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Introduction

Epilepsy syndromes in children are classified based on various factors. These include the kind and type of seizures, the time at which they began, how easy or difficult they are to control, whether there are any other neurological effects, and whether any other systemic signs accompany it.

They are divided into the following broad types depending on the various similarities present:

1. Juvenile Myoclonal Epilepsy (Janz syndrome, impulsive petit mal)

This begins at puberty. Generalised convulsions are present accompanied by myoclonic seizures. Jerking of muscles can be controlled with medication but the condition is generally not outgrown.

2. Childhood Absence Epilepsy (Petit Mal)

2-4% of childhood epileptics fit into this syndrome. The age group affected is between 3-10 years. The seizures are present for brief spells and is associated with distinctive wave EEG patterns. Patients may also present with absence seizures. 40% of patients outgrow this condition by puberty or eventually go into remission by the midthirties. This condition can be controlled by oral antiepileptics.

3. Benign Rolandic Epilepsy (Benign Partial Epilepsy)

One-third of epilepsy occurring in children aged between 4 and 10 years belong to this group. It presents as simple partial seizures affecting the face with drooling and inability to speak followed by convulsions. The convulsions mainly come on at night. The patients are otherwise normal and 95% of patients outgrow the seizures by the age of 18.

4. Infantile Spasms (West Syndrome)

The patient presents with clusters of rapid myoclonic jerks, and infants present with jerky upward and forward movements of the arms, which are bent or extended. EEG shows a classical pattern of hypsarrythmia. This syndrome is period- related and usually comes on only in the first year of life. There are associated developmental delays, and patients may go on to develop other epilepsy syndromes such as Lennox-treatment is steroids & ACTH, along with antiepileptic drugs.

5. Lennox-Gastaut Syndrome

This is a syndrome of mixed seizures. The patient can get absence attacks, stiffening, and drop attacks. It begins between the ages of 1 to 8 years and the EEG pattern is distinctive. It may also be associated with developmental delays & mental subnormality.

6. Rasmussen's Syndrome

This condition is very rare. One half of the brain is affected. Seizures are produced which affect the control of the opposite side. The mainstay of treatment is surgery.

7. Landau-Kleffner Syndrome

A very rare abnormality where the patient presents with seizures and speech abnormalities. The Child starts normal speaking patterns and then loses speech completely.

8. Lobar Epilepsy

Temporal & frontal lobe epilepsies are the commonest. The presentation may be quite dramatic with screaming, thrashing, bicycling, etc.

9. Febrile Seizures

Seizures may accompany very high fever. This is one of the commonest causes of seizures in childhood.

10. Seizures

Seizures may also be a feature of other conditions like tuberous sclerosis, cerebral palsy, mental retardation, tumours, autism and neurofibromatosis.