Management of childhood epilepsy

As "seizures beget seizures," it is essential to investigate the etiology and control seizures early. The multiplicity of causes, variability in the response to treatment and in the outcome, despite adequate treatment often create dilemmas for the physician. The best option for the clinician is to take cognizance of each reported symptom carefully, examine the patient thoroughly, elucidate the family history, examine the sequence of the disease process and tailor the prescription accordingly. The investigations should depend on the anticipated cause, keeping in view the cost benefit analysis and economic constraints with a simultaneous onus of not missing treatable causes. In addition, if the long term serious effects on social function are to be rectified, physicians must address these areas with equal enthusiasm to the drug treatment of childhood epilepsy. Development of newer antiepileptic drugs and rationalising epilepsy surgery will be the challenges of the coming millennium.