Epilepsy in ChildrenSymptoms, Doctors, Treatments, Advances & More
Learn About Epilepsy in Children
Epilepsy is a brain disorder in which a person has repeated seizures over time.
A seizure is a sudden change in the electrical and chemical activity in the brain. A single seizure that does not happen again is not epilepsy.
Seizure disorder - children; Convulsion - childhood epilepsy; Medically refractory childhood epilepsy; Anticonvulsant - childhood epilepsy; Antiepileptic drug - childhood epilepsy; AED - childhood epilepsy
Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown.
Common causes of epilepsy include:
- Traumatic brain injury
- Damage or scarring after infections of the brain
- Birth defects that involve the brain
- Brain injury that occurs during or near birth
- Metabolic disorders present at birth (such as phenylketonuria)
- Benign or malignant brain tumor, often very small
- Abnormal blood vessels in the brain
- Stroke
- Hereditary conditions (run in families)
- Other illnesses that damage or destroy brain tissue
Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy.
A febrile seizure is a convulsion in a child triggered by a fever. Most of the time, a febrile seizure is not a sign that the child has epilepsy.
Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected.
Your child's health care provider can tell you more about the specific type of seizure your child may have:
- Absence (petit mal) seizure: Staring spells
- Generalized tonic-clonic (grand mal) seizure: Involves the entire body, including aura (specific warning symptoms), rigid muscles, and loss of alertness
- Partial (focal) seizure: Can involve any of the symptoms described above, depending on where in the brain the seizure starts
Some children can have more than one type of seizure. Most of the time, the seizure is similar to the one before it, although that may change over time. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of déjà vu (feeling that something has happened before). This is called an aura.
Treatment for epilepsy includes:
- Medicines
- Lifestyle changes
- Surgery
If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed.
Medicines to prevent seizures are called antiseizure medicines. They are also known as anticonvulsants or antiepileptic medicines. These may reduce the number of future seizures.
- These medicines are taken by mouth, but some can be given by feeding tube, or intravenously (IV). The type of medicine prescribed depends on the type of seizure your child has.
- The dosage may need to be changed from time to time. Your provider may order regular blood tests to check for side effects.
- Always make sure your child takes the medicine on time and as directed. Missing a dose can cause your child to have a seizure. Do not stop or change medicines on your own. Talk to your child's provider first.
Other medicines are used to stop a seizure that doesn't stop on its own. These can be given under the tongue or by an injection into the muscle. They are called rescue medicines.
Many antiseizure medicines may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements.
Epilepsy that is not well controlled after trying a number of antiseizure medicines is called medically refractory epilepsy. In this case, your child's provider may recommend surgery to:
- Remove the abnormal brain cells causing the seizures.
- Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures.
Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, also may be helpful. Be sure to discuss these options with your child's provider before trying them.
Epilepsy is often a lifelong or chronic illness. Important management issues include:
- Taking medicines
- Staying safe, such as never swimming alone, fall-proofing your home and avoiding activities that could lead to a fall
- Managing stress and sleep
- Avoiding alcohol and medicine or illegal drug abuse
- Keeping up in school
- Managing other illnesses
Managing these lifestyle or medical issues at home can be a challenge. Be sure to talk with your child's provider if you have concerns.
Johns Hopkins Outpatient Center
Catherine Chu is the director of the Division of Pediatric Neurology and the John M. Freeman Pediatric Epilepsy Center in the Johns Hopkins Department of Neurology, as well as the vice president of child neurology at the Kennedy Krieger Institute. As a child neurologist, epileptologist and clinical neurophysiologist, Dr. Chu cares for children diagnosed with epilepsy and disorders of the nervous system (neurophysiology). She specializes in electroencephalogram (also known as EEG) analysis, seizure localization, surgical planning and neuromodulation for adult and pediatric patients with difficult to control epilepsy. She is nationally and internationally recognized for her work identifying causes of and treatment options for cognitive dysfunction and seizures in epilepsy and neurodevelopmental disorders. Dr. Chu’s team specializes in identifying and developing tools to detect and understand brain rhythms that support complex cognitive functions throughout development, including how these rhythms are disrupted by seizures and neurodevelopmental disorders. Dr. Chu earned her medical degree and a master’s degree in social anthropology from Harvard University. She completed an internship in pediatrics at Massachusetts General Hospital, and then a residency in neurology and child neurology at Massachusetts General and Brigham and Women’s Hospital. After completing two fellowships at Massachusetts General, one in epilepsy and another in clinical neurophysiology, Dr. Chu earned a master’s degree in medical science, focused on clinical investigation, from Harvard Medical School. Dr. Chu is rated as an Elite provider by MediFind in the treatment of Epilepsy in Children. Her top areas of expertise are Benign Rolandic Epilepsy, Epilepsy in Children, Seizures, and Epilepsy.
The Children's Hospital At Montefiore
Elissa G. Yozawitz, MD, is Director of Neonatal Neurology at Children’s Hospital at Montefiore Einstein and Professor of Neurology and Pediatrics at our Albert Einstein College of Medicine. Dr. Yozawitz focuses on the neurological management of children, from the neonatal period through adolescence, particularly those with difficult-to-treat seizures. She also specializes in the diagnosis and treatment of hypoxic-ischemic encephalopathy, stroke and seizures in the newborn. Dr. Yozawitz’s expertise includes electroencephalography (EEG) and state-of-the-art treatments. Dr. Yozawitz is rated as an Elite provider by MediFind in the treatment of Epilepsy in Children. Her top areas of expertise are West Syndrome, Epilepsy in Children, Spasmus Nutans, and Epilepsy.
Johns Hopkins Outpatient Center
Dr. Eric Kossoff focuses on the diagnosis and treatment of childhood seizures and epilepsy, particularly treatments other than medications such as diet and neurostimulation. He is one of the world experts on dietary treatment for epilepsy (ketogenic diet) and lectures around the world about this therapy. His specific interests include the ketogenic diet, the modified Atkins diet for children and adults, infantile spasms, benign rolandic epilepsy, the interaction of migraine headaches with epilepsy, and Sturge-Weber syndrome. Dr. Eric Kossoff is also very involved in teaching and is the Director of the Pediatric Neurology Residency Program. He is a professor of neurology and pediatrics at the Johns Hopkins University School of Medicine. He is a co-author of Treatment of Pediatric Neurologic Disorders and the 7th edition of Ketogenic Diet Therapies. Dr. Kossoff sees patients in the Johns Hopkins Outpatient Center (5th floor) in Baltimore on Tuesday afternoons and Thursday mornings. He sees patients at Green Spring Station on Wednesday afternoons. He also participates in telemedicine. Dr. Kossoff received his medical degree from SUNY at Buffalo School of Medicine in New York. He went on to complete a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a second residency in child neurology and a fellowship in pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore. Dr. Kossoff is rated as an Elite provider by MediFind in the treatment of Epilepsy in Children. His top areas of expertise are Epilepsy, Epilepsy in Children, Seizures, Endovascular Embolization, and Gastrostomy.
The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.
Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, your provider may suggest stopping their medicines.
For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued.
Children who have developmental disorders in addition to epilepsy may face challenges throughout their life.
Knowing more about the condition will help you take better care of your child's epilepsy.
Complications may include:
- Difficulty learning
- Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia
- Irregular heartbeat
- Injury from falls, bumps, or self-caused bites during a seizure
- Permanent brain damage (stroke or other damage)
- Side effects of medicines
Call 911 or the local emergency number if:
- This is the first time your child has a seizure
- A seizure occurs in a child who is not wearing a medical ID bracelet (which has instructions explaining what to do)
If your child has had seizures before, call 911 or the local emergency number for any of these emergency situations:
- The seizure is longer than the child normally has or the child has an unusual number of seizures
- The child has repeated seizures over a few minutes
- The child has repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus)
- The child gets injured during the seizure
- The child has difficulty breathing
Contact your child's provider if your child has new symptoms:
- Nausea or vomiting
- Rash
- Side effects of medicines, such as drowsiness, restlessness, or confusion
- Tremors or abnormal movements, or problems with coordination
Contact your child's provider even if your child is normal after the seizure has stopped.
There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy.
Reduce the risk of head injury during risky activities by wearing a helmet. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy.
Summary: Epileptic spasms (ES) are a predominantly infantile seizure type observed frequently in certain genetic disorders. Ketogenic diet (high ratio of fat to carbohydrate/protein) is an established non-medication treatment for difficult to control seizures, including ES. Because ES are associated with worse developmental and cognitive outcomes if not detected or treated quickly and effectively, this tri...
Summary: 30% of patients with epilepsy suffer from drug-resistant seizures and are at risk of epilepsy-related complications, from cognitive dysfunctions to premature mortality. Both seizures and their complications are modulated by patients' vigilance states, with a tight and bi-directional interplay between sleep and epilepsy. Several epilepsy complications are associated with sleep, such as sleep-disord...
Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Ghatan S. Pediatric epilepsy surgery. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 267.
Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs I: treatment of new-onset epilepsy: report of the American Epilepsy Society and the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Epilepsy Curr. 2018;18(4):260-268. PMID: 30254527 pubmed.ncbi.nlm.nih.gov/30254527/.
Mikati MA, Tchapyjnikov D, Rathke KM. Seizures in childhood. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 633.
Pearl PL. Overview of seizures and epilepsy in children. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 61.