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Feature Article

Epilepsy in childhood and adolescence

Mark T Mackay

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Abstract

About two-thirds of children and adolescents with epilepsy respond to treatment with anticonvulsants, and more than half will outgrow their epilepsy.

Key Points

  • Epilepsy is a group of disorders associated with recurrent unprovoked seizures.
  • An EEG is recommended following a first afebrile single seizure but imaging is not required in all children with epilepsy.
  • Anticonvulsant medications are usually commenced after two or more unprovoked afebrile seizures. Sodium valproate is recommended for generalised epilepsy and carbamazepine or sodium valproate for focal epilepsy.
  • Childhood epilepsy generally has a good prognosis, with around two-thirds of patients responding to treatment and more than half ultimately ‘outgrowing’ their epilepsy.
  • Surgery offers the best chance of cure in the 20 to 30% of children who have medically refractory epilepsy.

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