Last modified: 2018-09-09
Abstract
Purpose - To review the applicability of new 2017 ILAE classification in children with epilepsy (CWE).
Method - We used the new ILAE multilevel classification for 96 children with 146 seizures.
Results - 103 seizures were focal onset, 34 generalized onset and in rest (9) onset was unknown. Motor seizures (74) were more frequent than non-motor seizures (29). In motor seizures, clonic (20) tonic versive (15), tonic-clonic (13) and tonic (11); and in non-motor behavioral arrest (19) were predominant phenomenology. Tonic-clonic seizures (21) were the prevailing generalized seizures.
EEG was abnormal in 86, and MRI was abnormal in 45, normal in 31 and not performed in 20. We classified epilepsies as focal (70), generalized (15), combined focal and generalized epilepsy (4) and unknown (7).
Specific syndromes diagnosed were IGE (14), benign focal epilepsy (22), epileptic & developmental encephalopathy (5), developmental encephalopathy (3), epileptic encephalopathy (1). 57 children were pharmaco-responsive, 15 were pharmaco-resistant.
Etiology was confirmed as perinatal injury in 32, other acquired insults in 4, structural disorder with presumed genetic etiology like focal cortical dysplasia, tuberous sclerosis in 16, and in genetic mutation in 1. Genetic etiology was presumed in 39 MRI negative children.
Comorbidities were observed in 64 CWE. ADHD(23) was the commonest comorbidity followed by ID(22).
Conclusion: The new epilepsy classification is easy, relevant in clinical practice and comprehensive as it integrates three levels of epilepsy diagnosis with etiology and comorbidities. It mirrors current understanding and provides useful tool for communication amongst professionals.