Seizures presenting in childhood

Introduction
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By Stephen L Nelson MD PhD

The anxiety and fear surrounding childhood epilepsy can have a profound impact on the patients and their families. The diagnosis of seizure disorders during childhood can sometimes be challenging due to the variety of types of seizures and nonepileptic events that are seen in the pediatric population. Making the appropriate diagnosis is important to ensure proper treatment and accurate determination of prognosis. In this clinical summary, Dr. Stephen Nelson of the Uniformed Services University of the Health Sciences discusses some guidelines and pitfalls in diagnosing seizures and epilepsy in childhood and adolescence.

Key Points

  • The diagnosis of a seizure requires a thorough history of the event with an emphasis on recognition of features that may suggest a nonepileptic cause.
  • EEG is the most useful diagnostic test in cases in which the history is not diagnostic, particularly if the event(s) in question occur(s) while the test is being done.
  • In the absence of signs or symptoms of infection or trauma, MRI is the preferred imaging modality for those patients with new-onset afebrile seizures who require imaging.
  • It is important to identify a patient’s epilepsy syndrome to assist in choosing the appropriate treatment and to discuss prognosis.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Localization
Pathophysiology
Differential diagnosis
Diagnostic workup
Syndromes and diseases in which the seizure type occurs
Prognosis and complications
Management
References
Contributors