Epilepsy is the most common neurological disease in children

Epilepsy is the most common neurological disease in children – it occurs in 4% of children. of them. It is optimistic that in two-thirds of cases it can be treated very effectively – told PAP Prof. Barbara Steinborn from the Medical University of Poznań (UMP).

The patron saint of people suffering from epilepsy is St. Valentine, whose holiday falls on February 14.

Prof. Barbara Steinborn, head of the Department of Developmental Age Neurology, UMP reminded in an interview with PAP that epilepsy is more common in children than in the general population, where it occurs at a frequency of 1%. (in Poland, about 400 people have epilepsy). Most of its cases – around two-thirds – are diagnosed in people under the age of 16.

Epilepsy is a very diverse disease, or in fact a syndrome, in which seizures occur in a relapsing manner and with varying frequency. They are the result of abnormal bioelectrical activity of the brain – explained the specialist.

She noted that although in society epileptic seizures are usually associated with generalized body convulsions, in fact they can be of a very diverse nature. These can be, for example, disturbances in emotions, sensations (numbness, disturbances in vision, hearing, taste and smell), but also a brief “shutdown” of consciousness, may proceed with or without loss of consciousness. Epileptologists distinguish up to 40 different types of seizures.

At this stage of medical development, about 50 percent. cases, we cannot give reasons for the development of epilepsy. We know that approx. 30 percent. these are damage to the nervous system that may result from brain malformations, past inflammation, infections or perinatal brain damage, the so-called ischemic encephalopathy. In approx. 25 percent. cases of epilepsy have genetic determinants – mentioned prof. Steinborn.

Genetically determined epilepsy includes, for example, childhood epilepsy with absences, which occurs in children in preschool or early school age. It manifests itself in the fact that the child thinks, “lingers”, sometimes for a few seconds. We can’t stop it. In this type of epilepsy, there are practically no other seizures, but changes are visible in the electrical activity of the brain (EEG), the specialist explained.

She added that these epilepsy can be treated very effectively and do not leave any defects in the form of cognitive impairment in children. Children just grow out of them.

Prof. Steinborn noted that the treatment of epilepsy generally depends on what type of seizures accompany it and how often they occur. There are epilepsy that don’t need treatment at all, because seizures are extremely rare – they happen once or twice in a lifetime. But in some cases, epilepsy is associated with dozens of seizures a day, and this significantly increases the risk of a child’s mental impairment and worsens his prognosis. The more frequent the seizures, the higher the risk of a disability, said the epileptologist.

She emphasized that it is optimistic that in almost two-thirds of patients, the first drug gives very good therapeutic effects – seizures become rare or disappear altogether.

However, about one-third of children, adolescents, and adults, no matter what medications are given, continue to seize. This is called drug-resistant epilepsy. In this case, we have to resort to surgical treatment – if it is possible to remove the epileptic focus or we use a vagus nerve stimulator – explained Prof. Steinborn.

She added that in Poland many epilepsy drugs are available and reimbursed. Our method of treatment does not differ much from other countries, although we are still waiting for the latest drugs – she added.

She also pointed out that at present it is not possible to predict whether a child will experience epilepsy and implement prior therapy on this basis.

Tuberous sclerosis is an exception – a rare genetically determined disease in the course of which seizures usually occur even before the first year of life. This disease can be detected in the unborn child as it is characterized by the presence of heart tumors.

Polish scientists under the supervision of prof. Sergiusz Jóźwiak from the Institute “Children’s Memorial Health Institute” in Warsaw observed that by cyclical EEG testing in these children, changes in the electrical activity of the brain can be observed early and that medications can be given before epilepsy occur. Doing so reduces the risk of intellectual impairment in toddlers. The international research project EPISTOP is currently underway. confirm these observations.

This is a pioneering work, but it covers only one seizure disorder so far. In other cases, we do not have such possibilities at present. As a rule, epileptologists administer treatment not after the first attack, but after two seizures, and only when there are changes in the EEG record – noted Prof. Steinborn. (PAP)