Epilepsy in young children: a retrospective study of patient profiles
TL;DR
Early diagnosis, comprehensive treatment with appropriate antiepileptic drug selection based on seizure type and epilepsy etiology, and rehabilitation improve prognosis and quality of life for children with epilepsy.
Abstract
Background. Epilepsy onset occurs in childhood in 70% of patients and is considered a major problem in pediatric neurology. Objective: To study the profile of inpatients aged 1 month to 3 years with newly diagnosed epilepsy. Material and methods. A retrospective analysis of 261 medical records of children with a newly diagnosed epilepsy admitted to the Early Childhood Psychoneurology Department No. 1 of the Children's Center for Psychoneurology and Epileptology at the Republican Children's Clinical Hospital (Ufa) between 2018 and 2024 was conducted. Patients ranged in age from 1 month to 3 years. The average age of patients was 8,7±0,7 months, with a predominance of boys (56,3%). All patients underwent clinical, instrumental, laboratory, neuroimaging, and electrophysiological (electroencephalography (EEG), video-EEG monitoring) examinations. Results. The rate of all cases of epilepsy peaked in children under 1 year of age – 206 (79%). West syndrome and Ohtahara syndrome were noted in 62 (23,7%) children aged 7 to 12 months. Depending on the etiology, structural epilepsy was observed in 197 (75,5%) patients. The most common cause of epilepsy with an established etiologic factor was hypoxic-ischemic, hemorrhagic lesion of the central nervous system – 159 (61%). In young children, a frequent combination of epileptic seizures with delayed psychomotor and psychospeech development was recorded (83,9%). In 23,7% of patients, hypsarrhythmia, “burst-suppression” – a pattern specific to epileptic encephalopathies (West and Ohtahara syndromes) were EEG recorded. Valproic acid was the drug of choice when prescribing anticonvulsant therapy. Serum antiepileptic drug levels remained adequate throughout treatment. Conclusion. The results of our study highlight the importance of a comprehensive approach to epilepsy treatment. Early diagnosis, comprehensive treatment with appropriate antiepileptic drug selection based on seizure type and epilepsy etiology, and rehabilitation improve prognosis and quality of life for children with epilepsy. Further research is needed to gain insights into genetic and environmental risk factors and to develop new methods for prevention and treatment of epilepsy in young children.