What are the seizure disorders affecting children?

From the Guidelines

Seizure disorders affecting children include febrile seizures, epilepsy, absence seizures, infantile spasms, Lennox-Gastaut syndrome, and benign rolandic epilepsy, with febrile seizures being the most common, affecting 2% to 5% of children between 6 and 60 months 1.

Key Seizure Disorders

• Febrile seizures: brief generalized seizures occurring in febrile children, usually not requiring long-term medication but possibly needing rescue medications like rectal diazepam during acute episodes 1
• Epilepsy: characterized by recurrent unprovoked seizures, treated with anticonvulsant medications such as levetiracetam, valproic acid, or oxcarbazepine, with medication choice depending on seizure type, age, and potential side effects
• Absence seizures, infantile spasms, Lennox-Gastaut syndrome, and benign rolandic epilepsy: each with distinct characteristics and treatment approaches

Management and Treatment

• Febrile seizures do not require continuous or intermittent anticonvulsant therapy due to the potential toxicities associated with these agents outweighing the relatively minor risks associated with simple febrile seizures 1
• Early diagnosis and treatment are crucial to prevent developmental delays and improve outcomes
• Regular medication administration, avoiding triggers, ensuring adequate sleep, and having an emergency seizure action plan are essential for management

Diagnostic Approaches

• Neuroimaging tests, such as those discussed in the ACR Appropriateness Criteria for seizures in children, can be useful in identifying underlying causes of seizures, including acute and chronic intracranial or systemic abnormalities 1
• Clinical scenarios, including patient age, precipitating event, and clinical and electroencephalogram findings, guide the selection of appropriate neuroimaging tests

Outcome Prioritization

• Morbidity, mortality, and quality of life are prioritized in the management of seizure disorders, with treatment decisions based on the most recent and highest-quality evidence, such as the 2008 clinical practice guideline for the long-term management of the child with simple febrile seizures 1

From the Research

Seizure Disorders Affecting Kids

• Febrile seizures are the most common type of seizure disorder in children, affecting 3-4% of children 2
• Febrile seizures are classified as simple or complex, with complex seizures lasting 15 minutes or more, or recurring within 24 hours 3
• Other seizure disorders affecting kids include:
  • Epilepsy, which is the most common neurologic disorder in childhood 4
  • Nonepileptic events, such as pseudo-seizures, which can resemble seizures but have a different cause 2
  • Subclinical seizures, which are seizures that are not visible but can be detected by electroencephalography (EEG) 4
• Seizure disorders in children can be caused by a variety of factors, including:
  • Fever 3, 5
  • Genetic predisposition 3, 5
  • Environmental factors 5
  • Underlying cerebral pathology 6
• The prognosis for children with seizure disorders is generally favorable, with most febrile seizures being benign and self-limiting 3, 5
• However, some children with seizure disorders, such as those with complex febrile seizures or epilepsy, may be at risk of subsequent seizures or neurodevelopmental delays 4, 5
• Treatment for seizure disorders in children typically involves antiseizure medications, but may also include other therapies such as the ketogenic diet or epilepsy surgery 4