abilities in pediatric epilepsy cases are evaluated using electrical cortical stimulation (ECS) language mapping, electrocorticography (ECoG), fMRI, Wada testing, and magnetoencephalography (MEG). fMRI has been shown to offer a promising strategy for defining language activation patterns as well as laterization patterns. It is important to identify language regions involved in epilepsy, particularly temporal lobe epilepsy, before surgical resection in order to reduce the risk of postoperative language deficits. Currently, ECS mapping is the standard of care in localization of areas involved in focal seizure onset and pre surgical planning. Many pediatric and adult epilepsy patients develop atypical language lateralization due to the reorganization of connections in the epileptic brain. There have been documented cases of interhemispheric and intrahemispheric reorganization of language areas. Several factors may be involved in the extent to which reorganization occurs. "Table 1: Variables Associated With Interhemispheric and Intrahemispheric Reorganization Found in fMRI and ECS Studies." The effects of epilepsy on language may be impacted by location of epileptiform activity, severity and duration of electrical discharges, age of onset, treatment method, and surgical resection areas. In some cases, language impairment may be the first indicator of epileptiform activity in the brain of children. A study done at the University of Gothenburg showed that language impairments were more common in children with epileptic brain activity than children without. They then investigated whether the epileptic activity was the cause of the language deficit or whether there were other factors involved. They found the greatest impairments in language in the children with misfiring on the left side of the brain, the side that controls linguistic abilities. This likely indicates that epileptic activity leads to language difficulties and suggests that in children with language impairments of unknown etiology, evaluations for epilepsy should be considered. Causes and symptoms The causes of epilepsy in childhood vary. In about of cases, it is unknown. Unknown 67.6% Congenital 20% Trauma 4.7% Infection 4% Stroke 1.5% Tumor 1.5% Degenerative .7% Some of the known causes include: an imbalance of nerve-signaling brain chemicals (neurotransmitters), brain tumors, stroke, brain damage from illness or injury. However, a seizure may be caused by a combination of these. In most cases, the cause of a seizure can not be found (Hopkins medicine). There are many different symptoms to look for in epilepsy in children. Your child's symptoms depend on the type of seizure. General symptoms or warning signs of a seizure