childhood epilepsy
Last edited 09/2018
Epilepsy is defined as the tendency to continuing seizures.
Epilepsy is the commonest paediatric neurological problem. Estimates suggest that 0.7-0.8% of school-aged children have active epilepsy (1).
60% of adult patients with epilepsy had their first fit during childhood.
Note that it is recommended that all children who have had a first non-febrile seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs (2,3).
When possible, choose which anti-epileptic drug (AED) to offer on the basis of the presenting epilepsy syndrome. If the epilepsy syndrome is not clear at presentation, base the decision on the presenting seizure type(s) (3).
A large multicentre trial (the SANAD trial) evaluating newer drugs in newly diagnosed epilepsy (accepting some limitations) suggested that sodium valproate should be the drug of choice in generalised and unclassifiable epilepsies, and lamotrigine in focal epilepsies (3).
Reference:
- 1) Appleton R, Gibbs J (Eds). Epilepsy in Childhood and Adolescence. Second edition. London: Martin Dunitz Ltd, 1998.
- NICE (April 2004). Newer drugs for epilepsy in children.
- NICE (April 2018). Epilepsies: diagnosis and management
classification of the epilepsies and epilepsy syndromes
aetiology of childhood epilepsy
diagnosis of the epilepsy syndrome
anticonvulsant treatment in focal or generalised tonic clonic seizures or tonic (atonic) seizures
management of myoclonic seizures
management of childhood-onset typical absence epilepsy
management of febrile convulsions
management of benign rolandic epilepsy of childhood
management and prognosis of juvenile myoclonic epilepsy
management of infantile spasms
management of childhood-onset typical absence epilepsy
management and prognosis of Lennox-Gastaut syndrome
NICE guidance - use of newer drugs for epilepsy in children
review and specialist referral
indications for monitoring/checking drug levels of antiepileptics