PMID: 18431909Apr 25, 2008Paper

The diagnostic and therapeutic management in the first cerebral attack in childhood

Przegla̧d lekarski
Janusz Wendorff

Abstract

Cerebral attacks are the most frequent neurological problem in childhood. The diagnostic and therapeutic management in the first cerebral attack belongs to subjects often discussed in literature but currently it arouses some controversies concerning especially the notions "cerebral attack", "unprovoked seizures" and also the fact when epilepsy should be diagnosed after the first or the second unprovoked attack of seizures and when to start its treatment. The author presents in detail the principles of the management of cerebral attack and its differentiation in children. In relation to the neurological examinations (EEG, cerebrospinal fluid analysis, neuroimaging examination), the author demonstrates both the indications for their performance as well as limitations due to frequently obtained negative results. Among cerebral attacks, after exclusion of symptomatic attacks and febrile seizures, the first epileptic seizure can be diagnosed in 50% of children. The treatment of epilepsy after the first epileptic seizure decreases effectively the number of seizures within the first three years. However, the percentage of children who achieved 3-5-year remission is in these patients similar to that in the group treated after 2 success...Continue Reading

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