Childhood epilepsy

Epilepsy is defined as the tendency to continuing seizures.

Epilepsy is the commonest paediatric neurological problem. Estimates suggest that 0.7-0.8% of school-aged children have active epilepsy (1).

60% of adult patients with epilepsy had their first fit during childhood.

Note that it is recommended that all children who have had a first non-febrile seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs (2,3).

When possible, choose which anti-epileptic drug (AED) to offer on the basis of the presenting epilepsy syndrome. If the epilepsy syndrome is not clear at presentation, base the decision on the presenting seizure type(s) (3).

A large multicentre trial (the SANAD trial) evaluating newer drugs in newly diagnosed epilepsy (accepting some limitations) suggested that sodium valproate should be the drug of choice in generalised and unclassifiable epilepsies, and lamotrigine in focal epilepsies (3).

Reference:

1. 1) Appleton R, Gibbs J (Eds). Epilepsy in Childhood and Adolescence. Second edition. London: Martin Dunitz Ltd, 1998.
2. NICE (April 2004). Newer drugs for epilepsy in children.
3. NICE (April 2018). Epilepsies: diagnosis and management