[Epileptic seizures in childhood: classification, diagnosis, therapy]

This is a review about epilepsies of childhood dealing with the elementary principles in classification, diagnosis and treatment. In each case of a patient suffering with epilepsy 3 diagnoses have to be made: the diagnosis of the seizure-type, the diagnosis of the epilepsy-type, the diagnosis of the etiology. The seizure-type has to be diagnosed as generalized (e.g. grand mal, absence seizure) or partial (simple or complex) which can be obtained from the clinical picture and EEG. The classification of seizures is different from the classification of epilepsies: recurrent seizures, only a single type or more types in the same patient, make the diagnosis of the epilepsy-type. The etiologic diagnosis is often not possible to make and requires careful judgment in the use of special procedures; however, the diagnosis of the seizure-type includes their etiology in as much as, for example, awake-grand mal and absence seizures can be classified as idiopathic resp. sleep-grand mal and partial seizures as symptomatic. The most essential principle for the treatment of epilepsies is: the seizures diagnosis determines the appropriate therapy. The drugs of choice for partial seizures and most cases with grand mal are phenytoin and/or carbamazepine; absence seizures and benign myoclonic seizures highly respond to valproate; atonic seizures are most resistant to therapy. To make an effective treatment you have to know the dose, the therapeutic plasma drug level, the drug's half life and the side-effects. The aim of epilepsy-treatment has to be: avoidance of seizures without side-effects.