|Neonatal Problems: Seizure Disorders|
Epilepsy represents the most common serious neurological problem affecting
children, with an overall incidence approaching 2% for febrile seizures
(due to fever) and 1% for idiopathic epilepsy (without an identifiable
Classification of seizure disorders has evolved considerably over time
and terms like grand mal or petit
mal have largely been replaced by more detailed classifications
based on specific clinical manifestations (symptoms), mode of onset (i.e.
focal are or generalised, cf. International Classification below
) and discrete clinical syndromes.
At present, the epilepsies of childhood are most frequently classified
using variations of the .
Symptoms and Signs
Childhood seizures are characterised by abnormal, excessive discharges
originating from populations of cortical neurones (i.e. in the brain)
and resulting in some clinically evident alteration of function or behaviour.
Therefore, the symptoms of childhood seizures need not include recognisable
motor activity such as tonic-clonic movement. Possible symptoms may include
staring, drop attacks, behavioural changes, or even autonomic disturbances.
The causes of epilepsy in childhood vary in an age-dependent fashion.
For example, seizures in neonates, infants, and toddlers most frequently
result from perinatal brain injury, ,
congenital central nervous system malformations, and metabolic derangements
Conditions that cause seizures in newborns are often serious.
Central nervous system infection, genetic epilepsies, and neurodegenerative
disorders are more likely to present with seizures beginning in later
These causes stand in stark contrast to the adult population, where traumatic
brain injury, cerebrovascular disease, and neoplasms represent the most
frequent causes of seizures.
Diagnosis and Treatment
Often brain-imaging techniques are employed to help in the diagnosis
of epilepsy, e.g. , computed tomography (CT), magnetic
resonance imaging (MRI) or an electroencephalogram
Diagnosis is complicated by the fact that many symptoms are age-dependent
and differ substantially from adult seizure disorders. For example, infantile
spasms may be misinterpreted as a simple startle reflex and absence (petit
mal) seizures are sometimes attributed to inattention or .
Effective treatment depends largely on the physician's ability to establish
an accurate diagnosis and choose appropriate therapy based on the likelihood
of clinical benefit as well as potential side effects.
Determination of appropriate treatment for a child with epilepsy must
be individualised based on the specific type(s) of seizure, the child's
age, and the likelihood of significant side effects. Anticonvulsant monotherapy
is preferred when possible and is effective in a majority of children.
For a more detailed table of treatment options depending
on the type of epilepsy diagnosed, go .
The information in this page is presented in summarised form and has been taken
from the following source(s):
Loyola University Medical Education Network:
(def;articles & more)