack of sleep or flashing lights.

Lennox-Gastaut syndrome (LGS)

A severe epilepsy that starts between ages 1 and 6. It involves multiple seizure types and is often linked to developmental delays. Seizures can be difficult to control and may impact daily functioning.

Infantile spasms (West syndrome)

A rare epilepsy that appears before age 1. It causes sudden, repetitive spasms affecting the head, arms, or legs, often in clusters. If untreated, it can lead to developmental issues.

Benign occipital epilepsy

Affects vision and has two types: Panayiotopoulos Syndrome, which starts between ages 3 and 5 and causes vomiting, visual disturbances, and seizures, and Gastaut-Type Syndrome, which begins around ages 8 to 9 and includes visual hallucinations and focal seizures.

Landau-Kleffner syndrome (LKS)

A rare epilepsy that appears between ages 3 and 7. It causes a gradual loss of language skills, making it difficult for children to speak and understand words. Seizures mostly occur during sleep.

Febrile Seizures

Not epilepsy, but it's common in children between 6 months and 5 years. These seizures are triggered by high fever and usually last a few minutes. Most children outgrow them without complications.

Developmental and epileptic encephalopathies

Severe syndromes that cause both frequent seizures and developmental delays. Examples include

• Ohtahara Syndrome, which appears in infancy with tonic spasms,

• Dravet Syndrome, which begins in infancy with prolonged seizures often triggered by fever

Signs and symptoms of pediatric epilepsy

Epilepsy in children doesn’t always look like what most people imagine—shaking and falling to the ground. In reality, seizures can be much more subtle, and symptoms vary depending on the type of seizure and which part of the brain is involved.

Below are common signs of seizures:

General signs of seizures

Seizures can look different from child to child, but some common warning signs include:

• A strange feeling in the stomach (like “butterflies”)

• Sudden fear or panic

• A sense of déjà vu (feeling like they’ve been in the moment before)

• Tingling or numbness in part of the body

• Seeing flashing lights or distorted images

• Hearing unusual sounds, like buzzing or ringing

Behavioral and cognitive symptoms

Epilepsy can sometimes affect learning, memory, and emotions. If your child:

• Forgets things easily or has trouble focusing in school

• Struggles with speech or understanding instructions

• Seems withdrawn, anxious, or moody for no reason

• Gets unusually aggressive or hyperactive

…it might not just be a “phase.” Seizures can briefly disrupt brain function, leading to these issues. Studies show that up to 71% of children with epilepsy have behavioral problems before treatment.

Symptoms based on seizure types and their presentation

Depending on which part of the brain is affected, seizures can look very different.

1. Focal (Partial) seizures

These seizures begin in one section of the brain and don’t always cause a loss of awareness, so they might be mistaken for brief, unusual behavior.

• Simple focal seizures – when your child suddenly experiences a weird sensation like tingling, dizziness, or a strong wave of emotions like fear or excitement. They may have involuntary twitching in one hand or leg, but they can still talk and respond.

• Complex focal seizures – these are a bit trickier to spot. The child may seem confused, stare blankly, chew or smack their lips, or make repeated movements (like rubbing their hands or fiddling with clothes). They may not respond when spoken to.

2. Generalized Seizures

They affect both sides of the brain at once and may cause loss of consciousness.

• Tonic-clonic seizures (Grand mal seizures) – this is the classic seizure most people think of. The child suddenly stiffens (tonic phase), and then the body starts jerking (clonic phase). They may fall, lose consciousness, bite their tongue, or even lose bladder control. It can be scary to witness, but it usually lasts less than 2 minutes.

• Absence seizures (Petit mal seizures) – your child suddenly staring into space for a few seconds, they don’t respond, blink rapidly, or look “checked out.” These are often mistaken for daydreaming or lack of attention in school.

• Myoclonic seizures – quick, sudden jerks or twitches, like an exaggerated startle reflex. They often occur in the morning after waking up.

• Atonic seizures (drop attacks) – The child suddenly loses muscle tone and falls to the ground, often leading to injuries.

3. Infantile spasms (West syndrome)

This severe type of epilepsy happens in babies, usually before 1 year old. The baby may suddenly bend forward, stretch their arms, or jerk their head repeatedly. It often occurs in clusters and can lead to developmental delays if not treated.

4. Febrile seizures

These occur in young children when they have a high fever (above 100.4°F or 38°C). The child may shake, stiffen, or lose consciousness for a few minutes. While febrile seizures are usually harmless and are not considered epilepsy, repeated episodes can increase the risk of developing epilepsy later in life.

When to see a doctor

If your child shows any of these signs, it's important to see a doctor:

• Frequent blank stares or sudden confusion

• Recurrent sudden collapses or falls without tripping

• Episodes where they don’t respond when spoken to

• Unexplained jerking movements or stiffening episodes

• Repetitive behaviors like lip-smacking, fumbling, or blinking

However, a seizure doesn’t mean epilepsy every time. In some cases, fever, infections, or metabolic issues can trigger them. But if they happen more than once, consult a neurologist who can evaluate your child to rule out epilepsy.

Concerned about your child’s seizures? Contact QCG and find support with our trusted doctors and hospitals.

What is the main cause of epilepsy in children?

Epilepsy occurs when there is unusual electrical activity in the brain. It can have different triggers, and sometimes, the exact cause isn’t clear. Here are some possible causes:

Genetic causes

Some children inherit epilepsy from their parents or develop it due to genetic mutations. If a family member has epilepsy, the child may have a higher chance of developing it.

Certain genetic conditions, like Dravet syndrome or Rett syndrome, are also linked to epilepsy. Studies show that genetic factors cause about 28.7% of early childhood epilepsy cases.

Brain structure issues

Sometimes, epilepsy happens because of problems in the brain’s structure. Some children are born with brain malformations that interfere with normal electrical activity.

Others may develop epilepsy due to complications at birth, such as a lack of oxygen (hypoxic-ischemic injury), which is responsible for 22% of drug-resistant epilepsy cases. Head injuries from accidents or conditions like brain tumors can also trigger epilepsy.

Metabolic and chemical imbalances

The brain needs the right balance of chemicals to work properly. If something disrupts this balance, it can lead to seizures.

Some rare metabolic disorders, low blood sugar in newborns, and exposure to harmful substances during pregnancy can increase the risk. Infections during pregnancy, like rubella, can also affect a baby’s brain development and lead to epilepsy.

Brain infections

Certain infections can also affect the brain and lead to epilepsy. Meningitis and encephalitis are two serious conditions that can cause swelling in the brain, which may trigger seizures. Children who have had infections affecting their nervous system are more likely to develop epilepsy later on.

Developmental Conditions

Some children with developmental conditions like autism and cerebral palsy are more prone to epilepsy. Studies show that about one-third of children with autism experience seizures. Other conditions, like Sturge-Weber syndrome and tuberous sclerosis, can also raise the risk of epilepsy.

Acquired causes

Things that happen before or during birth can increase the risk of epilepsy. If a baby is exposed to alcohol or drugs in the womb, it can affect brain development. Difficult births, where the baby doesn’t get enough oxygen or experiences head trauma, can also lead to epilepsy later in life.

Unknown Causes

In many cases, doctors can’t find a clear reason why a child has epilepsy. This is called idiopathic epilepsy, meaning there’s no obvious medical cause. Studies suggest that around 40% of pediatric epilepsy cases fall into this category.

Diagnosis of epilepsy

Diagnosing epilepsy in children requires a detailed medical history, brain activity tests, and imaging scans. Since seizures vary in appearance, doctors use multiple methods to confirm epilepsy and find the best treatment.

Medical history and symptoms

Doctors first gather information about the child’s seizures:

• What happens during and after the seizure?

• How long does it last?

• Any warning signs?

• Family history of epilepsy or past brain injuries?

Parents may be asked to record videos of seizures for better assessment.

Electroencephalogram (EEG)

An EEG records brain activity using small electrodes placed on the scalp. It helps detect abnormal electrical patterns linked to seizures. If a standard EEG is normal, longer or video EEG tests may be needed.

Brain imaging (MRI and CT scans)

These scans help identify possible causes, such as:

• Brain malformations present at birth

• Scars from past injuries or infections

• Rare tumors or cysts

MRI is the preferred scan for detecting epilepsy-related brain changes.

Genetic testing

If no clear cause is found, genetic tests may help diagnose epilepsy syndromes, especially in cases with early-onset seizures or developmental delays.

Electroclinical syndromes

Doctors also categorize epilepsy based on the age when it starts:

• Neonatal (birth to 1 month): Ohtahara syndrome, early myoclonic encephalopathy

• Infancy (1 month to 1 year): West syndrome (infantile spasms), dravet syndrome

• Childhood (1-10 years): Childhood absence epilepsy, Lennox-Gastaut syndrome

• Adolescence (10-18 years): Juvenile myoclonic epilepsy, epilepsy with generalized tonic-clonic seizures

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How is epilepsy in children treated?

Treatment of pediatric epilepsy depends on the type and severity of seizures. Some kids respond well to medication, while others may need a special diet, medical devices, or even surgery.

The main goal of treatment is to reduce or stop seizures so children can live healthy, active lives. Let’s take a look at some popular treatment options:

Medications (Antiepileptic drugs - AEDs)

For most children, medication is the first line of treatment for epilepsy. Antiepileptic drugs (AEDs) help regulate brain activity and prevent seizures.

Studies show that 81% of children can become seizure-free with either medication or surgery. However, finding the best medication may take time since different drugs work for different types of seizures.

Some common medications for pediatric epilepsy include

• Levetiracetam (Keppra) – commonly prescribed, with fewer side effects

• Valproate (Depakote) – often used for generalized seizures

• Ethosuximide (Zarontin) – effective for absence seizures

Most kids tolerate these medications well, but side effects can include drowsiness, mood changes, or stomach issues. Doctors usually recommend starting medication after a child has experienced at least two unprovoked seizures.

Ketogenic diet

If medications aren’t effective, doctors may suggest a high-fat, low-carb diet. This diet changes how the body produces energy, which can help lower seizure frequency.

However, it requires strict meal planning with measured amounts of fat and carbohydrates. Plus, kids on this diet need regular medical check-ups to make sure they get proper nutrition. Some children may experience digestive issues or low energy at first.

Despite these challenges, many families find that the ketogenic diet improves their child’s seizures and overall well-being.

Neurostimulation therapies

Neurostimulation is another way to help manage epilepsy in children. These treatments use small electrical signals to help calm irregular brain activity and reduce seizures.

These therapies include:

• Vagus nerve stimulation (VNS): A small device implanted in the chest sends gentle electrical signals to the brain through the vagus nerve, helping prevent seizures.

• Responsive Neurostimulation (RNS): A device placed in the brain tracks activity and delivers small electrical pulses when it detects the early signs of a seizure.

Research shows that around 41% of children using RNS experienced at least a 50% decrease in seizures. While neurostimulation doesn’t cure epilepsy, it can make seizures less frequent and easier to manage.

Surgery

For some children, epilepsy is caused by a specific area in the brain that can be surgically removed. Surgery is only considered when:

• Seizures come from one clear location in the brain

• Medications and other treatments haven’t worked

• The benefits of surgery outweigh the risks

Doctors may perform:

• Resection surgery that removes the small part of the brain responsible for seizures

OR

• Corpus callosotomy that partially disconnects the left and right sides of the brain to stop seizures from spreading.

As per research, up to 45% of children who undergo epilepsy surgery become completely seizure-free. Many others see a significant drop in seizure frequency, improving their quality of life.

How to manage epilepsy in kids with lifestyle changes?

Making simple changes in daily habits can help reduce seizures and improve your child’s well-being.

• Follow a regular sleep schedule to prevent sleep-related seizures.

• Provide a healthy diet and keep your child hydrated to support brain function.

• Help manage stress with relaxation techniques like deep breathing.

• Identify and avoid triggers such as flashing lights or excessive screen time.

• Encourage safe physical activities like swimming or biking with supervision.

• Make sure medications are taken on time and exactly as prescribed.

Bottom line

Managing pediatric epilepsy can be challenging, but with the right care, kids can still live happy, active lives. Early diagnosis makes a big difference, and with expert medical support and lifestyle adjustments, seizures can be better controlled.

If you're looking for expert guidance, Quality Care Global (QCG) has a trusted network of pediatric epilepsy specialists and neurologists who can help. Reach out today to explore treatment options abroad!