Mechanisms, Classification and Management of Seizures and Epilepsies

Clinical manifestations linked to chronic recurrence of paroxysmal discharges within neuronal networks of the brain define epilepsy. Causes comprise various combinations of brain damage, genetic predisposition and maturation phenomena characteristic of the child’s brain. The wide range of clinical expression includes acute events, the epileptic seizures, and/or progressive deterioration of motor, sensory or cognitive functions. Various patterns are observed, consisting of recurrent seizures as in adults, acute episodes of prolonged or recurrent seizures called status epilepticus, and intermediary conditions in which distinct seizures are combined with progressive deterioration of brain functions, but the latter are not linked to the seizures themselves but to a combination of seizures and EEG so-called “interictal” paroxysmal activity. The latter condition, called epileptogenic encephalopathy is very specific of pediatric epilepsy. Epilepsy may last from days to decades, and consequences range from simply an odd experience to complete loss of cognitive abilities that may persist throughout life although the epilepsy has died out.