Childhood Epilepsy: Management from Diagnosis to Remission

✍ Scribed by Richard Appleton, Peter Camfield

• Publisher: Cambridge University Press
• Year: 2011
• Tongue: English
• Leaves: 167
• Edition: 1
• Category: Library

✦ Synopsis

Sixty percent of the epilepsies start in childhood, and most of the clinically significant and often life-changing aspects of the disease occur at this time. Childhood epilepsy is frequently a complex disorder, demanding integrated medical, educational and community services. Its treatment encompasses acute and disability medicine. The many types or syndromes of childhood epilepsy present both diagnostic and management challenges. Although many children with epilepsy will be referred to specialist units, the majority will initially present to paediatricians and paediatric neurologists. This book provides a practical, problem-oriented manual to help clinicians with diagnosis, evaluation and management. This book addresses epilepsy as an evolving disorder from presentation, through active disease and finally to either spontaneous remission or a chronic lifelong condition. Structured on the child's age at presentation, Childhood Epilepsy offers a practical overview for paediatricians, paediatric neurologists and primary care practitioners who treat children with epilepsy in their daily practice.

✦ Table of Contents

Contents......Page 6
Preface......Page 8
Contributors......Page 9
1 The only place to start: making the diagnosis of epilepsy......Page 12
Introduction......Page 16
Symptomatic epilepsies in early infancy......Page 17
Disorders of brain structure......Page 18
Metabolic disorders with epilepsy in infancy......Page 19
West syndrome......Page 20
Severe myoclonic epilepsy of infancy (Dravet syndrome and other SCN1A-related epileptic encephalopathies)......Page 23
Migrating partial seizures in infancy (MPSI)......Page 24
Benign infantile seizures......Page 25
General considerations......Page 26
West syndrome......Page 28
Dravet syndrome (SMEI)......Page 30
General considerations......Page 31
Family adjustment......Page 32
What to do if the first drug fails?......Page 33
Epilepsy surgery......Page 34
Ketogenic diet......Page 35
West syndrome......Page 36
Outcome of the benign epilepsy syndromes of infancy......Page 37
REFERENCES......Page 38
The history......Page 40
Acute presentation of seizures......Page 41
Staring, blank spells or 'absences'......Page 43
Fall with abnormal movements or convulsions......Page 44
Distinguishing features between syncope and generalized tonic-clonic seizures......Page 45
Events during sleep......Page 46
Abnormal behavior......Page 47
Regression with or without epileptic seizures......Page 49
Childhood absence epilepsy (CAE)......Page 50
Benign focal epilepsies of childhood (also known as idiopathic focal epilepsies)......Page 51
Epileptic encephalopathies......Page 53
Summary......Page 55
Compliance (concordance) and monitoring of medication......Page 56
Other injuries......Page 58
Co-morbidities in pediatric epilepsy......Page 59
Cognitive delay......Page 60
Attention deficit disorder and behavior problems......Page 61
Autism......Page 62
Ensure compliance and re-evaluate the diagnosis and epilepsy syndrome......Page 63
a. Idiopathic generalized epilepsy......Page 64
b. Symptomatic generalized epilepsy......Page 65
Symptomatic partial epilepsy......Page 66
What is the duration of treatment with an antiepileptic drug?......Page 67
What should be done if seizures persist?......Page 68
Resective surgery......Page 69
b. Corpus callosotomy......Page 71
Ketogenic diet......Page 72
a. Corticosteroids (85, 86)......Page 73
Medical......Page 74
Cognitive......Page 76
Social......Page 77
REFERENCES......Page 78
Incidence of epilepsy during puberty and adolescence......Page 84
The diagnosis of epilepsy in adolescence: common problems......Page 85
Convulsive syncope......Page 87
Non-epileptic attack disorder (NEAD); also called psychogenic non-epileptic seizures (PNES) or 'pseudo-epileptic seizures'......Page 88
Juvenile myoclonic epilepsy (JME)......Page 90
Focal epilepsy: general themes......Page 93
Temporal lobe seizures......Page 94
Frontal lobe epilepsy......Page 96
Progressive myoclonic epilepsy (PME)......Page 97
Principles of drug treatment in adolescents......Page 99
Adherence issues......Page 102
Triggers......Page 103
Focal (partial) epilepsy......Page 106
Progressive myoclonic epilepsies......Page 107
Epilepsy surgery......Page 108
Social and cognitive outcome of juvenile myoclonic epilepsy......Page 110
Social and cognitive outcome of the focal epilepsies......Page 111
Suggestions for management of young people with epilepsy and cognitive or behavioral problems......Page 112
Young people with relatively normal intelligence......Page 113
Young people with severe learning difficulties......Page 114
The good news......Page 115
REFERENCES......Page 116
Introduction......Page 119
Physical injury and accidental death......Page 120
Risks for recurrence and remission of seizures......Page 121
Likelihood of remission......Page 122
Recurrence risk after AED withdrawal......Page 123
Risks of status epilepticus......Page 124
Treatment protocols to minimize risks for children with prolonged seizures and status epilepticus......Page 125
Dose-related side effects......Page 126
Idiosyncratic reactions......Page 127
Effects of AEDs on the unborn fetus......Page 128
Cognitive and behavioral effects......Page 129
Quality of life......Page 130
Psychological risks of epilepsy......Page 131
Impact of intractable epilepsy as perceived by children and adolescents......Page 132
Long-term outcome and impact of childhood-onset epilepsy into adulthood......Page 133
REFERENCES......Page 134
Convulsive status epilepticus......Page 137
Non-convulsive status epilepticus......Page 139
Epilepsia partialis continua (EPC)......Page 142
ADDITIONAL READING......Page 143
7 The prevention of epilepsy and its consequences
......Page 144
Prevention of the primary and severe (malignant) familial epilepsies......Page 145
Prevention of the secondary causes of epilepsy......Page 146
Prevention of a wrong treatment of epilepsy......Page 148
REFERENCES......Page 149
8 Medico-legal aspects of epilepsy
......Page 150
REFERENCES......Page 153
Seizure characteristics......Page 154
Focal or partial seizures (previously called localization-related seizures)......Page 155
Specific syndrome characteristics......Page 156
Status epilepticus......Page 157
Diagnosis......Page 158
Treatment......Page 159
Clinical course......Page 160
Index......Page 161