Epilepsy in children means a tendency to have repeated seizures that are not caused by fever or a passing illness. It is not one disease. There are many childhood epilepsy syndromes, from mild forms that children outgrow to severe forms that begin in infancy.
Most children become seizure-free on the first or second medicine, and many can later stop treatment under supervision. Around a third continue to have seizures despite medicines, and these children should be assessed at a specialist centre for other options.
Symptoms
- Brief staring spells in which the child stops and does not respond, sometimes many times a day
- Stiffening followed by rhythmic jerking of the whole body
- Sudden jerks of the arms, often soon after waking
- Clusters of brief bending or stiffening movements in a baby (infantile spasms)
- Episodes of confusion, lip smacking or fiddling with the hands
- Seizures from sleep with twitching of the face and drooling
- A decline in learning, speech or behaviour alongside seizures
Causes and risk factors
In many children no cause is found and the brain looks normal on scans; genetic factors are thought to play a part. Known causes include differences in how the brain formed before birth, lack of oxygen or bleeding around birth, past meningitis or encephalitis, head injury, brain tumours, and single gene or metabolic disorders. Febrile convulsions in a young child with a fever are common and are not epilepsy. Faints, breath-holding spells, tics, night terrors and daydreaming are often mistaken for seizures, so a careful description matters.
How it is diagnosed
- History and video: A detailed account from someone who saw the event is the most useful information. A phone video of an episode helps greatly.
- EEG: Records the brain's electrical activity, sometimes during sleep or after sleep deprivation. It helps classify the epilepsy type, though a normal EEG does not exclude epilepsy.
- Brain MRI: Looks for a structural cause. Young children may need sedation or a short anaesthetic to lie still.
- Video EEG monitoring: Several days of recording in hospital to capture events, used when the diagnosis is uncertain or surgery is being considered.
- Genetic and metabolic tests: Considered when seizures start in infancy, are hard to control or come with developmental delay.
Treatment options
- Anti-seizure medicines: Chosen according to the seizure type and syndrome, the child's age and sex. Doses are built up slowly and side effects on mood, sleep and learning are watched.
- Ketogenic diet: A strict medically supervised high-fat diet that helps some children with drug-resistant epilepsy. It needs a dietitian and regular blood tests.
- Epilepsy surgery: For selected children whose seizures come from one identifiable area. It needs detailed evaluation at a paediatric epilepsy centre.
- Vagus nerve stimulation: An implanted device that can reduce seizure frequency when surgery is not possible. It rarely stops seizures completely.
- Emergency rescue medicine: Buccal midazolam or rectal diazepam prescribed for the family to give during a prolonged seizure, with a written plan for home and school.
When it is urgent
Call an ambulance if a seizure lasts longer than 5 minutes, if seizures follow one another without recovery, if it is the child's first seizure, if the child has trouble breathing or is injured, or if the seizure happens in water. A baby with clusters of spasms should be seen by a paediatrician within days, because early treatment matters. None of these situations should wait for a planned trip.
Travelling to Türkiye for treatment
A child with epilepsy needs a paediatric neurologist close to home for dose changes, school plans and emergencies. Travel makes sense for a defined purpose: a second opinion on a difficult diagnosis, video EEG monitoring and high-resolution MRI, or a surgical evaluation when medicines have failed. Bring all EEG reports, scan images on disc and a list of every medicine tried with doses. Discuss flying, time zones and medicine timing with your child's doctor first, and carry rescue medicine in hand luggage.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
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Will my child grow out of it?
Many do. Several childhood syndromes, such as childhood absence epilepsy and self-limited epilepsy with centrotemporal spikes, commonly settle by the teenage years. Others are lifelong. Your neurologist can tell you which pattern your child fits.
Do the medicines affect learning?
Some can cause drowsiness, slower thinking or mood changes, especially at higher doses. Uncontrolled seizures also affect learning. Tell the doctor about any change so the medicine or dose can be adjusted.
When is surgery considered?
When two suitable medicines at proper doses have failed and tests suggest seizures start from one area. Referral for evaluation should not be left for many years.
Can my child do sports and swim?
Usually yes, with sensible supervision. Swimming needs an adult who knows about the epilepsy watching closely, and heights and cycling on roads need individual advice.