Epilepsy
Introduction
Epilepsy, or recurrent afebrile seizures, is a pediatric disorder occurring in 5.2 to 7.3 per 1,000 school age children. Fortunately, most children who have a single seizure will not go on to develop epilepsy. Even when they do, the majority will have a relatively benign disorder that can be effectively controlled with a single antiepileptic drug and over time the disorder often resolves itself, allowing the discontinuation of treatment. Proper selection of medication is critical, since all antiepileptic drugs have a potential for significant side effects that may become more severe with higher doses and with polydrug therapy (taking more than one anti-epileptic medication).
Despite proper selection of medication and satisfactory compliance, some patients continue to suffer from epileptic seizures. In these children, drug dosages are gradually increased and polydrug therapy is instituted in pursuit of seizure control. Side effects like lethargy, dulled mentation, hyperactivity, aggressivity, double vision, nausea, tremor, and others are to be expected; they must be carefully balanced against the emotional, psychological, and physical consequences of recurring seizures.
These sequelae are extremely traumatic for epileptic children. Unsure of when the next attack may occur, they are unable to relax, play, and just be kids. In addition, other children often taunt them. The convulsive movements, loss of urinary continence, impairment of consciousness, postictal confusion, and lethargy all create a social stigma that is particularly severe in childhood. Neurosurgery is increasingly being used to treat medically refractory epilepsy, and several centers already offer this treatment.
