eMedicine Specialties > Neurology > Pediatric Neurology

Epileptic and Epileptiform Encephalopathies: Follow-up

Author: Dean Patrick Sarco, MD, Instructor, Department of Neurology, Harvard Medical School; Assistant Physician, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital Boston
Coauthor(s): Masanori Takeoka, MD, Assistant Professor, Department of Neurology, Harvard Medical School; Consulting Staff, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital Boston
Contributor Information and Disclosures

Updated: Jul 29, 2009

Follow-up

Further Inpatient Care

  • The evaluation and management of epileptic and epileptiform encephalopathies usually are performed on an outpatient basis, although the initial long-term EEG and evaluation may be performed in the hospital.
  • Patients with intractable seizures may need hospitalization at times for seizure control.

Complications

  • The complications of epileptic and epileptiform encephalopathies usually are secondary to the treatment, especially with antiepileptic drugs (AEDs) or high-dose steroids. However, the psychiatric and psychological problems associated with a neurological handicap, especially a neurodegenerative process, can have a great impact on both the child and the family. In Landau-Kleffner syndrome (LKS), behavioral and emotional disturbances are the major problems encountered.

Prognosis

  • The prognosis is related to the underlying disorder.

Patient Education

  • Input from a neurologist, developmental pediatrician, psychologist, neuropsychologist, audiologist, or speech pathologist is needed to determine the proper educational program.
  • For excellent patient education resources, visit eMedicine's Brain and Nervous System Center. Also, see eMedicine's patient education article Epilepsy.

Miscellaneous

Medicolegal Pitfalls

  • In any neurological disorder, determining the etiology is important, since specific etiologies may require specific treatments. Excluding an underlying structural or metabolic disorder is especially important when regression in intellectual or motor milestones has occurred. A thorough evaluation, including appropriate laboratory studies, neuroimaging, and consultations, should be performed as indicated by the history and examination. 
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Stavros M Hadjiloizou, MD, and James J Riviello Jr, MD, to the development and writing of this article.



More on Epileptic and Epileptiform Encephalopathies

Overview: Epileptic and Epileptiform Encephalopathies
Differential Diagnoses & Workup: Epileptic and Epileptiform Encephalopathies
Treatment & Medication: Epileptic and Epileptiform Encephalopathies
Follow-up: Epileptic and Epileptiform Encephalopathies
Multimedia: Epileptic and Epileptiform Encephalopathies
References
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Further Reading

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Keywords

epileptic encephalopathy, epileptic encephalopathies, epileptiform encephalopathy, epileptiform encephalopathies, catastrophic epilepsy, catastrophic epilepsies, epileptiform aphasia, malignant epilepsy, malignant epilepsies, early myoclonic encephalopathy, early infantile epileptic encephalopathy, Ohtahara syndrome, migrating partial epilepsy, migrating partial epilepsy in infancy, West syndrome, infantile spasms, severe myoclonic epilepsy in infancy, Dravet syndrome, myoclonic status, myoclonic status in non-progressive syndromes, myoclonic astatic epilepsy, Doose syndrome, Lennox-Gastaut syndrome, Landau-Kleffner syndrome, LKS, acquired epileptiform aphasia, verbal auditory agnosia, language regression, word deafness, continuous spikes and waves during slow wave sleep, electrical status epilepticus of sleep, autism, autistic spectrum disorders, pervasive development disorder, PDD, transient cognitive impairment, benign childhood epilepsy with centro-temporal spikes, BCECTS, benignrolandic epilepsy

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Contributor Information and Disclosures

Author

Dean Patrick Sarco, MD, Instructor, Department of Neurology, Harvard Medical School; Assistant Physician, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital Boston
Dean Patrick Sarco, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

Coauthor(s)

Masanori Takeoka, MD, Assistant Professor, Department of Neurology, Harvard Medical School; Consulting Staff, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital Boston
Masanori Takeoka, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, American Medical Association, Child Neurology Society, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Robert Baumann, MD, Program Director, Professor, Departments of Neurology and Pediatrics, University of Kentucky
Robert Baumann, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American College of Epidemiology, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jose E Cavazos, MD, PhD, FAAN, Associate Professor with Tenure, Departments of Neurology, Pharmacology, and Physiology, University of Texas Health Science Center at San Antonio; Co-Director, South Texas Comprehensive Epilepsy Center; Director of the Epilepsy Center, Audie L Murphy Veterans Affairs Medical Center
Jose E Cavazos, MD, PhD, FAAN is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and Society for Neuroscience
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Amy Kao, MD, Assistant Professor, Department of Pediatrics, Division of Pediatric Neurology, Department of Neurology, Oregon Health and Science University; Consulting Staff, Shriners Hospital for Children
Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

 
 
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