Clinical review of pediatric epilepsy (original) (raw)

Epilepsy in Children: From Diagnosis to Treatment

Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive or synchronous neuronal activity in the brain characterized by an abrupt and involuntary skeletal muscles activity. An early diagnosis, treatment and specific medical support must be performed to prevent Status Epilepticus (SE).…

Epilepsy in Children: From Diagnosis to Treatment with Focus on Emergency

Journal of Clinical Medicine, 2019

Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive, or synchronous neuronal activity in the brain characterized by abrupt and involuntary skeletal muscle activity. An early diagnosis, treatment, and specific medical support must be performed to prevent Status Epilepticus (SE). Seizure onset, especially in the child population, is related to specific risk factors like positive family history, fever, infections, neurological comorbidity, premature birth, mother's alcohol abuse, and smoking in pregnancy. Early death risk in children without neurological comorbidity is similar to the general population. Diagnosis is generally based on the identification of continuous or recurrent seizures but Electroencephalogram (EEG) evaluation could be useful if SE condition is suspected. The main goal of therapy is to counteract the pathological mechanism which occurs in SE before neural cells are irreversibly damaged. According to the latest International Guidelines and Recommendations of seizure related diseases, a schematic and multi-stage pharmacological and diagnostic approach is proposed especially in the management of SE and its related causes in children. First measures should focus on early and appropriate drugs administration at adequate dosage, airway management, monitoring vital signs, Pediatric Intensive Care Unit (PICU) admission, and management of parent anxiety.

Childhood Epilepsy: An Update on Diagnosis and Management

American Journal of Neuroscience, 2014

Within the past few years there is a rapid expansion in our understanding of epilepsy. The development of new anti-epileptic drugs and refinements to epilepsy surgery are widening the therapeutic options for epilepsy. In addition, the classification of the epilepsies continues to evolve based on an increased understanding of the molecular genetics of the condition and this includes the recognition of possible novel epilepsy syndromes. This review considers some of these exciting developments, as well as addressing the essential features of the diagnosis, investigations, management and impact of epilepsy in childhood.

Pediatric Epilepsy Syndromes: An Update and Critical Review

Epilepsia, 1996

Epilepsy syndromes occupy an important position in the current nosology of the epilepsies, describing and classifying seizure disorders with shared clinical and EEG features. Increasingly, this schema is being refined as new information becomes available and our understanding of etiology and presentation of each syndrome widens. Advances in neuroimaging and neurogenetics have been particularly important and are likely to fundamentally change our concepts of syndrome classification. At present, the International League Against Epilepsy classification of epilepsy syndromes according to presumed localization (partial, generalized, undetermined) and etiology (idiopathic, cryptogenic, symptomatic). In clinical practice, it is often useful to conceptualize epilepsy syndromes according to their usual age at presentation, which greatly facilitates syndrome identification in new patients and recognizes the age-related expression of many childhood epilepsies. Definitional problems exist for many pediatric epilepsy syndromes, particularly the epileptic encephalopathies of early infancy, the benign epilepsies of infancy and childhood, the myoclonic epilepsies of infancy and early childhood, and the idiopathic generalized epilepsies of childhood and adolescence. It is likely that further input from the fields of molecular genetics and neuroimaging will enable the classification of epilepsies to become more etiologically oriented and disease specific.

The infant with seizures (excluding neonatal seizures)

Paediatrics and Child Health, 2013

Seizures in the infant (1 monthe1 year) are a common presentation to the paediatrician and paediatric neurologists. Seizure semiology includes several seizure types. The phenotypes of the seizures are important to recognize to guide investigations and management. The multiple electro-clinical syndromes with many different causes make this a challenging group to investigate and manage. The epileptic encephalopathies are the group with refractory epilepsy with particularly poor prognosis. In contrast to this, are the benign infantile seizures with relatively good prognosis. Magnetic resonance imaging and the availability of detailed genetic investigations, has shed light on these complex group of epilepsies. The therapeutic options include anti-epileptic drugs and ketogenic diet. Surgical treatment is reserved for the few children where focus of the seizure is proved by detailed investigations. This review article focuses on the various infantile epilepsy syndromes, underlying aetiology, an approach to clinical diagnoses, investigations and management, useful for a paediatrician and paediatric neurologists.

Clinical Study of Epileptic Children with Frequent Seizures

Pediatrics International, 1989

The subjects were 98 children with an average age of 5.8 years. The frequent seizures were categorized into the following three modes: (1) seizures occur more than five times a day; (2) 1 ‐4 seizures occur every day for one week or more; (3) 1 ‐4 seizures a day occur weekly for one month or more. The incidence of each mode was as follows: (1) 15.3%; (2) 16.3% (3) 173% (1) + (2) 43.9% etc. We observed frequently the cases of tonicclonic seizures in mode (l), infantile spasms (IS) in mode (2), simple partial seizures (SPS) in mode (3), and minor seizures, IS, and Lennox‐Gastaut syndrome (LCS) in mode (1) + (2). Abnormal CT findings were observed in 37.8%. Of all the patients, 33.7% indicated a developmental quotient (DQ) or intelligence quotient (IQ) above 80, and 31.6% showed a DQ or IQ under 30. Of 96 patients followed for the past one year or more, 32.3%, consisting mainly of the cases with absence seizures and IS, had been seizure‐free for at least one year; 60.4% including the ca...