ABSTRACT
Pediatric Epilepsy Is Common ..................................................................................4 Pediatric Epilepsy Encompasses a Wide Range of Disorders ...................................4 Pediatric Epilepsy Viewed from a Developmental Context ......................................9 A Wide Range of Treatment Options is Available ................................................... 10 Pediatric Epilepsy Is Not Just About Seizures......................................................... 11 Summary .................................................................................................................. 12 References ................................................................................................................ 12
Epilepsy is a common, and commonly misunderstood, chronic medical condition of childhood. As frequently encountered as childhood asthma, convulsions occur in approximately 5% of all children in the United States, and 1% of children are diagnosed with epilepsy.5,9,11,23 Appropriate diagnosis and management are crucial given the potential for lifelong consequences to the developing brain. Not all seizures need to be treated, as there are differences in the management of true epileptic conditions versus reactive or isolated seizures. An example of the former would be recognizing the clinical phenotype of infantile spasms, a particularly devastating type of developmental brain disorder. An illustration of the latter would be refraining from use of anticonvulsant medications for children with recurrent, brief febrile seizures. This common form of acute provoked seizure does not reect an enduring epileptic condition, and daily preventative treatment is not warranted. Furthermore, there are many paroxysmal disorders affecting children, such as parasomnias and behavioral problems, which are frequently mistaken for epileptic phenomena. The epilepsies of childhood differ signicantly both from each other as well as from those encountered in adulthood; the pediatric brain is not just a smaller adult brain. The key, then, is to understand what epilepsy is and what it is not, and to appreciate the unique age-and syndrome-dependent nature of epileptic conditions to guide proper diagnosis and management. In this introductory chapter, a few key points regarding pediatric epilepsy will be highlighted, and expanded upon in the remainder of this book.
