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Cerebral palsy (CP) affects between 2 and 3 per 1000 live births and is thought to be the most common cause of serious physical disability in childhood. A widely used topographical classification of CP has been formulated by the Surveillance of Cerebral Palsy in Europe group. This divides CP into spastic, dyskinetic, and ataxic subtypes. Children with CP due to central nervous system (CNS) malformation, infection, and gray matter damage were more likely to have epilepsy than those with CP due to white matter damage. The predominant type is focal seizures or focal seizures evolving into secondary generalized tonic-clonic (GTC) seizures. The majority of CP etiologies can be established based on a detailed history, examination, and neuroimaging without the need for other investigations. Magnetic resonance imaging (MRI) is the imaging modality of choice. Epilepsy surgery can have a good outcome particularly for children with hemiplegia.
This chapter deals with epilepsy in girls and young women, and reviews the common epilepsy syndromes, treatment challenges, and educational and social concerns. Some seizure disorders can be grouped together as an epilepsy syndrome. The epileptic syndromes that present in adolescence are juvenile absence epilepsy, juvenile myoclonic epilepsy (JME), and generalized tonic-clonic seizures on awakening. Decisions about treating seizures in children and adolescents involve considerations of when to treat, how long to treat, selection of the best medications to use, supplementation with vitamins, and compliance with the treatment plan. Knowledge of possible drug interactions is important, for the physician, the caretakers, and the girl with epilepsy. Some antiepileptic drugs (AEDs), for example phenytoin, alter the concentration of vitamin D in the body. Children and adolescents who have normal cognitive development include those with febrile seizures, childhood absence epilepsy, benign focal epilepsy (rolandic epilepsy) and JME.
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