Epilepsy in babies is one of the diseases that parents fear most.
In Indonesia, epilepsy is often known as ayan disease. This disease if not prolonged and untreated can cause permanent damage, due to decreased oxygen flow to the brain and excessive brain cell activity.
However, some experts say that epilepsy in babies can be cured, depending on when it occurs and the type that attacks the little one.
What are the symptoms of epilepsy? Then, how to care for a child who suffers from the disease? Read the following information until the end!
What is Epilepsy in Babies?
Epilepsy in babies is a brain condition that causes your little one to have seizures . It is one of the most common nervous system disorders.
The disease affects children and adults of all races and ethnic backgrounds.
The brain is made up of nerve cells that communicate with each other through electrical activity.
A seizure occurs when one or more parts of the brain experience a burst of abnormal electrical signals that disrupt normal brain signals.
Anything that disrupts the normal connections between nerve cells in the brain can cause a seizure.
These include high fever , high or low blood sugar, alcohol or drug withdrawal, or concussion.
However, when a child experiences 2 or more seizures without a known cause, it is diagnosed as epilepsy.
The risk of seizures in infants is highest in the first year after birth and especially in the first month of life.
This is especially true for babies born too early. There are 3 groups of babies at risk of having seizures, namely:
This explains some of the most common seizures these babies experience, as well as some of the causes.
Conditions related to febrile seizures , which are seizures triggered by high temperatures are not included here.
What are the Types of Epilepsy in Children?
As reported by Healthline , there are several types of epilepsy that specifically occur in children, including:
- Myoclonic astatic epilepsy of childhood (Doose syndrome) . This seizure is characterized by sudden loss of muscle control without any known cause.
- Benign rolandic epilepsy . These seizures involve twitching, numbness, or tingling of the face or tongue and may cause problems with speech or salivation. The condition usually resolves by adolescence.
- Rasmussen syndrome . This rare autoimmune syndrome is characterized by focal seizures that are usually the first symptom. Surgery is usually the best treatment for this condition, as seizures can be difficult to manage with medication.
- Lennox-Gastaut syndrome . This rare condition involves several types of seizures and is often seen in children with developmental delays . The cause of this condition is unknown.
- Electrical status epilepticus during sleep . This disorder is characterized by seizures during sleep and abnormal EEG findings during sleep. It usually occurs in school-age children, especially while they are sleeping. It can involve learning or language delays as well.
- Sturge-Weber syndrome . Children with this condition usually haveflammable nevus(also called port-wine spots) on their scalp, forehead, or around their eyes. They may experience seizures, weakness, developmental delays, and vision difficulties. Surgery is sometimes needed when medications don’t help the condition.
- Myoclonic epilepsy . This condition begins around puberty and usually presents as small, rapid jerking movements called myoclonic seizures. Absence seizures can also occur. This condition can usually be managed with medication.
What are the Symptoms of Epilepsy in Babies According to Type?
Symptoms of epilepsy in babies depend on the type of seizure. There are different types of seizures depending on which part and how much of the brain is affected and what happens during the seizure. The two main categories of epileptic seizures are focal (partial) seizures and generalized seizures.
1. Focal Seizures
Focal seizures occur when abnormal electrical brain function occurs in one or more areas on one side of the brain (partial or partial).
Before a focal seizure, a child may have an aura or signs that a seizure is about to occur. This is more common in complex focal seizures.
The most common symptoms involve feelings, such as deja vu, impending doom, fear, or euphoria.
In fact, babies may experience visual changes, hearing abnormalities , or changes in their sense of smell.
The following 2 types of focal seizures are:
Simple focal seizures
Symptoms depend on which area of the brain is affected.
If the abnormal electrical function of the brain is in the part of the brain involved with vision (occipital lobe), the baby’s vision may change.
More often, muscles are affected. Seizure activity is limited to isolated muscle groups.
For example, it may only involve the fingers, or the larger muscles in the arms and legs.
Babies may also sweat, feel nauseous, or turn pale. However, they will not lose consciousness in this type of seizure.
Complex focal seizures
This type of seizure often occurs in the area of the brain that controls emotional and memory functions (temporal lobe).
The child will most likely lose consciousness. This may not mean that he will pass out . However, he will seem to stop being aware of what is happening around him.
Your little one may also seem awake, but have various unusual behaviors. For example, suddenly gagging , suddenly screaming, crying, or laughing.
Children may also appear overly tired or sleepy after a seizure. This is called the postictal period.
2. Generalized seizures
Generalized seizures occur on both sides of the brain. The baby will lose consciousness and become tired after the seizure (postictal state). Types of generalized seizures include:
Absence of seizures
This is also called a seizuresmall.
These seizures cause a brief altered state of consciousness and gaze.
The baby will likely maintain his posture . His mouth or face may twitch or his eyes may blink rapidly.
Seizures usually last no more than 30 seconds.
When the seizure is over, the baby may not remember what just happened.
He may continue with his activities as if nothing had happened. These seizures can occur several times a day.
This type of seizure is sometimes mistaken for a learning or behavioral problem. Absence seizures almost always begin between the ages of 4 and 12.
Atonic seizures
This is also called a drop attack. With an atonic seizure, the baby suddenly loses muscle tone and may fall from a standing position or suddenly drop his or her head. During the seizure, the baby will be limp and unresponsive.
Generalized tonic-clonic seizures
Generalized Tonic-Clonic (GTC) seizures are also called generalized tonic-clonic seizures.grand mall. The classic form of this type of seizure has 5 distinct phases.
The baby’s body, arms, and legs will flex (contract), extend (straighten), and shake (shake).
This is followed by muscle contractions and relaxation (clonic period) and a postictal period.
During the postictal period, the baby may be drowsy . He or she may have problems with vision or speech, and may have a severe headache, fatigue, or body aches.
Not all of these phases occur in everyone with this type of seizure.
Myoclonic seizures
This type of seizure causes rapid or sudden jerking movements of a group of muscles.
These seizures tend to occur in clusters.
This means that they can occur several times a day, or for several days in a row.
Common symptoms or warning signs of a seizure may include:
- Eyes widen
- Jerking movements of the arms and legs
- Body stiffness
- Loss of consciousness
- Breathing problems or stopping breathing
- Loss of bowel or bladder control
- Sudden fall for no apparent reason, especially when associated with loss of consciousness
- Not responding to sounds or words for a short period of time
- Seems confused or blurry
- Rhythmic head nodding, when associated with loss of consciousness or awareness
- Periods of rapid eye blinking and bulging.
During a seizure, the baby’s lips may turn blue and his or her breathing may be abnormal.
After a seizure, a baby may be drowsy or confused.
Seizure symptoms may resemble other health conditions. Make sure your baby sees his or her healthcare provider right away for a diagnosis.
How Big is the Risk of Epilepsy in Babies?
In 2015, 1.2% of the total US population had active epilepsy. This is about 3.4 million people with epilepsy nationwide: 3 million adults and 470,000 children.
According to recent estimates, about 0.6% of children aged 0-17 years have active epilepsy. Imagine a school with 1,000 students—that means about 6 of them may have epilepsy.
Meanwhile, seizures in infants are the most common neurological emergency in the first 4 weeks of a baby’s life.
As many as 1–5 babies per 1,000 experience seizures.
Some seizures last only a few minutes and occur once, leaving no lasting damage.
When babies have frequent seizures, they need treatment to prevent brain damage.
Brain damage occurs due to frequent disturbances in brain oxygen levels and excessive brain cell activity.
What is the Difference Between Epilepsy and Seizures?
The difference between epilepsy and seizures is that a seizure is a single event while epilepsy is a neurological condition characterized by two or more unprovoked seizures.
In addition, seizures are the main symptom of epilepsy, but seizures can also be caused by a number of other events.
Non-epileptic seizures are seizures caused by situations unrelated to epilepsy.
Some causes of nonepileptic seizures include fever, head injury, infection such as meningitis , choking, very high blood pressure, metabolic problems such as kidney or liver failure, low blood sugar levels, stroke, or brain tumors .
What Causes Epilepsy in Babies?
Epilepsy begins with seizures more than 2 times. Seizures can be caused by many things. Commonly it is an imbalance of brain chemicals that signal nerves (neurotransmitters), brain tumors, strokes, or even brain damage due to disease or injury.
Seizures can be caused by a combination of these things. In most cases, the cause of the seizures cannot be found. Some of them are:
Structural Causes
Born on time but lack of oxygen to the brain.
This condition is called perinatal hypoxia and can lead to brain injury called hypoxic-ischemic encephalopathy or being born with some damage to their brain.
In addition, this event is also called cerebral dysplasia or dysgenesis.
Cerebral means relating to the brain. Dysplasia or dysgenesis means abnormal development.
Metabolic Causes
Having low levels of glucose, calcium, or magnesium in the blood.
Causes of Infection
Have an infection such as meningitis or encephalitis.
Genetic Causes
Inheriting a medical condition, such as self-limiting familial infantile spasms, or having a disorder such as GLUT 1 deficiency, or a genetic disorder, such as Dravet syndrome or Ohtahara syndrome.
Meanwhile, quoted from the Epilepsy Action page , babies born prematurely are very susceptible to brain injury and are prone to seizures in the first weeks of life.
The most common causes of seizures in premature babies are brain bleeding and infection, although the cause is not known for all babies.
Babies with low birth weight appear to be at particular risk for seizures.
What are the Dangers of Epilepsy in Babies?
Some babies will continue to have seizures as they get older, but some babies will never have another seizure.
It really depends on when the seizures started, and what type of seizures they were having.
Seizures, especially in early infancy, can be catastrophic to cognitive and motor development .
Because the human brain is not fully developed at birth, during infancy and early childhood, children’s brains undergo a long period of growth and maturation.
If seizures occur during this critical period, they can cause serious impairment in cognitive, behavioral, and psychiatric functioning.
Experts agree that early surgical intervention is essential in infants with catastrophic epilepsy to prevent developmental arrest or regression.
Abnormal brain waves between seizures that begin early in life are more likely to be associated with intellectual deficits, epileptic encephalopathy, autism , and reduced brain volume.
How is Epilepsy Diagnosed?
The healthcare provider will ask about your baby’s symptoms and medical history. Parents will be asked about other factors that may cause seizures in their little one, such as:
- Recent fever or infection
- Head injury
- Congenital health conditions
- Premature birth
- The latest medicines.
Babies may also have:
- Neurological examination
- Blood tests to check for blood sugar problems and other factors
- Brain imaging tests, such as an MRI or CT scan
- Electroencephalogram, to test the electrical activity in a child’s brain.
- Lumbar puncture (spinal tap), to measure pressure in the brain and spinal canal and test cerebral spinal fluid for infection or other problems.
How to Differentiate Epilepsy from Infant Reflexes?
Sometimes, when babies show signs of seizures, they are showing healthy reflexes. Types of reflexes in babies, namely:
Moro Reflex
The Moro reflex , or startle, reflex is a healthy part of a baby’s development.
If a baby hears a loud noise or feels a sudden movement, they may throw their head back and suddenly stiffen and reach out with their arms.
Parents or caregivers should not be alarmed when they see this behavior. Babies tend to outgrow this reflex by 3–6 months.
Tonic Neck Reflex
The tonic neck reflex is a movement in which the baby looks to the side with one arm extended and the other bent; it may look like he is imitating holding a sword or shooting an arrow.
This reflex first develops in the womb and helps babies coordinate their eyes and control fine movements. Babies can show this reflex up to 9 months of age.
However, although this reflex appears with signs such as eye rolling, lip paddling, and leg paddling, these are normal movements, especially in newborns.
It should be noted that this reflex does not present with the typical features of a seizure, such as jerking or stiffening.
How to Cure Epilepsy in Babies?
The goal of treatment for epilepsy in infants is to control, stop, or reduce how often seizures occur. Treatment is most often with medications. Many types of medications are used to treat seizures and epilepsy.
Drugs
Some epilepsy drugs used in infants include carbamazepine, clonazepam, levetiracetam, phenobarbital, phenytoin, sodium valproate, stiripentol and vigabatrin.
Pyridoxine ( vitamin B6 ) is also sometimes used. An epilepsy specialist may also prescribe other epilepsy medications, depending on the baby’s condition.
The child’s healthcare provider needs to identify the type of seizure the baby is having.
Medications are selected based on the type of seizure, the child’s age, side effects, cost, and ease of use.
Medications used at home are usually taken in the form of capsules, tablets, sprinkles, or syrups.
Some medications can be given into the rectum or nose. If your baby is in the hospital with seizures, medications may be given by injection or through a vein (IV).
It is important to give your baby medication on time and as prescribed. The dose may need to be adjusted for best seizure control. All medications can have side effects.
Talk to your child’s healthcare provider about possible side effects.
If your baby has side effects, talk to your healthcare provider. Do not stop giving your baby the medicine.
This can cause more or worse seizures.
Ketogenic Diet
If medication doesn’t work well enough for your baby to control seizures or they have problems with side effects, your healthcare provider may suggest another type of treatment.
Babies may be treated with other healing methods, such as a ketogenic diet.
The ketogenic diet is a type of diet that is very high in fat, and very low in carbohydrates.
Sufficient protein is included to help promote growth.
Dieting causes the body to make ketones. These are chemicals made from the breakdown of body fat.
The brain and heart work normally with ketones as an energy source.
This particular diet must be followed strictly. Too many carbohydrates can stop ketosis.
Researchers aren’t sure why the diet works.
However, some children become seizure-free while on the diet. The diet does not work for every child.
Vagus Nerve Stimulation
Vagus nerve stimulation (VNS) treatment sends small energy pulses to the brain from one of the vagus nerves.
This is a pair of large nerves in the neck. If your child is 12 years or older and has partial seizures that are not well controlled with medication, VNS may be an option.
VNS is performed by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around one of the vagus nerves.
The battery is then programmed to send energy impulses every few minutes to the brain. When the child feels a seizure coming on, he or she can activate the impulses by holding a small magnet over the battery.
In many cases, this will help stop the seizures. VNS can have side effects such as hoarseness, sore throat, or voice changes.
Operation
Surgery may be performed to remove the part of the brain where the seizures occur.
In fact, surgery helps stop the spread of bad electrical currents through the brain.
Surgery may be an option if a child’s seizures are difficult to control and always start in one part of the brain that does not affect speech, memory, or vision.
Surgery for epileptic seizures is very complex. It is performed by a specialized surgical team.
Your child may be awake during surgery. The brain itself does not feel pain. If your child is awake and can follow commands, the surgeon will be better able to examine areas of his or her brain during the procedure. Surgery is not an option for everyone with seizures.
How to Prevent Epilepsy?
The World Health Organization (WHO) estimates that up to a quarter of all epilepsy cases are preventable.
While this does not apply to epilepsy caused by genetics, WHO shares a number of measures that can help prevent epilepsy, including:
- prevent head injuries
- improving prenatal care to reduce birth injuries
- provide appropriate drugs and methods to reduce children’s fever and prevent febrile seizures
- reduce cardiovascular risks such as smoking, alcohol use, and obesity
- treat infections and eliminate parasites that can cause epilepsy from central nervous system infections.
Tips for Caring for Babies with Epilepsy
Parents can help babies with epilepsy manage their health. Be sure to:
- If age appropriate, make sure your baby understands the type of seizure he or she is having, and the type of medication needed.
- Know the dosage, timing, and side effects of all medications. Give your baby medications exactly as directed.
- Talk to your child’s healthcare provider before giving your baby any other medicines. Medicines for seizures can interact with many other medicines. This can cause the medicine to not work as well, or cause side effects.
- Help your baby avoid anything that might trigger a seizure. Make sure your baby gets enough sleep, as lack of sleep can trigger a seizure.
- Make sure your baby sees his or her healthcare provider regularly. Try to get your baby tested as often as needed.
- Keep in mind that your baby may not need lifelong medication. Talk to your healthcare provider if your child has not had a seizure for 1 to 2 years.
- If your baby’s seizures are well controlled, you may not need to limit many activities. Make sure your baby wears a helmet for sports like skating, hockey, and biking. Make sure your baby has adult supervision when swimming.
Popular Frequently Asked Questions Regarding Epilepsy in Babies
What are the Characteristics of Epilepsy in Babies?
Some of the characteristics of epilepsy in babies that mothers should know are:
- Baby has repeated seizures
- Skin looks bluish during a seizure
- The baby often looks dazed
- The seizures experienced do not have a clear cause.
- Usually babies can do their normal activities after a seizure.
- Seizures may be accompanied by delays in the baby’s development.
- May be accompanied by persistent motor disturbances.
Can Infant Epilepsy Be Cured?
Unfortunately, epilepsy in babies cannot be completely cured.
To date, there is no known cure for epilepsy.
However, to control seizures, there are many therapies and treatments that can help epilepsy patients.
What Do Children with Epilepsy Behave Like?
Epilepsy can indeed affect a child’s growth and development.
The most common thing that is seen is that children become less enthusiastic, have behavioral problems (easily angered), frustrated, have anxiety disorders, impulsive behavior, and are reluctant to socialize because they are embarrassed or isolated from their peers.
Is Congenital Epilepsy Present from Birth?
Yes, epilepsy is associated with congenital diseases, brain tumors, skull injuries. even strokes. It can happen unexpectedly to anyone and even to those with multiple disabilities.
***
