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Approximately 9% of the United States population will have a seizure sometime during their lives; 3% of these have epilepsy. At least 1% of children can be expected to have an afebrile seizure by 14 years of age. The risk of recurrent afebrile seizures ranges from 4 to 8.1 per 1000 by age 11. Principles of recognition, classification and treatment are similar in children and adults. Focal or partial seizures are perhaps more common than primary generalized seizures though recognition of focal onset is often difficult in young children. Some epilepsy syndromes are seen uniquely in children. The more common syndromes are described here.

This ebook created by

1. Hema Patel, MD
   Clinical Associate Professor of Neurology,
   Department Of Neurology
   Indiana University School of Medicine
   Indianapolis, IN
2. Laurence E. Walsh, MD
   Visiting Assistant Professor of Medical Genetics and Neurology
   Departments of Medical Genetics and Neurology
   Indiana University School of Medicine
   Indianapolis, IN
3. Bhuwan P. Garg, MB, BS
   Professor of Neurology, Department of Neurology
   Indiana University School of Medicine,
   Indianapolis, IN

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Lennox-Gastaut Syndrome

This syndrome manifests in children from 1 to 7 years of age, and a significant number of patients have previous history of infantile spasms. Multiple seizure types are common in this syndrome. Most common seizures are tonic, atonic, and atypical absence seizures but myoclonic, generalized tonic-clonic seizures (GTCS) and partial seizures also occur. EEG exhibits slow background activity and generalized bisynchronous 1-2 cps (cycles per second) spike and slow wave discharges. The seizures are difficult to control and prognosis is poor with psychomotor retardation. Antiepileptic medications, which are often only partially effective, include valproic acid and lamotrigine. Sedative anticonvulsants should be avoided if possible, because these drugs may increase seizure frequency by decreasing alertness. These patients are best managed by epilepsy specialists.

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