Pediatric epilepsy

Knupp, Kelly G.; Koh, Susan; Park, Kristen

doi:10.1212/cpj.0b013e31824c6cbd

Cited by 13 publications

(10 citation statements)

References 42 publications

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“…These differences may be related to types of seizure and epilepsy syndrome. 11 Clinicians should take a comprehensive and neurologically focused history and conduct thorough clinical examination. This is important for both diagnosis and management of epilepsy in children.…”

Section: Epilepsy In Childrenmentioning

confidence: 99%

“…8 The objectives of treatment of epilepsy in children include providing freedom from seizures without adverse events and helping patients achieve overall function similar to their age-specific population. 11 Three important types of seizures in children, namely, febrile seizures, juvenile myoclonic epilepsy, and absence epilepsy are discussed below.…”

Section: Epilepsy In Childrenmentioning

confidence: 99%

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Optimizing epilepsy treatment in children, adults and elderly: clinical perspectives

2022

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Epilepsy is a common neurological condition among all age groups. Its diagnosis depends on clinical history and is supported by investigations like electroencephalograph and magnetic resonance imaging. In children, febrile seizures and juvenile myoclonic seizures are common. In adults and elderly, epilepsy could be new onset or present since childhood. Several antiseizure medications (ASMs) are available for treatment of epilepsy. Each of these drugs has different advantages as well as limitations. Several factors including patient related factors (e. g. age, comorbidities, and gender), seizure characteristics and epilepsy type, and drug related factors (namely, pharmacokinetics, pharmacodynamics, efficacy, side effects, and risk of drug-drug interactions) are considered while selecting drug therapy. There are concerns related to teratogenicity due to pharmacotherapy in females of child-bearing potential. Elderly patients also need special considerations while selecting an appropriate treatment option for epilepsy. Advisory board meetings with a group of expert neurologists were conducted at eight cities across India to gain clinical insights on management of epilepsy in different age groups. Consensus was supported by relevant literature obtained from PubMed and Google scholar using the keywords ‘epilepsy’, ‘diagnosis’, ‘children’, ‘adults’, ‘elderly’, and ‘management’. According to the experts, choice of appropriate ASM is driven by patient- and drug-related factors and seizure characteristics. In India, valproate remains a commonly prescribed agent except in females of childbearing age. Levetiracetam is preferred because of its safety profile whereas clobazam is an effective initial add-on therapy. Newer drugs are largely useful as adjuvants.

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Section: Epilepsy In Childrenmentioning

confidence: 99%

Section: Epilepsy In Childrenmentioning

confidence: 99%

Optimizing epilepsy treatment in children, adults and elderly: clinical perspectives

2022

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“…Sekitar 50 juta orang di dunia menderita epilepsi, menjadikan epilepsi sebagai beban bagi pelayanan kesehatan (WHO, 2019). Sebanyak 1-2% populasi pediatri menderita epilepsi sehingga epilepsi merupakan salah satu penyakit yang paling umum didiagnosis pada pediatri (Knupp, Koh and Park, 2012). Prevalensi kasus epilepsi pada pediatrik di Indonesia diperkirakan sekitar 40-50%.…”

Section: Pendahuluanunclassified

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Ilma¹,

Endriastuti²,

Suryoputri³

2021

Acta Pharm Indo

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Epilepsi merupakan penyakit kronis dengan prevalensi tinggi pada pediatrik. Salah satu obat anti epilepsi yang banyak diresepkan pada pediatrik adalah asam valproat. Luaran klinis utama pengobatan anti epilepsi adalah tercapainya periode bebas kejang. Tercapainya luaran klinis epilepsi sulit diprediksi karena dipengaruhi oleh banyak faktor. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan luaran klinis pasien epilepsi pediatrik yang menggunakan asam valproat. Pengambilan data dilakukan melalui wawancara kepada orangtua/wali pasien. Epilepsi dikatakan terkontrol jika tercapai periode bebas kejang ≥6 bulan selama menggunakan asam valproat. Analisis data dilakukan dengan uji chi square atau uji Fisher, dilanjutkan dengan uji regresi logistik binomial. Pasien pada penelitian ini berjumlah 39 pasien. Sebagian besar pasien pediatri (64.1%) yang menggunakan terapi asam valproat memiliki epilepsi yang terkontrol, dengan 20 pasien (51.3%) menggunakan monoterapi asam valproat. Faktor yang berhubungan dengan luaran klinis pasien adalah jumlah obat antiepilepsi yang digunakan (p-value <0.05). Meskipun demikian, epilepsi yang tidak terkontrol dapat menjadi penyebab pasien diberikan politerapi.

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“…Childhood-onset epilepsy differs from epilepsy in adults not only in the clinical manifestations, including seizure type and epilepsy syndrome, but also in the presence of distinctive electroencephalogram (EEG) patterns, etiologies, and response to anti-seizure medication. The goals in treating epilepsy in children are complete control of their seizures, improvement of psychomotor development, and maintenance of quality of life for them and their family [ 3 ]. Previous follow-up studies [ 4 , 5 , 6 , 7 ] have reported that 60–70% of the patients with childhood-onset epilepsy entered remission under adequate treatment, and nearly half of them had sustained seizure remission following withdrawal of anti-seizure medication.…”

Section: Introductionmentioning

confidence: 99%

Over 10-Year Outcomes of Infantile-Onset Epilepsies

Kim

Jang

Ahn

et al. 2021

JCM

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Seizures in infancy have highly variable courses and underlying etiologies. However, there are only a few long-term follow-up studies regarding infantile-onset epilepsy. Therefore, we aimed to describe the clinical courses, seizure outcomes, and risk factors of infantile-onset epilepsy followed up for more than 10 years in a tertiary center. Methods: Data of the patients with epilepsy, diagnosed under the age of 12 months and followed up for more than 10 years, were retrieved from the electronic medical records of Asan Medical Center Children’s Hospital. The patients’ medical records were retrospectively reviewed, and clinical outcomes were assessed based on the duration of seizure freedom at the last follow-up. Results: Of the 146 patients, 103 (70.5%) entered at least one remission, of whom epilepsy was resolved in 46 (31.5%). Forty-nine (33.6%) were found to be intractable at last contact. Delayed development, neurological deficits, and later onset (>3 months) were significantly associated with intractable epilepsies (p < 0.01). Conclusions: This study demonstrated that many patients with infantile-onset epilepsy can experience seizure remission. However, in some cases, early onset epilepsy was highly associated with various comorbidities and intractable seizures. Therefore, appropriate diagnosis and treatment are necessary to prevent further neuropsychiatric complications.

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Pediatric epilepsy

Cited by 13 publications

References 42 publications

Optimizing epilepsy treatment in children, adults and elderly: clinical perspectives

Optimizing epilepsy treatment in children, adults and elderly: clinical perspectives

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Over 10-Year Outcomes of Infantile-Onset Epilepsies

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