Causes of Pediatric Seizure Disorders

A pediatric seizure disorder may be inherited, may be the result of a brain malformation, or may develop after an accident or injury. It may also be caused by an infection, a tumor, or a cardiovascular disorder such as an arteriovenous malformation (AVM).

Here are some commonly known causes of pediatric seizure disorders that, in some cases, can be successfully treated with surgery. Brain surgery to remove or disconnect the affected portion of the brain that is generating the seizure focus may be considered if a child’s seizures can’t be controlled by medication, always start in one area of the brain, and occur in a part of the brain that can be removed without disrupting important behaviors or functions. (See Surgery for Pediatric Seizure Disorders to learn more.)

Mesial temporal sclerosis is scarring of the inner portions of the brain’s temporal lobe that can be idiopathic or sometimes be caused by brain injury or infection. This can lead to seizures that start in the temporal lobe but can spread to other areas of the brain. It is often associated with intractable epilepsy (seizures that don’t respond to medication) but surgery to remove the scarred area of the temporal lobe can be curative.

Tuberous sclerosis complex (TSC) is a genetic disorder associated with lesions in different organs, including the brain, as well as behavior changes and cognitive impairment. These lesions can lead to refractory seizures and in certain cases can be treated with staged surgery.

Sturge-Weber Syndrome is a rare congenital (present at birth) condition characterized by a birthmark (called a port wine stain) on one side of the face and neck, as well as neurological abnormalities. It is caused by abnormal blood vessels on the surface of the brain that can cause seizures that may become generalized and evolve into other types of seizures over time. Surgery called a hemispherotomy, which involves disconnecting the abnormal side of the brain from the normal side, can be used to treat it.

Rasmussen encephalitis is a rare childhood disorder where cells in one part of one hemisphere of the brain become inflamed and swollen, triggering progressive seizures that lead to weakness, loss of function, and cognitive deficits. The cause of the inflammation is not often known, but could be the result of a viral infection, and auto-immune disorder, or trauma. Successful seizure control requires a hemispherotomy to disconnect the affect side of the brain from the normal side.

Lennox-Gastaut syndrome is a rare form of epilepsy in children that typically starts between the ages of 3 and 5 years. It can result in many different kinds of seizures (both convulsive and non-convulsive) that vary widely from child to child and can happen multiple times a day. Lennox-Gastaut syndrome is difficult to treat, but palliative surgery (in which the corpus callosum – a band of tissue that connects the hemispheres of the brain and a pathway along which seizures can spread – is cut, helping to reduce the number and severity of seizures) may be recommended.

Cortical dysplasia is a malformation that occurs during embryogenesis when normal brain cells do not fully migrate to the correct location. It is one of the most common forms of epilepsy in children. These abnormal rests of cells irritates the surrounding brain and trigger seizures. Surgical treatment involves resection of the focus of dysplasia, or abnormally located cells. These dysplasias can be small and focused, or can involve an entire lobe.

Perinatal stroke may result in permanent injury to the brain. Studies show that four of five newborn infants who experience a stroke around the time of birth will develop neurologic disorders, including epilepsy. Most often, when seizures result from a perinatal injury, treatment involves disconnection or resection of the affected area of brain.