Practitioner review: use of antiepileptic drugs in children.
BACKGROUND
The aim in treating epilepsy is to minimise or control seizures with full respect of quality-of-life issues, especially of cognitive functions. Optimal treatment first demands a correct recognition of the major type of seizures, followed by a correct diagnosis of the type of epilepsy or of the specific syndrome.


METHODS
Review of data from literature and personal clinical experience in treating children with epilepsy.


RESULTS
After summarising the general aspects on the diagnosis and treatment of the main forms of childhood epilepsy, we review key issues about management of seizure disorders, including when to start treatment, how to proceed when the first treatment fails, and how to set the targets of treatment. A special section is devoted to the new concept of epileptic encephalopathy and to the influence of "interictal" EEG abnormalities on cognition, behaviour, and motor abilities in children, providing some suggestions on why and how to treat these conditions. A second section approaches the choice of treatment according to the specific syndromes including infantile spasms, focal epilepsies, syndromes with typical absence seizures, the myoclonic epilepsies and the Lennox-Gastaut syndrome.


CONCLUSIONS
Antiepileptic drugs (AEDs) can efficiently control seizures in most children. However, the specificity of AEDs is relatively limited, although continuing research is leading to a better understanding of the relationship between pathogenesis and the mechanism(s) and site(s) of drug action.
Guerrini
Renzo
R
Division of Child Neurology and Psychiatry, University of Pisa & IRCCS Fondazione Stella Maris, via dei Giacinti 2, 56018 Calambrone, Pisa, Italy. renzo.guerrini@inpe.unipi.it
Parmeggiani
Lucio
L
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects; D002648:Child; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D013577:Syndrome; D016896:Treatment Outcome
D000927:Anticonvulsants