Epilepsy and epileptic syndromes in pediatric patient

Epilepsija je paroksizmalni poremećaj funkcije središnjeg živčanog sustava koji je po svom karakteru rekurentan i stereotipan. Uz glavobolju, to je najčešća (primarna) bolest živčanog sustava. Cilj: Istražiti karakteristike cerebralnog napadaja u dječjoj dobi te značaj kliničke slike i EEG nalaza u dijagnozi epileptičkih sindroma i konvulzija u febrilitetu. Nacrt studije: dvogodišnja retrospektivna studija Ispitanici i metode: U istraživanje je uključeno 198 pacijenata koji su hospitalizirani zbog cerebralnog napadaja na Klinici za pedijatriju KBC-a Osijek, u razdoblju od 1. 1. 2014. godine do 31. 12. 2015. godine. Podaci su prikupljeni iz medicinske dokumentacije. Rezultati: Tijekom 2 godine hospitalizirano je 198 pacijenata s cerebralnim napadajima, djece do 18. godine života. Prosječna dob pacijenta iznosila je 7 godina, a oba spola su bila podjednako zastupljena. Od tipova cerebralnih napadaja dominaciju su imali parcijalni (žarišni) napadaji (67,17 %). Klinička slika cerebralnog napadaja najčešće se prezentirala autonomnim (neurovegetativnim), senzoričkim simptomima (znakovima), a od motoričkih (simptoma) znakova prevladavali su toničko-klonički grčevi. Febrilne konvulzije najčešće su se pojavljivale u djece između 0 i 6 godina. EEG nalaz bio je uredan kod 77 (42,80 %) pacijenata, a patološko-epileptiformno promijenjen kod 103 (57,20 %) pacijenta. Zaključak: Klinička slika cerebralnog napadaja u dječjoj dobi raznolika je i može imati skrivenu kliničku sliku. Za postavljanje dijagnoze vrlo je važno iskustvo kliničara te kombiniranje kliničkih znakova s EEG nalazom. Definiranje kliničkog fenotipa ili epileptičkog sindroma važno je da bi se pravovremeno uključila odgovarajuća antiepileptička terapija.Epilepsy is a paroxysmal central nervous system disorder which is characteristically recurrent and stereotypical. Apart from headache, it is the most common (primary) nervous system disorder. Aim: Research cerebral seizure characteristics with children and the significance of clinical features and EEG findings in the diagnosis of epileptic syndromes and febrile convulsions Study outline: A two-year retrospective study Sample and method: The study included 198 patients who were hospitalized because of cerebral seizures at the Department of Child Neurology at the Pediatrics Clinic of the Clinical Hospital Osijek from the 1st January 2014 until the 31st December 2015. Medical records were used for obtaining necessary data. Results: The study included 198 patients with cerebral seizures who were children up to 18 years of age. The average patient age was 7. Both sexes were equally represented and were without perinatal period risk factors. Maternal risk factors were proven insignificant. The dominant types of cerebral seizures were partial seizures (67,17%). The clinical features of cerebral seizures were mostly exhibited through autonomous (neurovegetative), sensory symptoms (signs). Among motoric (symptoms) signs, tonic-clonic cramps were dominant. Febrile convulsions mostly appear with children between the ages of 0 and 6. EEG findings were clean with 77 (42,80%) patients. Pathologic-epileptiform changes have been observed with 103 (57,20%) patients. Conclusion: The clinical features of a cerebral seizure in childhood are diverse and can have some hidden factors. The experience of a physician and the combining of clinical signs with EEG results are very important when establishing a diagnosis. Defining the clinical phenotype or epileptic syndrome is important to include an appropriate antiepileptic therapy as early as possible