Update in Pediatric Neurology

Abstract

Paroxysmal events leading to an alteration in the level of consciousness and neurological functioning are extremely common in the pediatric population. Very often these events raise concerns on the part of caregivers as to whether such events represent epilepsy. The pediatric practitioner is required to become familiar with features of epileptic seizures and syndromes encountered in children as well as conditions that mimic epilepsy. In this chapter we provide a description and review of the most common clinical features, frequency, etiologies, differential diagnosis, approach to investigation, and selected aspects of the management of such events. To ease the process of discussion, the material is presented in three sections; the first two sections (“Epilepsy Syndromes in the Neonate” and “Epilepsy Syndromes in the Infant, Child and Adolescent”) deal with definitions and provide a broad outline of epileptic seizures, seizure semiology, value of localization, and age-dependent epilepsy syndromes. Recognition of both benign and more serious epilepsy syndromes is very important. While an approach to the differential diagnosis and management is outlined, seeking appropriate consultation with tertiary care specialists is critical. The section on “Non-epileptic Events” discusses the clinical presentation and management of non-epileptic events that mimic seizures, including conditions as diverse as the following: syncope, breathholding spells, movement disorders, and psychogenic non epileptic events.