Specific Problems of Children with Epilepsy

Summary: In both adults and children, the seizure type and frequency of occurrence largely determine the burden of epilepsy, for the patient and his family. Epilepsy in children can range from the severe to the relatively benign, and it is important to make the correct diagnosis as early as possible. In those under 5 years of age, epilepsy often presents as an age‐related syndrome, e.g. West and Lennox‐Gastaut syndromes. Later, typical absences and generalized tonic‐clonic convulsions are more usual. Drug therapy should take account of the different pharmacodynamics of antiepileptic drugs in children, and phenobarbital should be avoided. Rectal diazepam has an important role in the emergency management of childhood seizures. Psychological difficulties may be manifested by both the child and the parents. They should be prevented if possible by active intervention at an early stage after diagnosis, or managed on a continuing basis by expert medical and paramedical advice. The aim of such counseling is to ensure, so far as is possible, that the epileptic child develops normally in a normal family environment.