Covers the definition of epilepsy and how it differs from seizures provoked by fever, low glucose or head injury, then febrile seizures with simple and complex types. Lists the ILAE 2017 seizure classification in a table, followed by a table of childhood epilepsy syndromes with age, features and treatment. Also walks through diagnosis and mimics, drug treatment, drug-resistant epilepsy, status epilepticus dosing, and a short note on dental management.
Topic 8 of 30 in the MU Sofia syllabus for Paediatrics and Infectious Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 8 sections, about 459 words (5 min of reading), with 16 flashcards.
In this note
Introduction
Definitions
Febrile seizures
Types of seizure (ILAE 2017)
Epilepsy syndromes of childhood
Diagnosis
Treatment
Status epilepticus
Introduction
A seizure is a burst of abnormal, excessive, synchronous electrical activity in the brain. Epilepsy is a tendency to have unprovoked seizures. About 1 child in 200 has epilepsy, and most can become seizure-free with treatment.
Definitions
Epilepsy is diagnosed (ILAE 2014) after two unprovoked seizures more than 24 hours apart, or one unprovoked seizure with a high chance (≥ 60%) of more, or when an epilepsy syndrome is recognised. A seizure provoked by fever, low glucose, low sodium or calcium, head injury or meningitis is not epilepsy.
Febrile seizures
The commonest seizures of childhood (2–5% of children): a seizure with fever, aged 6 months to 5 years, without CNS infection.
Look for the cause of fever; exclude meningitis (lumbar puncture if signs, or if under 12 months and unvaccinated or pre-treated with antibiotics).
A third recur; the risk of later epilepsy is only slightly raised after simple febrile seizures.
Paracetamol makes the child comfortable but does not prevent seizures; no regular antiepileptic medicine. Teach parents first aid and, for long seizures, buccal midazolam.
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