Patient's question:
A child who is 8 years old has episodes of staring and accompanied by smacking lips. What could be the reason? Can it be treated? (Thank you, doctor, for your quick response—how should it be treated and prevented?)Doctor's answer:
The etiological factors or causes of epilepsy are numerous. They can be caused by focal brain lesions or diffuse brain abnormalities, systemic metabolic toxicity, or some causes that remain unknown to date. In clinical practice, common etiological factors include traumatic brain injury, brain tumors, cerebrovascular diseases, intracranial infections, and others, which are particularly significant.① Traumatic Brain Injury: This includes open and closed traumatic brain injuries. Statistics show that approximately one-third of epilepsy patients have a history of head trauma. Without a doubt, traumatic brain injury is one of the primary etiological factors of epilepsy. While epilepsy may develop in some patients after traumatic brain injury, about 5% of patients experience epilepsy recurrence post-injury. Notably, among those who have early epilepsy recurrence after traumatic brain injury, one-fourth may develop late epilepsy. Traumatic brain injuries sustained during childbirth are a significant etiological factor for epilepsy in children.
② Brain Diseases: This includes brain tumors, cerebrovascular diseases, intracranial infections, and others, which are also common factors triggering epilepsy recurrence, especially in cases of late-onset epilepsy in adulthood, where the proportion is relatively higher. The growth of brain tumors can compress or affect surrounding brain tissue and blood vessels, leading to cerebral edema, swelling, hypoxia, ischemia, brain tissue hardening or atrophy. These metabolic abnormalities and changes in membrane potentials of neurons often result in abnormal discharges under endogenous or exogenous stimuli, triggering epilepsy. Another group of pediatric patients may develop epilepsy due to vascular malformations. Additionally, some patients may experience epilepsy recurrence due to intracranial bacterial or viral infections, leading to conditions such as encephalitis, meningitis, arachnoiditis, or brain abscesses.
③ Epilepsy Caused by Systemic Factors: This includes carbon monoxide poisoning, hypoglycemia, acute or chronic renal failure, hypertensive encephalopathy, pancreatic adenomas, hypocalcemia, hyperthyroidism, and various systemic infections, as well as vitamin B6 deficiency, all of which may trigger epilepsy recurrence. Epilepsy recurrence is caused by abnormal discharges of brain neurons. These abnormal discharges occur due to damaged neurons, so restoring the repair of neurons to enable the brain's microbioelectricity to generate in an orderly manner can completely prevent epilepsy recurrence, thereby achieving clinical recovery from epilepsy.