Diagnosis and management of epilepsies in children and young people.
Diagnosis and management of epilepsies in children and young people.
27 October 2008
Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]
Summary,
GUIDELINE OBJECTIVE(S)
To provide evidence-based guidelines on the diagnosis and management of the epilepsies of children and young people aged from one month to 19 years of age (remaining in secondary education)
TARGET POPULATION
Children and young people (aged one month to 19 years) with epilepsy or status epilepticus
INTERVENTIONS AND PRACTICES CONSIDERED
Diagnosis
1. Patient history, including what occurred before, during, and after the attack, as described by the child and first-hand witnesses
2. Electrocardiography (ECG)
3. Home video recording
4. Electroencephalography (EEG)
* Standard EEG
* Repeat EEG
* Sleep EEG
* Ictal EEG
5. Magnetic resonance imaging (MRI)
6. Genetic investigations, with referral to genetics services, if appropriate
Management
1. Provision of appropriate information to patients and their carers with subsequent documentation of discussions
2. Provision of information for families that is appropriate given the sociocultural context
3. Provision of information for schools
4. Risk management including educating patients with regard to safety in common situations and the risks of sudden unexpected death in epilepsy (SUDEP)
5. Routine antiepileptic drug (AED) level monitoring (considered, but not recommended)
6. Discussion of the management of potential adverse effects of AEDs
7. Referral to tertiary care when appropriate
8. Withdrawal of anti-epileptic drugs
9. Inclusion of paediatric epilepsy nurse specialists on management teams
Treatment
1. AED monotherapy
2. Combination therapy of AEDs
3. Corticotropin or corticosteroids for West's syndrome
4. Nasal or buccal midazolam or rectal diazepam for prolonged or serial seizures
5. Co-administration of medications for comorbidities
MAJOR OUTCOMES CONSIDERED
* Sensitivity and specificity of diagnostic tests
* Remission rate
* Seizure frequency and severity
* Adverse events
* Quality of life
* Mortality"
Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]
Summary,
GUIDELINE OBJECTIVE(S)To provide evidence-based guidelines on the diagnosis and management of the epilepsies of children and young people aged from one month to 19 years of age (remaining in secondary education)
TARGET POPULATION
Children and young people (aged one month to 19 years) with epilepsy or status epilepticus
INTERVENTIONS AND PRACTICES CONSIDERED
Diagnosis
1. Patient history, including what occurred before, during, and after the attack, as described by the child and first-hand witnesses
2. Electrocardiography (ECG)
3. Home video recording
4. Electroencephalography (EEG)
* Standard EEG
* Repeat EEG
* Sleep EEG
* Ictal EEG
5. Magnetic resonance imaging (MRI)
6. Genetic investigations, with referral to genetics services, if appropriate
Management
1. Provision of appropriate information to patients and their carers with subsequent documentation of discussions
2. Provision of information for families that is appropriate given the sociocultural context
3. Provision of information for schools
4. Risk management including educating patients with regard to safety in common situations and the risks of sudden unexpected death in epilepsy (SUDEP)
5. Routine antiepileptic drug (AED) level monitoring (considered, but not recommended)
6. Discussion of the management of potential adverse effects of AEDs
7. Referral to tertiary care when appropriate
8. Withdrawal of anti-epileptic drugs
9. Inclusion of paediatric epilepsy nurse specialists on management teams
Treatment
1. AED monotherapy
2. Combination therapy of AEDs
3. Corticotropin or corticosteroids for West's syndrome
4. Nasal or buccal midazolam or rectal diazepam for prolonged or serial seizures
5. Co-administration of medications for comorbidities
MAJOR OUTCOMES CONSIDERED
* Sensitivity and specificity of diagnostic tests
* Remission rate
* Seizure frequency and severity
* Adverse events
* Quality of life
* Mortality"
