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Epilepsy
Filipa Bastos1, J Helen Cross2
1University College London National Institute of Health Research Biomedical Research Centre, Great Ormond Street Institute of Child Health, and Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom; Centre Hospitalier Universitaire de Lausanne, Child Neurology and Neurorehabilitation Unit, University of Lausanne, Lausanne, Switzerland.
Insights
Childhood epilepsy, a common neurological condition, can harm brain development and co-occur with cognitive issues. Accurate diagnosis is crucial for effective treatment and managing expectations for children with epilepsy.
Area of Science:
- Neurology
- Pediatrics
- Developmental Neuroscience
Background:
- Epilepsy is a chronic neurological disorder with significant neurobiological, cognitive, and psychosocial consequences.
- It is the most common chronic neurologic condition in childhood, affecting 0.5%-1% globally.
- Epileptic activity can disrupt normal brain development, frequently coexisting with neurocognitive and behavioral disorders.
Purpose of the Study:
- To provide a comprehensive overview of childhood epilepsy.
- To discuss the diagnostic challenges and management strategies.
- To highlight the importance of accurate diagnosis for treatment and prognosis.
Main Methods:
- Review of existing literature on childhood epilepsy.
- Synthesis of information on definition, epidemiology, diagnosis, management, and outcome.
- Discussion of the impact of epilepsy on brain development.
Main Results:
- Childhood epilepsy encompasses diverse disorders with varied etiologies, impacting management and outcomes.
- Accurate phenotypic and etiologic diagnosis is critical for guiding treatment decisions.
- Understanding the relationship between epilepsy and co-occurring neurocognitive disorders is essential.
Conclusions:
- Accurate diagnosis is paramount for effective management and setting realistic expectations for children with epilepsy.
- The field of childhood epilepsy is rapidly evolving, requiring continuous updates in diagnostic and therapeutic approaches.
- Addressing the complexities of epilepsy in children is vital for optimizing developmental trajectories and quality of life.
Abstract:
Epilepsy is considered a disease characterized by an underlying predisposition to seizures as well as neurobiologic, cognitive, psychologic, and social consequences. It is the most frequent chronic neurologic condition of childhood, affecting 0.5%-1% of children worldwide. It comprises a variety of disorders with many different etiologies, consequently affecting management and outcome. Although the great majority of children have epilepsies that are self-limited and have a good prognosis, it is nevertheless very well recognized that epileptic activity (be it seizures or interictal discharges) can be particularly deleterious to the developing brain acting as a disruptor to normal developmental function. Indeed, epilepsy and neurocognitive and behavioral disorders very frequently coexist, and it can be challenging to understand if there is causality or if they are all the reflection of the underlying brain disorder. Hence, accurate phenotypic and etiologic diagnosis is of utmost importance as it will not only guide decision making with regard to choice of treatment but also enable management of expectations concerning outcome. The current chapter aims to provide a general overview of the fast evolving and vast field of childhood epilepsy from its definition and epidemiology, to its diagnostic challenges, management, and outcome.
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