Pediatric epilepsy: primary care treatment and health care management

Childhood seizures are encountered frequently in the primary care setting. Seizures can cause considerable embarrassment and discomfort--as well as dangerous consequences--if not properly treated. Accurate diagnosis often depends on history and a parent's or teacher's clear and reliable description of the seizure. About two-thirds of properly treated patients achieve seizure remission within 10 years of diagnosis. In this article, the authors review standards of treatment and present the latest findings on the treatment of epilepsy. The goal of pharmacologic treatment is to reduce the frequency of seizures with few adverse effects. Because all antiepileptic drugs affect cognition to same degree, diminishing the potential cognitive and psychosocial effects of epilepsy is also a treatment goal. Commonly used and new antiepileptic drugs are discussed. Patient education is an important part of care and requires discussion of beliefs about epilepsy, lifestyle, self-esteem, and resources.