It can be really difficult to cope with teenagers, but teens with epilepsy pose additional problems. Although adolescence is a traumatic time, both biologically and socially, when complicated by epilepsy, it can pose great challenges to young people and their families and physicians.
In addition, epilepsy can be a torment to a teen, arousing fears of isolation and humiliation. Restriction on routine activities can further aggravate differences from others. Before knowing the causes, let’s look at what we mean by epilepsy.
What is epilepsy?
Epilepsy is a medical disorder that leads to unprovoked and recurrent seizures. Seizures occur when there is an imbalance in the brain’s electrical activity. The brain cells constantly deliver electrical signals that reach the body via the nervous.
These signals instruct the body’s muscles to perform movements. Seizures occur when these electrical signals originating from the brain begin to misfire. Epilepsy is indicated in people with two or more unexplained seizure attacks (unprovoked).
What Are the Signs of a Seizure?
It’s hard to know if someone is having an epileptic seizure. Sometimes, a person’s whole body might start to shake. Other times, a person may stare blankly into space for a few seconds to minutes.
Someone having a seizure may experience the following signs:
- Loss of consciousness
- Loss of alertness and unawareness of surroundings
- Making involuntary movements (having uncontrolled motions such as jerking or thrashing one or more parts of the body)
- Unusual sensations (like unexplained fear)
What causes seizures?
For many teenagers diagnosed with epilepsy, a specific cause of epilepsy may be found. Knowing the reason can give the correct information on what to expect over time. For example, causes can be associated with:
- Types of seizures
- Chance of seizures responding to therapy
- Chance of outgrowing seizures
- Types of treatments that work best for the particular type of seizure
- Underlying health problems or conditions that may be seen
Let’s have a look at some specific causes of seizures in teenagers:
Genetic
Epilepsy is said to have a genetic cause if seizures result from a congenital disability or problem associated with epilepsy. Some pathogenic genetic variants (or changes in genes) can occur spontaneously in teens without being present in either parent. Some epilepsies with a genetic cause may have additional environmental reasons as well.
Genetic causes can be of various kinds:
Inherited Gene Changes
In genetic conditions (autosomal dominant, autosomal recessive for X-linked disorders), the affected gene is inherited from either parent. Therefore, most genes have over one copy.
Boys with pathogenic variants on the X chromosome are an exception, as they have only one copy of the affected gene. Some conditions (autosomal dominant disorders) need only one gene copy.
In such cases, either of the parents typically also has the disease. Others (autosomal recessive disorders) require at least two copies of the abnormal gene for epilepsy. In autosomal recessive disorders, each parent carries one copy of the affected gene and one unaffected gene.
As a result, they do not show any symptoms of epilepsy. If the child inherits both copies of the affected gene, they will show epilepsy.
Acquired Gene Changes
These conditions arise from pathogenic variants seen in affected teenagers. Here, genetic changes happen when cells divide and form in the body.
These genetic conditions are not inherited from parents, and congenital abnormalities may be present in only some cells in an individual, rather than all cells. Whether these changes result in seizures depends on how many and which cells are affected.
Polygenic Affected Genes
These types of epilepsies result from changes in several genes. These genes are affected by environmental factors as well. When this happens, there is a higher chance of epilepsy in other family members but no clear inheritance pattern.
Structural
Epilepsy has a structural cause if a particular physical reason is present in the brain that substantially increases the risk of seizures.
Structural abnormalities can be
Congenital: a developmental change in the brain seen during birth. A genetic component may also be present in congenital structural changes
Acquired: some injury or process has occurred, such as trauma, tumor, or stroke. These include:
- Multiple Sclerosis
- Traumatic brain injury (TBI)
- Perinatal brain injury
- Vascular injury
- Cavernous and other vascular malformations
- Dysembryoplastic neuroepithelial tumors (DNETS), gangliogliomas, and low-grade tumors
Metabolic
Epilepsy may also have a metabolic cause if the process of the body used to convert food to make energy is disrupted. It may also occur if a specific food substance’s breakdown is impaired, which builds up in brain cells, affecting normal brain function.
Most metabolic disorders causing epilepsy are genetic. These include:
- Glut 1 (Glucose Transport) Deficiency Syndrome (SLC2A1)
- Vitamin dependent (Pyridoxine and Folinic acid)
- Creatine transporter disorders
- Mitochondrial disorders
- Storage disorders
Immune
Epilepsy may have an immune cause of brain inflammation from a protein that alters brain excitability, resulting in seizures. Most teenagers with an immune cause will have the presence of abnormal antibodies, either in blood or cerebrospinal fluid. This is also termed Autoimmune epilepsy (AE). AE is likely to develop in teens with a history of cancer and another autoimmune disorder.
Infection
Epilepsy may have an infectious cause if the infected part of the brain leads to seizures. Infection is one of the most common causes of epilepsy in teenagers worldwide but is more common in developing countries.
Here are some infectious diseases associated with epilepsy.
- Cerebral malaria
- TORCH infections (toxoplasmosis, other agents, rubella/German measles, cytomegalovirus, and herpes Simplex)
- Bacterial meningitis
- Viral encephalitis
- Tuberculosis
- Human immunodeficiency virus (HIV)
Conclusion
Seizures in teenagers vary by cause, impact, and severity. The risk for seizure episodes can be reduced or prevented by eliminating their causes, like ensuring proper prenatal and perinatal care and preventing head injuries and trauma.
Teenagers with epilepsy can live their everyday lives normally. They can still do regular activities, go on dates, and get jobs. However, your doctor will talk about being careful in certain situations and give you some instructions that you will have to follow.
For more information on epilepsy in teenagers, get in touch with our team of experts now!
About Author
Dr. Eshan Nerkar
Neurologist And Neurosuegeon
Dr. Eshan Nerkar, Consultant Brain & Spine Surgeon in Nashik specializes in Spine Surgery. He practices at AXON Brain & Spine Clinic. He is one of the best neurosurgeons in Nashik with more than 10 years of experience. He has performed more than 1000 surgeries related to brain and spinal surgery procedures.