1. What is epilepsy? What happens to the brain? Epilepsy is a group of neuronal hypersynchronization abnormal discharge syndrome in the brain caused by different etiologies, characterized by recurrent, transient abnormalities in central nervous system function. Due to different sites of abnormal discharging neurons, seizures can manifest as sensory, motor, consciousness, mental, behavioral or autonomic dysfunction. 2. How does epilepsy in children cause? Congenital or acquired? The occurrence of epilepsy is the result of the interaction between intrinsic genetic factors and the external environment within the individual, and the etiology of each epileptic patient includes both of these factors. Currently, the International League Against Epilepsy Classification Working Group recommends that the etiology of epilepsy be divided into 6 major categories: genetic, structural, metabolic, immunological, infectious, and of unknown origin. Therefore, a child’s epilepsy specifically due to what cause needs to be evaluated comprehensively. 3. Can fever cause epilepsy? Fever itself does not cause epilepsy, but fevers caused by various encephalitis, infectious diseases of the central system, etc. may later develop sequelae of epilepsy. Children with febrile convulsions have a higher chance of developing epilepsy than normal children. 4. Is the child’s intelligence affected by epilepsy? Epilepsy is essentially a chronic neuronal dysfunction caused by a variety of factors, so it is not only seizures, but also often accompanied by other manifestations of chronic brain dysfunction, such as various psychiatric and behavioral problems and cognitive impairment. Some children with some types of epilepsy do have more pronounced cognitive impairment, such as infantile spasms and Lennox-Gastaut syndrome; however, most children with most types of epilepsy have completely normal intellectual development, such as benign childhood epilepsy with central temporal spike waves (BECT) and early-onset benign childhood occipital lobe epilepsy. 5. Is it necessary to treat epilepsy? Can it heal itself? What happens if it is not treated? The diagnosis and treatment of epilepsy are closely related, but not necessarily linked. It is not always necessary to treat epilepsy after it is diagnosed. For example, in children with benign partial epilepsy with sparse seizures or epilepsy with mild seizures (aura-only seizures), no treatment may be an option; however, if the cause of the seizures persists (e.g., a clear history of perinatal brain injury), antiepileptic medication should be given after the first seizure. Some age-related epilepsies, such as benign epilepsy in children with central temporal spikes (BECT), most seizures stop around puberty as they age. For epilepsy with frequent seizures, early treatment is needed because repeated seizures can cause further adverse effects on brain function, and sudden falls and loss of consciousness during seizures are also potentially dangerous to the child’s safety. 6. Treatment of epilepsy, is it medication or surgery? Can surgery be a complete cure? Anti-epileptic drug therapy is the most basic and important treatment for epilepsy and is often the first choice of treatment for epilepsy; epilepsy surgery is also an important part of epilepsy treatment, and it should be clear that epilepsy surgery is not the last part of epilepsy treatment, but may also be the first part. The current basic view is that for the vast majority of epilepsies, surgery is not the treatment of choice, but for symptomatic (e.g., intracerebral tumors, abscesses, etc.) epilepsies, those who can find a clear surgically resectable lesion can first undergo neurosurgery. The exact cure is related to a variety of factors such as the type of epilepsy and the condition of the lesion, and the cure/efficiency rate varies depending on the type of surgery chosen (resective, palliative, neuromodulation, and others).
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