Special considerations for a first seizure in childhood and adolescence.
Children with a first unprovoked seizure almost always present with a convulsive seizure. The differential diagnosis includes many paroxysmal events, especially convulsive syncope but even with a good history; there is often uncertainty that cannot be eliminated by investigations. In general, an EEG and MRI are indicated with other investigations determined on a case-by-case basis. Epilepsy syndrome identification may be very valuable. Current literature allows at least partial answers to parents' six most common questions: Will it happen again? How long do I have to wait for a recurrence? Could my child die during a recurrence? Could there be brain damage with a recurrence? If medication treatment is delayed will there be any long-term change in the chance of a permanent remission? Now that my child has had a seizure, how should his/her activities be restricted?
Camfield
Peter
P
Department of Pediatrics, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia, Canada. camfield@dal.ca
Camfield
Carol
C
D000293:Adolescent; D000367:Age Factors; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008279:Magnetic Resonance Imaging; D010290:Parents / Q000523:psychology; D012008:Recurrence; D013575:Syncope / Q000175:diagnosis; D013577:Syndrome; D009626:Terminology as Topic
D000927:Anticonvulsants