Identification and management of seizures in children
Keywords:Seizures, Epilepsy, Pediatrics, Children, Diagnosis, Identification, Management
Estimates from epidemiological studies indicate the high global prevalence of seizures in children. They can be associated with different complications that might even be life-threatening. Different risk factors have been reported to increase the risk and severity of seizures, like metabolic disorders, infections, and reduced access to needed care. Therefore, providing appropriate management is essential to enhance the prognosis of these cases. In the present article, we conducted a literature review to shed more light on identifying, diagnosing, and managing seizures in children. The identification process depends on different factors, including obtaining an adequate history from the patient or their caregivers, performing a thorough general and neurological examination, and conducting appropriate investigations whenever needed. It should be noted that in severe cases, these approaches should be made promptly not to delay the management approaches, which can be life-saving. Reassuring family attendants is also recommended. Besides, increasing awareness among these families about the diagnosis, identification, prognosis, reporting, and responding to seizures might reduce the risk of recurrence and enhance the prognosis of seizures. Choosing a treatment strategy is usually based on different factors, including the child's age, epilepsy type, family preferences, the presence of comorbidities, and ability to administer medications. For recurrent seizures, home-based medications, like rectal diazepam or buccal midazolam, might also be used to lower the risk of recurrence and reduce the intensity of seizures.
Glauser T, Shinnar S, Gloss D. Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016;16(1):48-61.
Idro R, Gwer S, Kahindi M. The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital. BMC Pediatr. 2008;8:5.
Verity CM, Greenwood R, Golding J. Long-term intellectual and behavioral outcomes of children with febrile convulsions. N Engl J Med. 1998;338(24):1723-8.
Mwipopo EE, Akhatar S, Fan P, Zhao D. Profile and clinical characterization of seizures in hospitalized children. Pan Afr Med J. 2016;24:313.
Wilmshurst JM, Donald KA, Eley B. Update on the key developments of the neurologic complications in children infected with HIV. Curr Opinion HIV AIDS. 2014;9(6):533-8.
Wilmshurst JM, Burgess J, Hartley P, Eley B. Specific neurologic complications of human immunodeficiency virus type 1 (HIV-1) infection in children. J Child Neurol. 2006;21(9):788-94.
Govender R, Eley B, Walker K, Petersen R, Wilmshurst JM. Neurologic and neurobehavioral sequelae in children with human immunodeficiency virus (HIV-1) infection. J Child Neurol. 2011;26(11):1355-64.
Wagner RG, Ibinda F, Tollman S, Lindholm L, Newton CR, Bertram MY. Differing Methods and Definitions Influence DALY estimates: Using Population-Based Data to Calculate the Burden of Convulsive Epilepsy in Rural South Africa. PloS One. 2015;10(12):e0145300.
Wagner RG, Bottomley C, Ngugi AK. Incidence, Remission and Mortality of Convulsive Epilepsy in Rural Northeast South Africa. PloS One. 2015;10(6):e0129097.
Ba-Diop A, Marin B, Druet-Cabanac M, Ngoungou EB, Newton CR, Preux PM. Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa. Lancet Neurol. 2014;13(10):1029-44.
Mung'ala-Odera V, White S, Meehan R. Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya. Seizure. 2008;17(5):396-404.
Edwards T, Scott AG, Munyoki G. Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors. Lancet Neurol. 2008;7(1):50-6.
Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord. 2015;17(2):117-23.
Shohet C, Yelloly J, Bingham P, Lyratzopoulos G. The association between the quality of epilepsy management in primary care, general practice population deprivation status and epilepsy-related emergency hospitalisations. Seizure. 2007;16(4):351-5.
Atadzhanov M, Haworth A, Chomba EN, Mbewe EK, Birbeck GL. Epilepsy-associated stigma in Zambia: what factors predict greater felt stigma in a highly stigmatized population? Epilepsy Behav. 2010;19(3):414-8.
Baskind R, Birbeck GL. Epilepsy-associated stigma in sub-Saharan Africa: the social landscape of a disease. Epilepsy Behav. 2005;7(1):68-73.
Tolaymat A, Nayak A, Geyer JD, Geyer SK, Carney PR. Diagnosis and management of childhood epilepsy. Curr Prob Pediatr Adolescent Heal Care. 2015;45(1):3-17.
Berg AT, Berkovic SF, Brodie MJ. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010;51(4):676-85.
Chen CY, Chang YJ, Wu HP. New-onset seizures in pediatric emergency. Pediatr Neonatol. 2010;51(2):103-11.
Chelse AB, Kelley K, Hageman JR, Koh S. Initial evaluation and management of a first seizure in children. Pediatr Ann. 2013;42(12):244-8.
El-Radhi AS. Management of seizures in children. Bri J Nurs (Mark Allen Publishing). 2015;24(3):152-5.
Ahmed SN, Spencer SS. An approach to the evaluation of a patient for seizures and epilepsy. State Med Society Wisconsin. 2004;103(1):49-55.
Davidson GT, Eaton M, Paul SP. Childhood epilepsy: a clinical update. Community Practitioner. 2016;89(4):25-29.
Sasidaran K, Singhi S, Singhi P. Management of acute seizure and status epilepticus in pediatric emergency. Ind J Pediatr. 2012;79(4):510-7.
Beghi E, De Maria G, Gobbi G, Veneselli E. Diagnosis and treatment of the first epileptic seizure: guidelines of the Italian League against Epilepsy. Epilepsia. 2006;47(5):2-8.
Hunter L, Sidebotham P, Appleton R, Dunkley C. A review of the quality of care following prolonged seizures in 1-18 year olds with epilepsies. Seizure. 2015;24:88-92.
Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015;56(10):1515-23.
National Institute for Health and Care Excellence: Clinical Guidelines. In: Epilepsies: diagnosis and management. London: National Institute for Health and Care Excellence (NICE) Copyright © NICE 2021. 2021.
Kowalczuk J. British National Formulary for Children (BNFC). Quality Safety Heal Care. 2006;552.
Garbi M. National Institute for Health and Care Excellence clinical guidelines development principles and processes. Heart (British Cardiac Society). 2021.
Patel AD. Variables associated with emergency department and/or unplanned hospital utilization for children with epilepsy. Epilepsy Behav. 2014;31:172-5.
England MJ, Liverman CT, Schultz AM, Strawbridge LM. Epilepsy across the spectrum: promoting health and understanding. A summary of the Institute of Medicine report. Epilepsy Behav. 2012;25(2):266-76.
O'Dell C, Wheless JW, Cloyd J. The personal and financial impact of repetitive or prolonged seizures on the patient and family. J Child Neurol. 2007;22(5):61s-70.