Seizures during infancy and childhood

Question 1

Types

Answer 1

1. Neonatal epilepsy syndrome
2. Epilepsy syndromes in children
3. Benign focal epilepsies
4. Childhood absence
5. Juvenile myoclonic
6. Infantile spasm

Question 2

1. Neonatal epilepsy syndrome types

Answer 2

Two rare but well-recognized neonatal seizure syndromes are associated with a relatively good prognosis

1. Benign (self-limited) neonatal seizures
2. Benign familial neonatal epilepsy

Seizures occur within the first seven days of life
Unifocal clonic

Question 3

2. Epilepsy syndromes in children types

Answer 3

The Lennox-Gastaut syndrome is associated with severe seizures in childhood
Genetic syndromes and hypoxic ischemic insults.
Children usually present in the first 7 years of life with a syndrome characterized by multiple seizure types, particularly tonic and atonic seizures, an atypical, slow spike and wave pattern on electroencephalogram (EEG), and mental retardation, often with psychotic features

Question 4

Benign partial/focal epilepsies of childhood

Answer 4

Idiopathic syndromes that occur in developmentally and neurologically normal children and have a benign course, remitting prior to adulthood

Question 5

Absence seizures

petit mal or generalized nonconvulsive seizures

Answer 5

The only or most predominant seizure type in several epileptic syndromes, which have markedly different clinical courses and prognoses.

Brief staring episodes with behavioral arrest that may occur tens to hundreds of times daily

Question 6

Antiepileptic drugs

Answer 6

Phenytoin
Phenobarbital
Ethosuximide

Question 7

Phenytoin

Answer 7

good for focal and generalized seizures

SE: gingival hypertrophy

Question 8

Tx: Lennox Gastaut syndrome

Answer 8

Valproic acid, lamotrigine, topiramate

NO carbamazepine

Question 9

Tx: Benign partial/focal epilepsies of childhood

Answer 9

Antiseizure drug treatment is often not recommended, particularly if only focal seizures without impairment of consciousness occur and if the child and family are comfortable with this approach