Epilepsy in Children

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

The Epilepsy Foundation estimates that nearly half a million U.S. children under age 17 have epilepsy. Children may have many types of seizures. It is easily controlled with medicine in some. Some age out of their seizures as a teen or adult.1,2

For others, epilepsy is hard to treat even with medicine, epilepsy surgery, or implantable brain devices. Hard-to-treat seizures can have many different causes, including:

  • Genetic conditions
  • Various syndromes
  • Brain infections
  • Structural abnormalities
  • Brain injuries

In about half of cases, the cause is unknown. Regardless of the reason, hard-to-treat epilepsies may lead to lifelong challenges in learning, behavior, and quality of life. Children with drug-resistant (refractory) epilepsy often face social isolation, bullying, and poor self-esteem.1

What causes childhood epilepsy?

There are many reasons why a child might have seizures, including:3

  • Fever
  • Genetic inheritance
  • Head injury
  • Infection of the brain (such as meningitis)
  • Lack of oxygen to the brain during birth (called hypoxic-ischemic injury)
  • Hydrocephalus (buildup of cerebrospinal fluid or “water” in the brain)
  • Issues with brain development (such as structural abnormalities or conditions such as autism or Down syndrome)

Brain tumors, cysts, and progressive disorders that cause brain decay are more rare.1

Two types of seizures are more common in children than in adults:3,4

  • Febrile seizures
  • Seizures triggered by bright, flashing lights

Do children “grow out” of their seizures?

About 2 out of 3 children with epilepsy will outgrow their seizures. Childhood seizures can be what doctors call “benign” (pronounced ba nine’). This means the seizures last a short time and go away as the child gets older. The seizures are not considered to be harmful. In these cases, the child’s development and ability to learn is normal.1,2

Febrile seizures, or seizures triggered by high fever from infancy up to age 6, are one example. Febrile seizures are quite common, occuring in 2 to 5 out of 100 children. Sometimes all the children in a family will have febrile seizures. Most children who have febrile seizures do not have them without fever after age 5.3

Childhood seizures caused by structural issues in the brain may be harder to control and may last a lifetime.

Having epilepsy may increase a child’s chances of developing other conditions, such as:2

  • Mood disorders (depression, anxiety)
  • Attention deficit disorder (ADD)
  • Learning disorders
  • Headaches

Childhood conditions confused with epilepsy

Many people think that all seizures look like a tonic-clonic generalized seizure. This involves jerking, twitching, and losing consciousness. However, seizures can be more subtle and harder to spot. This is why some seizures may be confused with common childhood behavior or conditions, including:5

  • Daydreaming
  • Holding their breath
  • Fainting
  • Muscle cramps

Daydreaming may be confused with absence (complex partial) seizures. Fainting, which can be common in children, may be confused with atonic, tonic, or tonic-clonic seizures. Movement disorders may be confused with tonic or motor seizures. Examples of movement disorders include a foot turning inward, fingers curling up, muscles jerking, or eyes blinking.5

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