Epilepsy in children

Topics: Epilepsy, Seizure, Neurology Pages: 36 (6123 words) Published: February 18, 2014
Epilepsy in Children: A Brief review
November 14, 2008

CHAPTER I
INTRODUCTION
Epilepsy is a condition in which seizures are triggered recurrently from within the brain. 1 A seizure is a sudden, transient disturbance of brain function, manifested by involuntary motor, sensory, autonomic, or psychic phenomena, alone or in any combination, often accompaniec by alteration or loss of consciousness and may occur after a metabolic, traumatic, anoxic, or infectious insult to the brain. 2 The epilepsy is considered to be present when two or more unprovoked seizures occur at interval greater than 24 hour apart. 1 The chance of having a second seizure after an intial unprovoked episode is 30 %. 2 Pinzon R reported that prevalence of epilepsy in children is ranged about 3 to 11 persons of 1000 people and the CDC reported that the prevalence of epilepsy in United States on age less than 15 years old on 1994 is ranged about 4 of 1000 people 3 that making the incidence is still quite high in childhood ages.

Although the prognosis for majority of children with symptomatic seizures or those associated with epilepsy is generally good, 4 seizures may signal a potentially serious underlying systemic or central nervous system (CNS) disorder that requires thorough investigation and management. 1,5 In many cases, the underlying disorder must be identified to aid in clasifying the seizure for leading to the diagnosis, and treated in order to control the seizures and prevent further brain dysfunction. 1,3,6 An incorrect diagnosis of a seizure disorder can have many negative consequences for the patient, including expensive and potentially toxic medication regimens, development of psychiatric disorder, uncontrolled recurrent seizures, and poor quality of life (QoL) of the patient. 1,3,5,6

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Epilepsy in Children: A Brief review
November 14, 2008

CHAPTER II
REVIEW ARTICLE

II.1. Definitions
The epileptic syndromes (table 1) and types of seizures (figure 1), were classified according to the current classification schemes and the guidelines of the International League against Epilepsy (ILAE) and the semiological seizure classification system. 7-9,13 ILAE9 classified seizures as generalized convulsive (e.g., tonic, clonic, or tonic–clonic), nonconvulsive (e.g., absence or myoclonic), or partial (focal). The epilepsy was classified as cryptogenic, symptomatic, or idiopathic, which reserved for seizures occurring in patients with epilepsy with a presumed genetic origin,9,10 according to the putative cause and depending on such factors as the age of the patient, the type of seizure, the presence or absence of a family history of epilepsy, and the presence or absence of an underlying neurologic lesion. Patients were considered to be free of seizures if they had not had seizures of any type for a minimum of one year while receiving the same dose of antiepileptic drug or while not taking any medication.11 An epileptic syndrome is a group of signs and symptoms that customarily occur together where the identification of the syndrome helps determine the appropriate therapy and the prognosis. 3,9,12

The semiological seizure classification (SSC) system (figure 1) identifies in detail the somatotopic distribution of the ictal semiology as well as the seizure evolution. 13-16 In this classification, seizures are classified as follows: a. Auras, an ictal manifestations having sensory, psychosensory, and experiential symptoms. b. Autonomic seizures, a seizures in which the main ictal manifestations are objectively documented autonomic alterations. c. "Dialeptic" seizures that have their main ictal manifestations an alteration of consciousness that is independent of ictal EEG manifestations. d. Motor seizures that were characterized mainly by motor symptoms and are subclassified as simple or complex. Simple motor seizures are characterized by simple, unnatural movements that can be elicited by electrical stimulation of the primary and...
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