Children and Adolescents
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Seizure disorders are common in the pediatric age group, but to the families who witness their child's first attack, such a statistic is meaningless because they are overwhelmed by what they interpret to be a catastrophic event. To some, the sudden loss of consciousness implies impending death. In almost all cases, there is great anxiety, fear of the unknown, concern regarding damage to the brain and intellect, and concern about recurrence. It is easy to see why many such parents become overprotective and over solicitous. Despite these many concerns, it is possible for many of the children with seizure disorders to live normal, active lives and look forward to productive adulthood. For those children whose seizures are complicated by mental retardation, learning disabilities, and/or cerebral palsy, improvement in seizure control makes life more tolerable and makes it possible to focus in on the associated disorder. Fortunately, this is an era in which advances in our understanding of the nervous system and of seizure disorders, in particular, have made it possible to apply this new knowledge in the diagnosis and treatment of children with recurring seizures. Computerized axial tomography (CT scan) and magnetic resonance imaging (MRI) are two of the new techniques utilized in identifying lesions in the brain that can result in seizures. Angiography is a valuable tool when vascular abnormalities are suspected as a cause of an underlying seizure disorder. Biochemical studies are used to document a metabolic basis for seizures in childhood. The electroencephalogram (EEG) with its many sophisticated refinements remains the number one ancillary diagnostic examination in childhood epilepsy. New anticonvulsant drugs and the ability to determine blood levels of anticonvulsant agents have improved seizure control. It is evident that diagnostic and therapeutic measures are available for children with seizures but, successful management of such children requires a long-term collaboration between the physician, the family, the child, his teachers, and the others involved in his growth and daily care. In this book, Dr. Leonardo Garcia-Mendez, one of my former students at the Columbia-Presbyterian Medical Center in New York and now a distinguished child neurologist in his own right, details the steps required for a successful collaboration. The reader is given a comprehensive discussion of seizures, an explanation of the methods and techniques of evaluating children with seizures, and the important aspects of medical treatment. Parental understanding of the nature of seizure disorders is the key to the successful management of their child's epilepsy. The intent of this book is to promote such an understanding. Parents and caretakers of children with seizures, their teachers, and physicians will find this book extraordinarily informative and useful. From
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