We have already seen what childhood epilepsy is, as well as the main childhood epileptic syndromes. Now it's time to meet the different types of childhood epilepsy.
These can be divided according to whether the crisis originates in a certain area of the brain or these discharges affect several parts of the brain at the same time. We can also differentiate between those crises that originate without evidence of alteration in the nervous system or in those that do exist.
According to what we have seen, we can talk about partial or focal seizures when the epileptic seizure has its beginning in a limited area of the brain, and may be accompanied by motor, sensory or psychic symptoms. These types of crises are the most frequent, and we can divide them, in turn, into:
- Simple: are those that occur without any loss of consciousness, but if with motor or sensory alterations, may be accompanied by photic sensations (related to light), taste, heat or tingling or numbness.
- Complex: unlike the previous ones, and as a consequence of an affectation of more complex brain structures, in this type of crisis there is a loss of consciousness, accompanied or not by feelings of fear, memory or cognitive problems, hallucinations or involuntary movements of different body parts.
On the other hand we find the generalized crises, which constitute discharge that affect more than one specific area of the brain at the same time, causing loss of consciousness that often occurs along with abnormal motor reactions.
They may be primary, which is when epileptic seizures occur simultaneously throughout the brain, or high schools which, on the contrary, is when the discharge originates from a certain part of the brain and subsequently spreads to the rest of the brain.
Likewise, they may or may not present motor disorders while the crises last. In the event that these motor discharges are manifested we can find different types of motor alterations, such as the bilateral massive myoclonus, which consist of involuntary jerking of the limbs of short duration and that cause violent movements in the child.
Can also occur clonic seizures, in which the child loses consciousness and muscle contractions occur that are repeated rhythmically, or tonic crisis, where there are sustained tight contractions in the muscles without them moving.
Finally, within seizures, calls may also occur. tonic-clonic seizures, which are also known as "crisis of great evil." The duration of these crises ranges between 5 and 10 minutes, with a total loss of consciousness.
It is divided into two phases, the first being the tonic phase, which sometimes occurs after intense pain in the abdomen and dizziness sensations. There is an intense contraction of all the muscles of the body, accompanied by a deviation of the gaze (when the crisis occurs, the little ones tend to look up), elevation of the arms and spasms in the larynx, which causes them to emit different sharp and intense shouts (called "epileptic shout").
After this comes the call clonic phase, during which there are several repeated convulsive movements in arms and legs, as well as inability to control the pee. After this phase, a brief comatose period arrives followed by a sleep phase after which the child is disoriented and confused, with headache, muscle and difficulty remembering what happened.
In the event that the crisis does not occur with any type of motor discharge, we could find atonic crises in which there would be a loss of consciousness and decreased muscle tone, which causes the child to collapse and can cause significant damage due to impact. On the other hand, the akinetic crises They also have a loss of movement and cause the child to fall to the ground, although there is no involvement of muscle tone.
The absences, called until recently "crisis of small evil", are very characteristic of childhood and usually disappear before approximately 15 years. During the absences the consciousness decreases (and may even be suspended) for about 2-15 seconds.
We realize that the child is having an absence because he stops doing what he was doing, remains still during that time, and at the end of the crisis he is disoriented. Alterations such as pale skin, inability to control pee or saliva may occur.
As you can see, when talking about epilepsy we do not always talk about the same thing, but that there are different types of childhood epilepsy that make us have to take it into account when carrying out the most appropriate treatment for each case.
