Childhood and Adolescent Epilepsy: The Effects, Treatment and Future Lisa C. Cortina
Final Research Paper: Due Week 11-2/16/2014
Social, Behavioral & Cultural Factors in Public Health 6115-9
In the last decade, the diagnosis of Epilepsy has taken on a different meaning for those who have it and mostly due to the fact that important strides have been made in research and in recognition of the disease. These changes are measurably improved and reflect significant progress to the field of neurological disorders. At the same time, it is a diagnosis that is still very challenging to manage in the eyes of the public health world as there are many social, psychological, behavioral and physiological dimensions it characteristically assumes. Children and adolescents with a diagnosis of epilepsy are more vulnerable and susceptible to complex treatments by virtue of having undeveloped bodies. Their bodies change more frequently and drastically in shorter periods of time and, therefore, present greater challenges than adults with the diagnosis. Children are at higher risk of developing epilepsy than adults because particular syndromes such as infantile spasms, Lennox-Gastaut syndrome, and Rasmussen’s encephalitis begin in childhood (NINDS, 2013). The concentration of research today is in genetics and biomarkers with a vision towards preventing the disease although there is still much work being done to find pharmacological treatments for those with the disease. In the ensuing paragraphs, I will present several aspects of childhood and adolescent epilepsy with a focus on how psychosocial, behavioral, and emotional factors and many others presently influence how the disease is generally perceived and how these factors affect policies in public health and what the future holds for this disease. Childhood and Adolescent Epilepsy: A Public Health Problem
Children and adolescents who have a diagnosis of epilepsy usually have a multitude of issues that need to be managed regularly if not daily. This largely is what makes the disease a public health issue. According to Bernd Neubauer (2007), a leading expert in the field of epilepsy research and practice, in his authored work about early childhood and adolescent epilepsy he notes that greater than 3% of the all of those who will suffer from epilepsy and that one quarter of newly diagnosed cases worldwide are children; these are alarming numbers to have to contend with on a global basis. On the positive side of the disease, with optimal treatment, around 70% will enter remission and in half the number of cases, for the most part, long term antiepileptic drugs can be discontinued (Devinsky, 2008). This shows a significant conversion rate for the disease. More importantly, most patients with epilepsy undergo normal cognitive development, a truly important statistic about childhood epilepsy. It can be understood from this information that there is a relatively good prognosis, but it contrasts with persistent public stigma surrounding the condition. Epilepsy occurrence in childhood measures approximately 0.5% and, in industrialized countries, approximately an average of about 50 in 100,000 children are diagnosed with epilepsy each year and children account for 25% of all new cases of epilepsy; the prevalence in developing countries ranges from 77-115 in 100,000 (ILAE, 2014).
For each individual, the diagnosis can vary widely meaning that some children suffer from one small seizure daily or periodically to those without seizures if well-controlled on medication to those who have extremely debilitating seizures that can involve a loss of consciousness (Wyllie, 2011). In order to fully comprehend the individual differences in epilepsy, it is important to understand the operational diagnosis (practical application) which is defined in general terms as an individual who has "at least two unprovoked seizures on...
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Curing Epilepsy: Pathways Forward. (2013). Retrieved from: http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.html
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Epilepsia (2014), International League against Epilepsy, Retrieved from: www.ilae- epilepsy.org
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