Special considerations for a first seizure in childhood and adolescence

Epilepsia
Peter Camfield, Carol Camfield

Abstract

Children with a first unprovoked seizure almost always present with a convulsive seizure. The differential diagnosis includes many paroxysmal events, especially convulsive syncope but even with a good history; there is often uncertainty that cannot be eliminated by investigations. In general, an EEG and MRI are indicated with other investigations determined on a case-by-case basis. Epilepsy syndrome identification may be very valuable. Current literature allows at least partial answers to parents' six most common questions: Will it happen again? How long do I have to wait for a recurrence? Could my child die during a recurrence? Could there be brain damage with a recurrence? If medication treatment is delayed will there be any long-term change in the chance of a permanent remission? Now that my child has had a seizure, how should his/her activities be restricted?

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Citations

Jun 19, 2013·Journal of Fluency Disorders·Mara E SteinbergMadison Berl
Nov 11, 2011·The New England Journal of Medicine·Orrin Devinsky
Dec 25, 2010·Seminars in Pediatric Neurology·Catherine J Chu-Shore, Elizabeth A Thiele
May 22, 2013·Epilepsy & Behavior : E&B·Carla A ScorzaFulvio A Scorza
Apr 13, 2021·Seizure : the Journal of the British Epilepsy Association·María José Jiménez-VillegasJaime Carrizosa-Moog

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