What is new in paediatric epilepsy?

There are many recent advances in the understanding and management of epilepsy in children. Epidemiological data support the requirement for two or more unprovoked seizures for the diagnosis. New epilepsy syndromes abound as magnetic resonance imaging has uncovered new causative brain malformations with important implications for counseling and treatment. Molecular genetics has uncovered the basic mechanisms for several epilepsy syndromes. Indications for new drugs are slowly being defined, while nonmedication treatments for intractable patients have been further developed (ketogenic diet, vagus nerve stimulation, cortical resection). Clinical studies show that the chance of long-term remission can be predicted fairly accurately for many children. Death from childhood epilepsy is exceedingly rare. Despite these gains, the social outcome in adulthood is often unsatisfactory.