Jul 2026· Research Journal of Pharmacology and Pharmacodynamics· 0 citations· 21 references
Abstract
0.5–1% of children worldwide suffer from epilepsy, a widespread neurological condition that affects people of all genders and demographics. It is a collection of disorders rather than a single illness that is typified by frequent, erratic seizures brought on by aberrant brain activity. These seizures can take many different forms, such as convulsions, sensory or behavioral abnormalities, or loss of consciousness. Recurrent unprovoked seizures, a high likelihood of recurrence, or an epileptic syndrome are the criteria used by the International League Against epileptic (ILAE) to describe epilepsy. Patients' neurological, emotional, and social well-being are greatly impacted by epilepsy, which is caused by neuronal hyperexcitability. Seizure type, EEG results, and related neurological characteristics determine classification. All things considered, epilepsy is a complicated condition with a wide range of causes and symptoms. In children, epilepsy and Attention Deficincy Hyperactivity Disorder (ADHD) often co-occur; approximately 30–40% of children with epilepsy also have ADHD. There are two types of epileptic seizures: focal and generalized. Automatisms, atonic or tonic episodes, clonic jerks, spasms, hyperkinetic movements, or myoclonus are examples of motor symptoms that can accompany focal seizures. Non-motor symptoms include autonomic changes, behavior arrest, cognitive disturbances, emotional changes, or sensory abnormalities. Absence seizures, myoclonic seizures, atonic seizures, tonic seizures, and tonic-clonic seizures are examples of generalized seizures that affect both hemispheres of the brain. This categorization aids in the diagnosis, management, and comprehension of epileptic seizure patterns. A common neurological condition in children, epilepsy is most common in the first year of life and is more common in low- and middle-income nations, where the majority of cases go untreated. The six main categories of its causes are structural, genetic, infectious, metabolic, immunological, and unknown. An imbalance between neuronal excitation and inhibition causes aberrant electrical activity during seizures, which can extend to different parts of the brain. Ion channel malfunction, neurotransmitter imbalance, and altered neuronal circuitry are some of the factors that lead to epileptogenesis and can have long-term repercussions on cognition, particularly following protracted or frequent seizures. When assessing epilepsy, a physical examination is crucial. This includes measuring blood pressure, looking for signs of neurocutaneous syndromes on the skin, and looking for anomalies in the skull that can point to underlying neurological conditions. Electroencephalography (EEG), neuroimaging, and genetic testing are used to diagnose epilepsy in children. Sleep EEG is crucial for focal epilepsies and epileptic encephalopathies. EEG is an easy-to-use method for identifying aberrant cortical excitability. While genetic testing, including next-generation sequencing, has identified over 265 genes associated with epilepsy, increasing the identification of genetic epilepsies, neuroimaging detects structural abnormalities in the brain. Antiepileptic medications including carbamazepine, ethosuximide, and levetiracetam are used in treatment; each is customized for a particular type of seizure and age group while taking side effects and effectiveness into account. An alternate strategy is offered by dietary therapy, especially the ketogenic diet, which lowers seizure frequency by altering neurotransmitter activity and brain metabolism. Together, these therapeutic and diagnostic approaches allow children with epilepsy to be Effecetiveiy managed.
Paediatric epilepsy is one of the most common chronic neurological disorders of childhood, characterised by recurrent unprovoked seizures resulting from abnormal neuronal activity. Accurate diagnosis is essential and is based on a detailed clinical history, seizure semiology, neurological examination, and electroencephalography (EEG), with neuroimaging such as magnetic resonance imaging (MRI) used to identify structural abnormalities. Classification according to seizure type and underlying aetiology genetic, structural, metabolic, immune, infectious, or unknown—guides appropriate management strategies. The primary goal of treatment is to achieve optimal seizure control while minimising adverse effects and supporting normal neurodevelopment. First-line management typically involves antiseizure medications (ASMs) selected according to seizure type, patient age, comorbidities, and potential drug interactions. Approximately two-thirds of affected children achieve seizure remission with pharmacological therapy. However, a significant proportion develop drug-resistant epilepsy (DRE), requiring alternative approaches such as ketogenic diet therapy, vagus nerve stimulation, or epilepsy surgery. Early identification of DRE is critical to reduce the risk of cognitive, behavioural, and psychosocial impairment. Comprehensive care extends beyond seizure management and includes addressing developmental, educational, and psychosocial needs. A multidisciplinary, family-centred approach involving neurologists, dietitians, psychologists, and educators is essential. Advances in genetic testing and precision medicine are improving diagnostic accuracy and enabling more personalised treatment strategies in (PE).
Jayesh S. Patil, Hitendra S. Chaudhari, S. Pawar et al.· Research and reviews : a jou...· 0 citations
Introduction:Seizure constitutes the most common neurological problem in children and most common neurological emergency attended by paediatrician.1 Less than one third of seizures in children are caused by epilepsy, a condition in which seizures are triggered recurrently from within the brain. An estimated 2.4 million new cases of seizure occur each year globally. At least 50% cases begin in childhood or adolescent age group. Computerised tomography (CT), magnetic resonance imaging (MRI), electroencephalography (EEG) and long term EEG monitoring are available to the health professionals.3 Understanding the classification of epileptic seizures is the first step towards the correct diagnosis, treatment and prognostication of the condition. The initial management of a patient with seizures begins with an understanding of the patient’s seizure type and, if pertinent, epilepsy syndrome. Specific seizure types or syndromes often respond better to specific medications or surgical approaches.5 We conducted this to study the clinical profile of epilepsy in children 6 months to 12 years of age & to classify epilepsy in children 6 months to 12 years of age according to International League Against Epilepsy classification 1989.Aims and Objectives:To study the clinical profile & Classification of epilepsy in children 6 months to 12 years of age having epilepsy according to International League Against Epilepsy classification 1989.Materials and Methods: The study was a cross-section conducted in the department of paediatrics of a tertiary care centre over 2 years. The study group consisted of two hundred seven children between the age groups of 6 months to 12 years having epilepsy were included in this study on the basis of predefined inclusion and exclusion criteria A detailed history and thorough clinical examination was done for all patients. E.E.G., CT scan and M.R.I was obtained from the case files. Statistical analysis was done using SSPE 21.0. P value less than 0.05 was taken as statistically significant.Results:Of the 207 studied cases there were 131 males & 76 females with M:F ratio of 1.72:1 showing a male preponderance.Conclusion:Generalized seizures with tonic clonic presentation were most common seizure type reported. The ILAE classification of epilepsy and epilepsy syndrome 1989 is more complex and many of the syndromes do not adequately fit in to this syndromic classification.Though it is complicated and hectic most patients can be classified by these schemes, with some time and effort.
Dr. Devanand Gulab, PraveenSingh Chaudhary, Dr.Ashwini Mohan et al.· PAIN, JOINTS, SPINE· 0 citations
Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal electrical activity in the brain. It remains a significant global health concern, particularly in low- and middle-income countries (LMICs). The recurrence of seizures in patients with epilepsy is influenced by multiple clinical and nonclinical factors involved in epileptogenesis. This literature review aims to summarize the risk factors for recurrent seizures in patients with epilepsy based on recent scientific evidence. The literature was obtained from PubMed, Google Scholar, and manual searches and included articles published in English and Indonesian between 2010 and 2026. The study designs included meta-analyses, systematic reviews, cohort studies, case-control studies, cross-sectional studies, and case reports. The findings indicate that seizure recurrence is associated with the etiology of epilepsy (structural, genetic, infectious, metabolic, immunological, and idiopathic), as well as with lifestyle and behavioral factors such as sleep deprivation, psychological stress, alcohol consumption, smoking, and non-adherence to antiepileptic drugs. Abnormal MRI findings also increase the risk of disease recurrence. Furthermore, neuroinflammatory mechanisms, particularly microglial activation and proinflammatory cytokine release, contribute to increased neuronal excitability. In conclusion, recurrent seizures in epilepsy result from complex interactions among biological, clinical, and behavioral factors. Early identification and management of these risk factors are essential to reduce seizure recurrence and improve the quality of life of patients.
Y. Imran, Reza Naulla· Journal of Society Medicine· 0 citations
Epilepsy is among the most prevalent chronic neurological disorders, affecting more than 50 million people worldwide and contributing substantially to the global burden of neurological disease. Beyond the seizures themselves, recurrent epileptic activity is increasingly recognized as a driver of progressive cognitive decline; however, cognitive comorbidity remains under-addressed in routine clinical management. This literature review synthesizes current evidence on the mechanisms, clinical manifestations, and assessment of cognitive impairment associated with recurrent seizures. Recurrent seizures arise from an imbalance between excitatory (glutamate) and inhibitory (GABA) neurotransmission, producing neuronal hyperexcitability and hypersynchronization. During and after seizure episodes, cyclooxygenase-2–dependent cerebral vasoconstriction induces localized hypoperfusion and hypoxia; when repeated, these events accumulate, causing structural and functional brain injury. The hippocampus, essential for memory, is particularly vulnerable to hypoxic-ischemic damage, whereas temporal- and frontal-lobe involvement disrupts memory, language, attention, and executive function. Approximately 60–70% of patients with chronic epilepsy experience cognitive impairment, the severity of which is modulated by age at onset, seizure frequency, duration, and antiepileptic drug use. Practical screening tools such as the Montreal Cognitive Assessment (MoCA), including its validated Indonesian version (MoCA-Ina), demonstrate higher sensitivity than the Mini-Mental State Examination for detecting mild impairment, while brain-derived neurotrophic factor represents a promising biomolecular marker of cognitive dysfunction. Collectively, the evidence indicates that epilepsy management should extend beyond seizure control to incorporate routine cognitive surveillance. Early detection through sensitive screening instruments enables comprehensive, individualized treatment planning and may ultimately improve the long-term quality of life for people living with epilepsy.
Y. Imran, Ainaya Az Zahra· Journal of Society Medicine· 0 citations
Pediatric occipital lobe epilepsy (OLE) comprises syndromes with seizures originating from the posterior cerebral cortex. Previously "benign", recent International League Against Epilepsy (ILAE) updates reclassified these as self-limited or structural focal epilepsies, reflecting their complex causes and morbidity potential. The 2017 ILAE guidelines shifted from syndromic recognition to an etiology-driven approach. High-resolution magnetic resonance imaging is crucial to differentiate self-limited genetic syndromes from structural OLE (e.g., focal cortical dysplasia), as the latter often requires surgery. Self-limited epilepsy with autonomic seizures (formerly Panayiotopoulos syndrome) presents with prolonged nocturnal autonomic seizures. Childhood occipital visual epilepsy (previously Gastaut type) manifests as frequent, brief daytime visual hallucinations. Despite high seizure freedom rates with monotherapy, patients face neurocognitive challenges in visuospatial processing and academic performance. For drug-resistant structural cases, surgery offers high seizure freedom rates, though with risk of visual deficits. Accurate differentiation between idiopathic and structural OLE is essential for improving outcomes. The shift from "benign" to "self-limited" terminology emphasizes the need to monitor cognitive comorbidities and syndrome evolution. Early diagnosis is critical to avoid clinical mimics and enhance neurodevelopmental outcomes. This review examines the evolving landscape of pediatric OLE, highlighting the shift from syndromic to etiological classification and management strategies.
Preeti Srivastava, D. Nag, Shikha Swaroop et al.· World Journal of Clinical Pe...· 0 citations
BACKGROUND: Eight to 12% of patients with benign epileptiform discharges of childhood (BEDC) on the electroencephalogram (EEG) develop epileptic seizures. A significant proportion of these patients have cognitive impairment. The issue of determining comprehensive predictors of epileptic seizures and cognitive impairment in patients with BEDC on the EEG remains unresolved.
AIM: To analyze the relationship between BEDC and epileptic seizures and also to evaluate their impact on the cognitive status of patients.
METHODS: The study involved 99 patients aged from 5 to 15 years (61 boys and 38 girls, mean age 9.3 years, standard error of the mean 0.23) with epileptic seizures (n = 57) and without them (n = 42). The following epilepsy types were recorded: age-dependent focal (n = 33, 58%), structural focal (n = 10, 18%), epileptic encephalopathy (n = 14, 24%). After therapy adjustment, patients received 1 anticonvulsant (54%), 2 anticonvulsants (26%), or 3 anticonvulsants (19%). The following anticonvulsants (in duo- and polytherapy, the main prescribed anticonvulsant was specified at the highest dose) were used: lamotrigine (n = 8), levetiracetam (n = 24), valproic acid (n = 13); in single cases, in combination with other drugs: ethosuximide (n = 2), topiramate (n = 1), oxcarbazepine (n = 1). The cognitive sphere was assessed on the EpiTrack Junior test scales, the P300 potential was recorded in the oddball paradigm.
RESULTS: The group of patients with epileptic seizures demonstrated a lower total score in the 'Words' test (4 [3; 5] versus 5 [4; 5]), the higher power of theta- and alpha-oscillations and lower frequency of alpha-oscillations on the EEG; in the same group, higher latency of N2 component of P300 was identified in Fz. The association between the number of taken anticonvulsants and the extent of cognitive impairments was assessed: children receiving 3 anticonvulsants showed lower scores on scale 1 of the EpiTrack test (2 [1; 3]) compared to children taking 1 or 2 anticonvulsants (4 [3; 5] and 4 [1; 5] respectively). The lowest results were recorded in patients receiving preparations of valproic acid. Logit regression analysis of neurophysiological parameters: χ2 indicator for the model was 8.7; p = 0.013; Hook–Jeevis estimation method; loss function — maximum likelihood; the number of correct classifications into group 1 was 86%, into group 2 — 69%; odds ratio — 4.52.
CONCLUSIONS: Correlates and predictors of the presence of epileptic seizures in patients with BEDC on the EEG can be the neurophysiological parameters of stimulus recognition based on P300 potential and average alpha rhythm frequency data. In patients with BEDC on the EEG and manifestation of epileptic seizures, the most pronounced cognitive impairment was observed in the group of patients with epileptic encephalopathy and structural focal epilepsy.
Y. Kalinina, R. Zorin, M. D. Naumov et al.· I P Pavlov Russian Medical B...· 0 citations