Epilepsy (Pediatric)

Definition

Epilepsy in children is a neurological disorder characterized by recurrent, unprovoked seizures due to abnormal electrical activity in the brain.

Epidemiology

• Prevalence of pediatric epilepsy is approximately 0.5–1% worldwide
• Peak incidence in the first year of life and early adolescence
• Slight male predominance
• Higher incidence in children with perinatal complications, CNS infections, or developmental disorders
• Genetic factors contribute significantly to certain epilepsy syndromes

Etiology

• Genetic mutations causing channelopathies or syndromic epilepsies
• Structural brain abnormalities (cortical dysplasia, stroke, malformations)
• Perinatal insults (hypoxic-ischemic encephalopathy, prematurity)
• CNS infections (meningitis, encephalitis)
• Metabolic disorders (hypoglycemia, inborn errors of metabolism)
• Traumatic brain injury
• Idiopathic or unknown causes in many cases

Pathophysiology

• Abnormal synchronous neuronal firing in cortical or subcortical regions
• Excitatory-inhibitory imbalance in neuronal circuits
• Altered ion channel function (Na+, K+, Ca2+) in genetic epilepsies
• Neuroinflammation may contribute to seizure propagation
• Structural lesions may act as epileptogenic foci
• Repeated seizures can lead to neuronal injury and cognitive impact