Pediatric epilepsy. Lifelong medication treatment? It's important to prevent a recurrence of seizures
Jul 09, 2024
Epilepsy is a chronic nervous system disease in which seizures occur repeatedly as a result of excessive excitement in brain cells in a certain area due to various causes and complex development processes. Epileptic seizures can occur at any age, but are most common in childhood and adolescence and the elderly. Although they may have vague fears of epileptic seizures, 80% of patients treated with anti-fracture drugs can live without seizures.
Professor Yoon Song-yi of the Department of Pediatrics and Adolescents at Gangdong Kyunghee University Hospital summarized the symptoms and treatments of childhood epilepsy.
▶ Epilepsy, over-excited electrical signals from brain cells causing convulsions, sensory disturbances, or loss of consciousness
Our body's brain controls behaviors and thoughts with various electrical signals exchanged from brain cells. Epilepsy is a disease in which these electrical signals are over-excited due to various causes and complex development processes, and convulsions or sensory abnormalities occur repeatedly. Seizures occur in the form of systemic or partially involuntary motor symptoms, sensory abnormalities, or loss of consciousness. There are various forms of seizures, and in the case of the most severe seizure, the whole body stiffens as you fall unconscious, you can't breathe properly, cyanosis appears on your lips and body, and a large amount of saliva or vomiting occurs in your mouth. A minor attack can stop acting with short consciousness damage within 5 to 10 seconds and remain dazed, or the eyes or face can tremble, and return to their original state as soon as symptoms stop.
▶ Brain deformities, genetic factors, damage, brain tumors, etc
According to data from the Health Insurance Review and Assessment Service, a total of 159,933 patients (disease code: epilepsy G40) visited the hospital for epilepsy in 2023. Among them, a total of 30,703 children under the age of 20 had epilepsy, accounting for 20% of all patients.
Professor Yun Song-yi said, "Children's epilepsy can be caused by various causes, including birth defects in the brain, genetic factors, brain damage, brain tumors, and brain damage after infection with the central nervous system."These causes may work in combination, and the mechanism may not be clear in some cases."
▶ Diagnose epilepsy if it occurs twice at intervals of more than a day
Epilepsy is diagnosed when non-induced seizures occur more than twice at intervals of more than 24 hours, or when seizures are expected to recur more than 60% even if there is only one, or when there is a seizure that can be diagnosed as epilepsy syndrome. The probability of recurrence within 2 to 3 years after the first non-volatile seizure varies from 20 to 80%, but the probability of a third seizure after recurrence is as high as 79 to 90%. Therefore, when seizures recur more than once and are diagnosed with epilepsy, medication is generally initiated.
▶ Preventing recurrence of a rash is the key to treatment
The first priority treatment is anti-fracture drug therapy, which aims to reduce seizure-related risk factors by preventing recurrence of seizures. Seizures themselves can create a variety of physical or psychosocial problems. Active treatment is needed because physical damage, traffic accidents, secondary brain damage can occur, and social life can be atrophy. The most important thing in the treatment of epileptic seizures is to find out the cause of the seizures. If there is a curable cause, the cause must be resolved to prevent the recurrence of seizures. In the past, there were many cases where the cause was not found or the treatment according to the cause was not identified, but advances in genetic testing have increased opportunities to identify the cause and provide effective treatment accordingly.
▶ Abortment of anti-oxidant drug treatment...There is a high risk of recurrence if the age of onset is young or high
About 80% of patients receiving anti-fracture drug therapy live without seizures and can discontinue the drug. About 20-30% of epilepsy patients have epilepsy throughout their lives. In childhood epilepsy, drug discontinuation depends on the onset age of seizures, the type of epilepsy, or the cause of epilepsy, but discontinuation can generally be considered when remission is maintained without seizures for more than two years. When the drug is rapidly stopped, there is a risk of recurrence, so it is gradually reduced and stopped over three to six months. Since recurrence may occur in about 20% of patients who discontinued medication, discontinuation of medication is decided through close consultation with an epilepsy specialist.
It is known that the longer the seizure relief condition before stopping the anti-fracture drug, the less risk of recurrence. When discontinued, the risk of recurrence of seizures is high, such as when the age of onset is young or high (under 2 years old or over 10 years old), when epilepsy-shaped discharge persists in brain waves, developmental disorders, neurological abnormalities, or a history of failure to discontinue anti-firing drugs, some epilepsy syndromes such as adolescent musculoskeletal epilepsy and Lennox Gasto syndrome, and various seizure types. In this case, even if there is no seizure, the medication discontinuation is carefully decided.
※Living rules for epilepsy patients
- The patient's guardian should be familiar with emergency response to seizures.
When seizures begin, the patient's body or head is turned to the side first to stabilize breathing. If you are biting your tongue, you should prevent damage by biting your handkerchief or hand into your mouth, but if not, leave it as it is. If the seizure does not stop within a few minutes, you should quickly visit the emergency room by calling 119.
-It is a good idea to avoid situations where there is a high risk of accidents such as swimming, climbing, and cycling.
Epilepsy patients are more likely to suffer damage than the general population, but the degree is mostly mild. However, caution is needed because accidents such as drowning may occur. In order to prevent damage related to epilepsy, swimming should not be done alone and work with bicycles and machines that may climb high, such as hiking, or risk a traffic accident should be avoided.
-Regular sleep is important. Irregular sleeping habits can cause seizures.
-There is no need to limit learning, exercise (excluding exercise with a high risk of accidents), and group life.
Rather, it has been reported that proper exercise reduces seizures and improves brain waves. However, if symptoms occur, it is better to come up with measures to cope with them.
Professor Yoon Song-yi of the Department of Pediatrics and Adolescents at Gangdong Kyunghee University Hospital summarized the symptoms and treatments of childhood epilepsy.
▶ Epilepsy, over-excited electrical signals from brain cells causing convulsions, sensory disturbances, or loss of consciousness
Our body's brain controls behaviors and thoughts with various electrical signals exchanged from brain cells. Epilepsy is a disease in which these electrical signals are over-excited due to various causes and complex development processes, and convulsions or sensory abnormalities occur repeatedly. Seizures occur in the form of systemic or partially involuntary motor symptoms, sensory abnormalities, or loss of consciousness. There are various forms of seizures, and in the case of the most severe seizure, the whole body stiffens as you fall unconscious, you can't breathe properly, cyanosis appears on your lips and body, and a large amount of saliva or vomiting occurs in your mouth. A minor attack can stop acting with short consciousness damage within 5 to 10 seconds and remain dazed, or the eyes or face can tremble, and return to their original state as soon as symptoms stop.
▶ Brain deformities, genetic factors, damage, brain tumors, etc
According to data from the Health Insurance Review and Assessment Service, a total of 159,933 patients (disease code: epilepsy G40) visited the hospital for epilepsy in 2023. Among them, a total of 30,703 children under the age of 20 had epilepsy, accounting for 20% of all patients.
Professor Yun Song-yi said, "Children's epilepsy can be caused by various causes, including birth defects in the brain, genetic factors, brain damage, brain tumors, and brain damage after infection with the central nervous system."These causes may work in combination, and the mechanism may not be clear in some cases."
▶ Diagnose epilepsy if it occurs twice at intervals of more than a day
Epilepsy is diagnosed when non-induced seizures occur more than twice at intervals of more than 24 hours, or when seizures are expected to recur more than 60% even if there is only one, or when there is a seizure that can be diagnosed as epilepsy syndrome. The probability of recurrence within 2 to 3 years after the first non-volatile seizure varies from 20 to 80%, but the probability of a third seizure after recurrence is as high as 79 to 90%. Therefore, when seizures recur more than once and are diagnosed with epilepsy, medication is generally initiated.
▶ Preventing recurrence of a rash is the key to treatment
The first priority treatment is anti-fracture drug therapy, which aims to reduce seizure-related risk factors by preventing recurrence of seizures. Seizures themselves can create a variety of physical or psychosocial problems. Active treatment is needed because physical damage, traffic accidents, secondary brain damage can occur, and social life can be atrophy. The most important thing in the treatment of epileptic seizures is to find out the cause of the seizures. If there is a curable cause, the cause must be resolved to prevent the recurrence of seizures. In the past, there were many cases where the cause was not found or the treatment according to the cause was not identified, but advances in genetic testing have increased opportunities to identify the cause and provide effective treatment accordingly.
▶ Abortment of anti-oxidant drug treatment...There is a high risk of recurrence if the age of onset is young or high
About 80% of patients receiving anti-fracture drug therapy live without seizures and can discontinue the drug. About 20-30% of epilepsy patients have epilepsy throughout their lives. In childhood epilepsy, drug discontinuation depends on the onset age of seizures, the type of epilepsy, or the cause of epilepsy, but discontinuation can generally be considered when remission is maintained without seizures for more than two years. When the drug is rapidly stopped, there is a risk of recurrence, so it is gradually reduced and stopped over three to six months. Since recurrence may occur in about 20% of patients who discontinued medication, discontinuation of medication is decided through close consultation with an epilepsy specialist.
It is known that the longer the seizure relief condition before stopping the anti-fracture drug, the less risk of recurrence. When discontinued, the risk of recurrence of seizures is high, such as when the age of onset is young or high (under 2 years old or over 10 years old), when epilepsy-shaped discharge persists in brain waves, developmental disorders, neurological abnormalities, or a history of failure to discontinue anti-firing drugs, some epilepsy syndromes such as adolescent musculoskeletal epilepsy and Lennox Gasto syndrome, and various seizure types. In this case, even if there is no seizure, the medication discontinuation is carefully decided.
※Living rules for epilepsy patients
- The patient's guardian should be familiar with emergency response to seizures.
When seizures begin, the patient's body or head is turned to the side first to stabilize breathing. If you are biting your tongue, you should prevent damage by biting your handkerchief or hand into your mouth, but if not, leave it as it is. If the seizure does not stop within a few minutes, you should quickly visit the emergency room by calling 119.
-It is a good idea to avoid situations where there is a high risk of accidents such as swimming, climbing, and cycling.
Epilepsy patients are more likely to suffer damage than the general population, but the degree is mostly mild. However, caution is needed because accidents such as drowning may occur. In order to prevent damage related to epilepsy, swimming should not be done alone and work with bicycles and machines that may climb high, such as hiking, or risk a traffic accident should be avoided.
-Regular sleep is important. Irregular sleeping habits can cause seizures.
-There is no need to limit learning, exercise (excluding exercise with a high risk of accidents), and group life.
Rather, it has been reported that proper exercise reduces seizures and improves brain waves. However, if symptoms occur, it is better to come up with measures to cope with them.
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