Epilepsy - children and young adults

Epilepsy - children and young adults most commonly affected

Epilepsy is a chronic condition and originates in the brain. It occurs most commonly during childhood, and sometimes resolves of its own accord at the time of puberty.

From time to time, epileptic seizures can occur with no apparent trigger. Their causes maybe sudden, short-term functional problems within the brain. As a rule, epileptic seizures last a few seconds or minutes and stop on their own without treatment. In status epilepticus, the seizure lasts for more than 20 minutes.

Five per cent of all people will experience an epileptic seizure by the age of 20. This is usually what is known as an occasional seizure, however. The term epilepsy is used only when at least two epileptic seizures have occurred that were not triggered by an immediately preceding recognisable cause.

Epilepsy - causes: How the condition develops

If the brain is intensely irritated by damage or inflammation, it can respond by triggering a seizure. The causes of this irritation may be a high fever, excessive fatigue, a brain injury, poisoning or alcohol.

Disturbances of brain maturation during pregnancy or birth complications can also cause epilepsy. During adolescence, accidents or brain tumours are the more likely causes of the condition. Epilepsy can also be inherited.

In many cases, however, there is no clear identifiable cause.

Symptoms: Indications of epilepsy

There are various indications of epilepsy. These can also change over the course of the disease. 

Frequent signs:

• Short breaks in consciousness
• Sudden twitching of the body in infants
• Facial convulsions and speech difficulties in childhood
• Unconsciousness, stiffness, twitching of arms and legs
• Febrile convulsions
• Especially in children: Specific learning disabilities, severe behavioural or intelligence disorders, speech loss

Modern monitoring unit for accurate diagnosis

With our modern monitoring unit for children, we are one of the few hospitals in Germany to be able to carry out precise and intensive video EEGs. For around a week, the children are monitored around the clock by video and EEG so that any seizure activity can be recorded. If the video EEG still fails to yield any precise results, a stereo EEG can be useful. With this tool, the voltage fluctuations on the surface of the head are visualised using deep electrodes directly from the brain. Since the inpatient stay can mean a long period of time spent in their hospital room for young patients, we have facilities for parents to stay overnight in their room with them.

Invasive diagnostic tests using stereo EEG

We are one of the few hospitals in Germany to implant electrodes deep into the brain. This method allows us to measure the brain's electrical currents even more precisely, enabling us to make an accurate diagnosis. Using the robot-assisted ROSA navigation system, our neurosurgeons often implant well over 10 electrodes deep into the brain. Thanks to the assistance of the robot, this is done very quickly and the time under anaesthetic can be shortened considerably. The robot uses pre-stored computer data and shows the surgeon the way. This means that the electrodes can be positioned with excellent precision. Using the most accurate data possible, our paediatric neurologists are now able to consult with the neurosurgeons to decide which sections of the brain can be removed without harming major brain functions. The aim of this is usually to eliminate seizures, but sometimes also to reduce the number of major seizures.

Localisation of areas responsible for function

Magnetic resonance imaging (MRI) yields high-resolution images: These allow even the tiniest changes in the brain to be made visible. Functional MRI also allows important areas responsible for function to be localised. Our consultants also use the most state-of-the-art examination method, known as the fibre tracking method, to establish a diagnosis. With this method, the MRI images are used to reconstruct the course of individual nerve fibres in the brain. Combined with neuro-navigation, fibre tracking represents a major advance in microsurgical approaches to treatment. As a result, we have been able to treat epilepsies that have previously been untreatable.