Diagnosis In 2014 the International League Against Epilepsy (ILAE) Task Force proposed the operational (practical) clinical definition of epilepsy, intended as a disease of the brain defined by any of the following conditions: # At least two unprovoked (or reflex) seizures occurring >24 h apart. # One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years. # Diagnosis of an epilepsy syndrome. It is important that as soon as someone is diagnosed with SE, they immediately get medical treatment which is primarily medication.The main test to diagnosis is an Electroencephalogram (EEG), this test is usually performed when the patient is sleep deprived. In this test, electrodes are attached to your scalp with a paste-like substance or cap. The electrodes record the electrical activity of your brain, the results are then read by a Doctor. Accurate diagnosis of your seizure type and where seizures begin is so important because it gives you the best chance for finding an effective treatment (Mayo clinic). diagnosis of Epilepsy and a Seizure disorder can eventually be considered resolved if the subject has not experienced a seizure in over 10 years and has also not been on anti-seizure medication for five years. The most common causes of SE in<unk>  are fever and infections of the CNS, or Central Nervous System. Other causes can be genetic and metabolic disorders, abnormalities of the CNS, ingestion of toxic elements, and Hyponatremia. Education Epilepsy can affect the education of<unk> , which can cause difficulty to learning resulting in lower grades. While many<unk>  are capable of functioning in a normal classroom environment, many end up in special education programs to ensure they are getting the educational support they need.<unk>  with epilepsy may be absent from school due to their diagnosis. There are two main types of seizures Tonic-clonic seizures and absence seizures. Tonic-clonic seizures can have a serious impact on education due to the memory loss they cause, and the time needed to recover following the seizure-causing there to be missed time in school. Absence seizures can have a high negative impact on a child's education. As they are less obvious than tonic-clonic seizures, they can occur many times within a single day, thereby resulting in the child's ability to learn being impaired, and leading to low grades. Often, these educational deficits lead to the investigation of neurological conditions and result in the diagnosis of this seizure subtype.<unk>  may appear to be 'zoning out' or day-dreaming during classes when in actuality they are experiencing uncontrolled absent seizures. Once treatment begins, these<unk>  often exhibit improved attention and their grades improve (John Hopkins). When seizures are controlled by medication, many anticonvulsants have side effects that include drowsiness, thereby also impacting a child's education (John Hopkins). The high school graduation ratewhere? has been reported at 64%, compared with an overall national average of 82%. Social It is very difficult for a child to struggle through the constraints of epilepsy. They cannot live the same carefree life that they may watch their friends living, but that does not mean their quality of life is any less. The diagnosis of SE is not a fatal or life-ending one, especially for a child. A child with Epilepsy must be much more wary of their surroundings at all time as well as being in communication with their own physical well-being. The social stigma of epilepsy may stand in the way, as the child is more prone to bullying. But as the child learns to manage the diagnosis, it may become a more conventionally normal life for them. Many<unk>  with epilepsy are overprotected by their parents, who put restrictions on them in the name of safety, requiring more adult supervision than other<unk> , and not allowing them to participate in certain activities normal to the age group, such as sports. It is a subject of debate if a child with controlled seizures needs additional protection or restrictions, or if the benefits outweigh the losses a child would face. Language In cases of chronic pediatric epilepsy there is often an association with reduced language skills. The classically understood language areas of the brain are Broca’s area and Wernicke’s area. Realistically, language is significantly more complex and involves several cortical areas beyond these regions. Language deficits may present with a wide variety of symptoms ranging from odd patterns of speech to complete aphasia of speech. Unfortunately there is not a significant amount of data that parses out how an epileptic firing patterns will cause a resulting language deficit. The correlation of epileptic activity and language deficit is undeniably present, but the mechanisms involved have yet to be unraveled. In the developing brain, epilepsy may cause the language areas to be structurally altered leading to developmental difficulties. In turn, a child may have trouble acquiring communication skills at a normal rate. This delay may in some<unk>  be resolved by compensatory mechanisms or alleviated by medication and therapy, but in some<unk>  with persistent epilepsy, the delay may remain or worsen as they age. In the case of temporal lobe epilepsy (TLE), studies have shown that there is structural compromise to the fiber tracts associated with memory and language, providing some explanation for the impairments in patients with epilepsy. Language abilities in pediatric epilepsy cases are evaluated using electrical cortical stimulation (ECS) language mapping, electrocorticography (ECoG), fMRI, Wada testing, and magnetoencephalography (MEG). fMRI has been shown to offer a promising strategy for defining language activation patterns as well as laterization patterns. It is important to identify language regions involved in epilepsy, particularly temporal lobe epilepsy, before surgical resection in order to reduce the risk of postoperative language deficits. Currently, ECS mapping is the standard of care in localization of areas involved in focal seizure onset and pre surgical planning. Many pediatric and adult epilepsy patients develop atypical language lateralization due to the reorganization of connections in the epileptic brain. There have been documented cases of interhemispheric and intrahemispheric reorganization of language areas. Several factors may be involved in the extent to which reorganization occurs. "Table 1: Variables Associated With Interhemispheric and Intrahemispheric Reorganization Found in fMRI and ECS Studies." Variable Effect on Language Organization Interhemispheric/Intrahemispheric/Both Early age of seizure onset Yes Both Left-sided seizure focus Yes Both Left-handedness Yes Both Cortical dysplasia (vs discrete tumors) Yes Intrahemispheric Lower IQ scores Yes Intrahemispheric Gender No Age at mapping No Treatment with antiepileptic medications No Ictal zone location No Duration of epilepsy No Seizure frequency No Seizure propagation patterns No The effects of epilepsy on language may be impacted by location of epileptiform activity, severity and duration of electrical discharges, age of onset, treatment method, and surgical resection areas. In some cases, language impairment may be the first indicator of epileptiform activity in the brain of<unk> . A study done at the University of Gothenburg showed that language impairments were more common in<unk>  with epileptic brain activity than<unk>  without. They then investigated whether the epileptic activity was the cause of the language deficit or whether there were other factors involved. They found the greatest impairments in language in the<unk>  with misfiring on the left side of the brain, the side that controls linguistic abilities. This likely indicates that epileptic activity leads to language difficulties and suggests that in<unk>  with language impairments of unknown etiology, evaluations for epilepsy should be considered.
Epilepsy in children
Epilepsy syndromes
Pediatric stroke
Abdominal epilepsy
Diabetes and deafness
Sudden unexpected death in epilepsy
Temporal lobe epilepsy
Childhood absence epilepsy