Epilepsy is a tendency to have epileptiform seizures, and some of the children who have spasms are epileptic. There can be several types of epilepsy, the most common being generalized tonic-clonic seizures, a type of seizure in which the child loses consciousness and has rhythmic jerking of the entire body. Another type of seizure is an aphasic seizure, which involves a brief loss of consciousness accompanied by blinking or twitching at the corners of the mouth. Aphasic seizures have a very characteristic EEG presentation. Partial seizures occur when an abnormality in a specific area of the brain causes a convulsion. Simple partial seizures do not cause altered consciousness, however, complex partial seizures cause some changes in consciousness. The manifestations and symptoms of epilepsy depend on which part of the brain the epilepsy comes from. For example, a partial seizure from the area of the brain that controls hand movement, such as this, will cause hand twitching. In contrast, a partial seizure from an area of the brain that controls emotions can cause feelings of fear. Sometimes it is difficult to distinguish between a partial seizure and an aphasic seizure, but they have different EEG presentations. Etiology Many factors can cause epilepsy. Many people with epilepsy have epileptic seizures at a young age. Any factor that interferes with brain development or brain function can cause epilepsy in children. Some children are deprived of oxygen before or at birth, and this can lead to cerebral palsy and epilepsy. Some children are born prematurely or have brain hemorrhage due to cerebrovascular malformations, which can also cause epilepsy. Epilepsy can also be caused by changes in genetic factors. Some children are born with the “epilepsy gene,” so they can develop epilepsy. These epilepsies may occur early or late in life, and in those who develop them late, they may occur as late as their 30s. Often, genetic factors cause a wide range of epilepsy. This means that epilepsy does not occur in just one specific area of the brain, but affects the entire brain at the same time. Other causes of epilepsy in children include brain tumors, brain infections (encephalitis), head trauma, and problems with the production of chemicals in the body and brain, among others. In all cases, it is important to remember that a child’s brain is more susceptible to epilepsy than an adult’s brain. Hazards Epilepsy can be life-threatening, but this is quite rare. Persistent status epilepticus (sustained convulsions for more than 30 minutes) can cause damage to the brain, but this too may be rare. However, uncontrolled epilepsy can lead to a variety of learning and developmental disabilities in children. The goal of treatment for childhood epilepsy is not just to control seizures, but to advance the child’s potential for brain development. Treatment Most people with epilepsy are treated with relatively simple medications (70-80%). Many antiepileptic drugs are now available. The choice of medication is based on several factors: the type of epilepsy, the age of the child, other clinical problems, and potential side effects of the medication. However, some patients do not respond to medications, so surgery or other treatments should be considered.