Clinical review of pediatric epilepsy

Seizure disorders are very common and represent the most common cause of referrals to pediatric neurology. Epilepsy,defined as recurrent unprovoked seizures, is also common with a frequency of 4-8 cases per 1000 children. In SaudiArabia, inherited neurological disorders, including epilepsy and genetic epilepsy syndromes, are more common becauseof the high rate of consanguinity. This article attempts to provide an updated overview of pediatric epilepsy and reviewthe most recent diagnostic and therapeutic guidelines. Seizures in children have wide variations in clinical expressionwith age specific presentation. Although epilepsy is a clinical diagnosis, EEG often provides supportive evidence andhelps in seizure classification. Epilepsy syndromes are more common in younger children, and their proper diagnosisprovides valuable genetic, therapeutic, and prognostic information. Magnetic resonance imaging is superior inidentifying congenital or developmental abnormalities and should be performed in preference to CT. Monotherapy isthe best management approach for better compliance and to prevent interactions or side effects. To conclude, epilepsyremains a clinical diagnosis and therefore, careful and detailed history remains the cornerstone of an accurate clinicaldiagnosis.