Epilepsy in children

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Epilepsy is a neurological condition of recurrent episodes of unprovoked epileptic seizures. A seizure is an abnormal neuronal brain activity that can cause intellectual, emotional, and social consequences. Epilepsy affects children and adults of all ages and races, and is one of the most common neurological disorders of the nervous system.^[1] Epilepsy is more common among children than adults, affecting about 6 out of 1000 US children that are between the age of 0 to 5 years old.^[2] The epileptic seizures can be of different types depending on the part of the brain that was affected, seizures are classified in 2 main types partial seizure or generalized seizure.^[1]

Once a child has their first seizure or suspect seizure, they should be referred to specialized paediatrician in epilepsy and seizures to assess the seizure and conclude a diagnosis. The specialist doctor will take a detailed history of the child, perform physical examinations, clinical laboratory tests such as blood and genetic test, and neuroimaging. If the child is suspected of epileptic seizures, then additional investigations are to be performed such as, an electroencephalogram (EEG) which can give more information of the brain electrical activity and the seizure type.^[3]

The epileptic seizure in the vast majority of pediatric epilepsy patients is ephemeral, and symptoms typically subside on their own after the seizure comes to an end, but some children experience what is known as a “seizure cluster," in which the first seizure is followed by a second episode approximately six hours later. These recurrent seizure episodes pose a higher risk of death for children.^[4]

Children should be treated with proper and effective therapy to prevent irreversible neural damage.^[5] Treatment options for epilepsy include medications, diet, and surgery.^[6] Diet and surgery are considered for children who have medication resistant epilepsy.^[7]

Epilepsy is classified according to seizure types, epilepsy types, and epilepsy syndromes. The seizure types include focal onset, generalized onset, and unknown onset,^[8] while the epilepsy types include focal, generalized, combination focal and generalized, and unknown. Accurate classification of epilepsy will help in providing an appropriate treatment and management therapy.^[9]