Pediatric epilepsy syndromes: an overview

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THE CLASSIFICATION of epileptic seizures has contributed to the rational therapy of epileptic seizures since the advent of the newer antiepileptic drugs, many of which have a relative specificity for reduction in particular seizure types.1 Classification has also aided in communication between physicians and researchers by standardizing terminology, which is critical in providing uniformity for the exchange of information.

In the past 20 years, it has become evident that, particularly in children, it is possible to identify epileptic syndromes of which individual seizures are but one manifestation.2 The seizure bears the same resemblance to the syndrome as a pigment does to a painting. While the seizure is part of the syndrome that draws attention to the condition, the composition of the syndrome is based on a variety of contributions made by family history, age at onset, presence or absence of abnormal neurologic or psychologic findings, presence or absence of interictal electroencephalographic (EEG) abnormalities as well as specific ictal EEG components, a particular natural history (sometimes suggesting spontaneous resolution and at other times, progression), response to medication, and developmental complications. Some of these syndromes carry with them a specific pathologic, chromosomal or biochemical signature.

Apart from its usefulness in communication, such a classification has significant implications for treatment. Obviously, in management of a condition which is potentially benign, one would avoid use of potentially toxic or cognitively stultifying medications, which might produce side effects worse than the condition under consideration. In conditions which are self-limited in time, one might choose to. . .



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