title: Medical management of children with epilepsy.
abstract: Epilepsy is a common neurological condition presenting to the pediatrician. There are many seizure mimics and the differential diagnosis of paroxysmal events is wide which may make a definitive diagnosis challenging. Epilepsy is a heterogeneous condition with marked variability in presentation, underlying etiologies, associated comorbidities and outcomes. The reorganization of epilepsies in 2010 reflects an increasing understanding of the neuropathological and etiological mechanisms as a result of rapid technological advances in neuroimaging techniques and molecular genetics in particular. An increasing number of treatment options are available although high quality evidence, applicable to children, is lacking. Choices should be tailored to the individual patient applying knowledge of adverse drug effects, including the potential for seizure exacerbation in certain syndromes. Neurobehavioral and psychiatric comorbidities occur in up to 80% of children and frequently remain unrecognized. Screening for these conditions should form part of holistic management, along with awareness of the psychosocial and educational needs of the child from the time of initial diagnosis. The management of individual children with epilepsy therefore presents a myriad challenges. Early referral to a specialist with expertise in the management of pediatric epilepsy should be sought whenever there is diagnostic uncertainty or a poor response to therapy.
authors.affiliation: Department of Paediatric Neurology, Department of Paediatrics and Child Health Red Cross War Memorial Children's Hospital University of Cape Town, Rondebosch, Cape Town, South Africa - jo.wilmshurst@uct.ac.za.
authors.forename: S
authors.initials: S
authors.lastname: Ackermann
authors.forename: J M
authors.initials: JM
authors.lastname: Wilmshurst
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008967:Molecular Biology / Q000379:methods; D059906:Neuroimaging / Q000379:methods; D010372:Pediatrics / Q000379:methods; D012017:Referral and Consultation
chemical_list: D000927:Anticonvulsants