A clinical approach to the child with seizures and epilepsy

Abstract

Generalized tonic-clonic seizures in children may have different causes and a different natural history than seizures and epilepsy in adults. The effects of medication may also be of greater importance during childhood. In making decisions about whether or not to treat a child who has had only one or a few seizures, the physician must consider the chance of further seizures and the possible consequences of further seizures. Since the major consequence of seizure recurrence is psychosocial, and since the psychosocial consequences of infrequent seizure recurrence vary with age during childhood and differ from those in adults, decisions about therapy should take these differences into account. The potential effects of anticonvulsants on learning and behavior should also be considered. Seizures should not be treated just "because they are there," but rather only when the risks and consequences outweight the benefits of being free of medication and its effects.