THE RELATIONSHIP BETWEEN EPILEPTIC AND NON-EPILEPTIC SEIZURES IN CHILDHOOD

U radu je opisan problem razlikovanja neepileptičkih i epileptičkih napadaja kod djece koja imaju interiktalno epileptiformno abnormalan EEG. Prikazano je vlastito iskustvo s dugotrajnim video EEG monitoriranjem (DVEM). Opisana je tehnika DVEM-a , objektivne i subjektivne poteškoće primjene kod djece. Potvrđena je korist DVEM-a kod učestalih neepileptičkih i epileptičkih napadaja, dok se kod rijetkih napadaja DVEM nije pokazao korisnim. U praktičnom radu dobro je kombinirati neurološke metode za razlikovanje neepileptičkih i epileptičkih napadaja, češće rabiti DVEM prije početka primjene potencijalno toksičnih antiepileptičkih lijekova. To je osobito važno kod autistične, mentalno retardirane i neurološki oštećene djece i one s refrakternim epilepsijama. Pravodobno dijagnosticiranje neepileptičkih napadaja uz pravodobnu primjenu odgovarajućeg liječenja svakako će poboljšati njegov konačni ishod. Klinička procjena i praćenje razvoja poremećaja i dalje je neizostavna metoda , jer procesi djetetova rasta i razvoja mogu utjecati na kliničke manifestacije poremećaja.This paper illustrates the difficulty in distinguishing non-epileptic and epileptic attacks in children who have abnormal epileptiform interictal EEG. We describe our own experience with long-term video EEG monitoring (VEEG), including the recording technique and objective and subjective monitoring difficulties specific to children. The usefulness of VEEG was demonstrated in cases where non-epileptic and epileptic seizures occurred frequently, however VEEG was not useful when seizures were infrequent. In practice it is recommended to combine neurological methods to differentiate non-epileptic and epileptic seizures and to use VEEG more frequently, especially prior to initiating potentially toxic anti-epileptic pharmacotherapy. This is particularly important in children with autism, mental retardation, other neurological dysfunctions and those with refractory epilepsies. Timely diagnosis of non-epileptic seizures with initiation of appropriate therapy will certainly improve the final outcome. Clinical assessment and developmental follow up continue to be crucial steps because the child\u27s growth and development can impact the clinical manifestation of the disorder