Pregledni rad
https://doi.org/10.26800/LV-145-supl1-35
Paroxysmal non-epileptic disorders in children and adolescents
Sanja Delin
orcid.org/0000-0003-4388-7249
; Odjel za pedijatriju, Opća bolnica Zadar, Zadar
Filip Sabol
Zlatko Sabol
Sažetak
Aim and methods: Through an extensive review of the literature, to describe paroxysmal non-epileptic seizures(PNEP)in childhood and adolescence, with the emphasis on the semiology and distinguishing clinical features of the disorder in relation to epileptic seizures, and provide general treatment guidelines. Results: PNEPs occur as sudden onset rapid seizures which can frequently recur and may be accompanied by or without loss of consciousness.Their origin is in cerebral dysfunction of various causes but never in disorders of cortical bioelectrical activity. PNEPs are frequent in children and occur at any time in children, from newborns to adolescents. They include anoxic/hypoxic paroxysmal disorders, psychogenic paroxysmal seizures, paroxysmal seizures during sleep, attacks with stereotypical changes in movement and body posture, or represent physiological forms of behaviour. It is estimated that about 10% of children in the general population have non-convulsive attacks.We find them in as many as 60% infants with suspicion of epileptic attacks, 60% of children with a certain degree of intellectual difficulties, and in 20% to 25% of children with normal psychomotor development. About 15% of patients referred to tertiary centres for epilepsy actually have PNEP.A significant number of these events do not require
specific treatment and regress spontaneously over time. Conclusion: Paediatricians should identify paroxysmal non-epileptic events, avoiding the mistaken diagnosis of epilepsy and its implications, as unnecessary tests, longterm pharmacotherapy and the negative psycho-social consequences for the patients (restrictions, stigmatization) and their families. In the clinical assessment and diagnosis of these disorders, the following should be taken into account: the child’s age, the clinical picture of the seizure, and the results of diagnostic workup.The diagnostic method of choice is video EEG polygraphy.In case of doubt, it is most appropriate to classify these disorders as paroxysmal events of unclear origin. Clinical monitoring and repeat assessment of the seizures/events/status will
lead to the correct diagnosis.
Ključne riječi
NON-EPILEPTIC PAROXYSMAL EVENTS; EPILEPTIC SEIZURES; CHILDHOOD; ADOLESCENCE
Hrčak ID:
300862
URI
Datum izdavanja:
17.4.2023.
Posjeta: 2.562 *