Classifying Epilepsy Syndromes
Epilepsy syndrome classification is very important in the management of infants, children, and adolescents with epilepsy. By understanding if your child's epilepsy fits any of the well understood patterns of a specific epilepsy syndrome, the doctor can provide you with important information about your child's condition. For example, some types of epilepsy may be out grown, whereas other epilepsy syndromes may very likely last a lifetime. Some epilepsy syndromes may not necessarily require medication as seizures are likely to occur infrequently and not put the child at significant risk. Other epilepsy types may have a high risk of frequent, poorly controlled seizures and may even put the child at risk for new learning problems or developmental delay. Determining what type of epilepsy (epilepsy syndrome) your child has can help your doctor determine what treatment options are most likely to control your child's seizures without exposing them to additional risks.
There are many epilepsy syndromes known to present in childhood. Some present in otherwise healthy neurologically normal children. Others epilepsy syndromes present in children with developmental delay or other associated neurological and medical problems. For some children it may be difficult to identify a specific epilepsy syndrome following the initial seizure or during the first several months or years after the initial diagnosis. Over time new symptoms (learning problems, speech delay, new or different types of seizures) or signs (stiffness on one side of the body or weakness, seizures brought on by heavy breathing or overheating) may develop. Additional tests like prolonged or overnight video EEG recordings, MRI or genetic tests may reveal new information that can eventually help classify your child's type of epilepsy. In the following section we will review several well understood epilepsy syndromes that effect infants, children, and adolescents. These syndromes will be presented according to the typical age when the children presents with symptoms and will be organized from infancy to adulthood.
Epilepsy syndromes are often grouped by the age when seizures first occur. A child's age plays an important role in their risk for seizures. The brain in infants and young children can more easily be provoked to have a seizure. This is because the brain is rapidly growing and making new connections between brain cells. This process of rapid growth is what allows the infant to rapidly learn new skills like sitting, walking and talking. However, this process also makes the brain very excited. Very little may be needed to tip this excited state into a seizure. This is especially true if an additional irritant or provocation like fever, infection or injury occurs. Additionally, a baby's brain is more at risk for specific types of seizures which cannot occur in the brain of an older child or adult. Finally, the EEG findings (brain waves) are highly influenced by age. Normal EEG patterns change rapidly over the first few weeks of life and continue to make dramatic changes over the first 3 years of life. Similarly, abnormal EEG patterns seen in infants and children with epilepsy may change over time. This changing information can provide additional clues and help provide your child with an accurate epilepsy syndrome diagnosis.