Generalized seizures with tonic clonic presentation were most common seizure type reported and were classified according to International League Against Epilepsy classification 1989.
Abstract
Introduction:Seizure constitutes the most common neurological problem in children and most common neurological emergency attended by paediatrician.1 Less than one third of seizures in children are caused by epilepsy, a condition in which seizures are triggered recurrently from within the brain. An estimated 2.4 million new cases of seizure occur each year globally. At least 50% cases begin in childhood or adolescent age group. Computerised tomography (CT), magnetic resonance imaging (MRI), electroencephalography (EEG) and long term EEG monitoring are available to the health professionals.3 Understanding the classification of epileptic seizures is the first step towards the correct diagnosis, treatment and prognostication of the condition. The initial management of a patient with seizures begins with an understanding of the patient’s seizure type and, if pertinent, epilepsy syndrome. Specific seizure types or syndromes often respond better to specific medications or surgical approaches.5 We conducted this to study the clinical profile of epilepsy in children 6 months to 12 years of age & to classify epilepsy in children 6 months to 12 years of age according to International League Against Epilepsy classification 1989.Aims and Objectives:To study the clinical profile & Classification of epilepsy in children 6 months to 12 years of age having epilepsy according to International League Against Epilepsy classification 1989.Materials and Methods: The study was a cross-section conducted in the department of paediatrics of a tertiary care centre over 2 years. The study group consisted of two hundred seven children between the age groups of 6 months to 12 years having epilepsy were included in this study on the basis of predefined inclusion and exclusion criteria A detailed history and thorough clinical examination was done for all patients. E.E.G., CT scan and M.R.I was obtained from the case files. Statistical analysis was done using SSPE 21.0. P value less than 0.05 was taken as statistically significant.Results:Of the 207 studied cases there were 131 males & 76 females with M:F ratio of 1.72:1 showing a male preponderance.Conclusion:Generalized seizures with tonic clonic presentation were most common seizure type reported. The ILAE classification of epilepsy and epilepsy syndrome 1989 is more complex and many of the syndromes do not adequately fit in to this syndromic classification.Though it is complicated and hectic most patients can be classified by these schemes, with some time and effort.
Comprehensive care extends beyond seizure management and includes addressing developmental, educational, and psychosocial needs, and a multidisciplinary, family-centred approach involving neurologists, dietitians, psychologists, and educators is essential.
Jayesh S. Patil, Hitendra S. Chaudhari, S. Pawar et al.· Research and reviews : a jou...· 0 citations
0.5–1% of children worldwide suffer from epilepsy, a widespread neurological condition that affects people of all genders and demographics. It is a collection of disorders rather than a single illness that is typified by frequent, erratic seizures brought on by aberrant brain activity. These seizures can take many different forms, such as convulsions, sensory or behavioral abnormalities, or loss of consciousness. Recurrent unprovoked seizures, a high likelihood of recurrence, or an epileptic syndrome are the criteria used by the International League Against epileptic (ILAE) to describe epilepsy. Patients' neurological, emotional, and social well-being are greatly impacted by epilepsy, which is caused by neuronal hyperexcitability. Seizure type, EEG results, and related neurological characteristics determine classification. All things considered, epilepsy is a complicated condition with a wide range of causes and symptoms. In children, epilepsy and Attention Deficincy Hyperactivity Disorder (ADHD) often co-occur; approximately 30–40% of children with epilepsy also have ADHD. There are two types of epileptic seizures: focal and generalized. Automatisms, atonic or tonic episodes, clonic jerks, spasms, hyperkinetic movements, or myoclonus are examples of motor symptoms that can accompany focal seizures. Non-motor symptoms include autonomic changes, behavior arrest, cognitive disturbances, emotional changes, or sensory abnormalities. Absence seizures, myoclonic seizures, atonic seizures, tonic seizures, and tonic-clonic seizures are examples of generalized seizures that affect both hemispheres of the brain. This categorization aids in the diagnosis, management, and comprehension of epileptic seizure patterns. A common neurological condition in children, epilepsy is most common in the first year of life and is more common in low- and middle-income nations, where the majority of cases go untreated. The six main categories of its causes are structural, genetic, infectious, metabolic, immunological, and unknown. An imbalance between neuronal excitation and inhibition causes aberrant electrical activity during seizures, which can extend to different parts of the brain. Ion channel malfunction, neurotransmitter imbalance, and altered neuronal circuitry are some of the factors that lead to epileptogenesis and can have long-term repercussions on cognition, particularly following protracted or frequent seizures. When assessing epilepsy, a physical examination is crucial. This includes measuring blood pressure, looking for signs of neurocutaneous syndromes on the skin, and looking for anomalies in the skull that can point to underlying neurological conditions. Electroencephalography (EEG), neuroimaging, and genetic testing are used to diagnose epilepsy in children. Sleep EEG is crucial for focal epilepsies and epileptic encephalopathies. EEG is an easy-to-use method for identifying aberrant cortical excitability. While genetic testing, including next-generation sequencing, has identified over 265 genes associated with epilepsy, increasing the identification of genetic epilepsies, neuroimaging detects structural abnormalities in the brain. Antiepileptic medications including carbamazepine, ethosuximide, and levetiracetam are used in treatment; each is customized for a particular type of seizure and age group while taking side effects and effectiveness into account. An alternate strategy is offered by dietary therapy, especially the ketogenic diet, which lowers seizure frequency by altering neurotransmitter activity and brain metabolism. Together, these therapeutic and diagnostic approaches allow children with epilepsy to be Effecetiveiy managed.
N. P. Patil, Divakar. R. Patil, Akash S. Jain et al.· Research Journal of Pharmaco...· 0 citations
Early-onset epilepsy in infancy exhibits heterogeneous features and the ILAE framework facilitates a systematic diagnostic approach and supports clinical management in pediatric patients.
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.
L. B. Novikova, K. M. Ziultsle, A. Akopyan et al.· Epilepsy and paroxysmal cond...· 0 citations
This review examines the evolving landscape of pediatric OLE, highlighting the shift from syndromic to etiological classification and management strategies and the need to monitor cognitive comorbidities and syndrome evolution.
Preeti Srivastava, D. Nag, Shikha Swaroop et al.· World Journal of Clinical Pe...· 0 citations
Focal seizures are the predominant type of seizure among pediatric patients and are primarily managed with benzodiazepines such as clobazam and lorazepam, followed by levetiracetam.
KOTHAI RAMALINGAM, RANGASAMY KRISHNAMOORTHI, MAGESH ELANGO et al.· Asian Journal of Pharmaceuti...· 0 citations