The diagnosis of epilepsy is only a preliminary diagnosis of the child’s disease, but there are different seizure types and seizure syndromes at the same time, and the seizure pattern varies among the different seizure types and seizure syndromes. Mastering certain basic rules can sometimes reduce seizures or predict seizure duration to some extent.
West syndrome
It is a typical age-dependent epilepsy syndrome with a peak incidence in the first 5 months of life. Seizures are usually likely to occur when sleepy and about to fall asleep or when waking up from sleep.
Dravet syndrome
Dravet’s syndrome usually develops within 1 year of age, with a peak incidence in the first 5 months of life, and presents as a heat-sensitive refractory epilepsy syndrome. Heat-related illnesses, elevated body temperature, and ambient temperature (hot baths) are common triggers, and seizures may be triggered by light and graphic stimuli, movement, and eye closure.
Benign childhood epilepsy with spikes in the central temporal region (BECTs)
Onset is between 1 and 14 years of age, with peak onset at 8 to 9 years of age. Genetic predisposition is common, characterized by brief simple partial hemifacial motor seizures, often with somatosensory symptoms, which can be followed by generalized tonic clonic seizures. The seizures occur mainly during the immediate period of sleep or before awakening, with the majority of seizures occurring during NREM sleep.
Disorientation seizures
The seizures are characterized by sudden onset of movements, interruption of ongoing activities, often accompanied by gaze and brain blanking. The frequency of seizures varies from a few to a hundred times a day. They are easily triggered by hyperventilation.
Juvenile myoclonic epilepsy syndrome
Age-related seizures characterized by akathisia, myoclonic seizures and GTCS with a genetic predisposition. Akathisia seizures often appear between the ages of 5 and 16 years. Sleep deprivation and fatigue, especially in conjunction with excessive alcohol consumption, are contributing factors to myoclonic seizures and generalized tonic-clonic seizures. In addition, seizures can be triggered by excitement, preoccupation, frustration, or video games.
Idiopathic generalized-compulsive seizures
The age of onset is 10 to 20 years in 80 patients. They occur mainly within a relatively short period of time after awakening (>90%) and have a high genetic susceptibility. Sleep deprivation, fatigue or excessive alcohol consumption are the main contributing factors. Night shift work, change in sleep habits, and flash stimulation can trigger seizures.
Autosomal dominant nocturnal frontal lobe epilepsy
It manifests as clustered, transient, frequent (almost nightly) sporadic motor seizures that manifest as hyperkinesia or dystonia or tonicity. Motor symptoms can be so violent that the patient falls out of bed, which can easily lead to injury. Seizures may occur shortly after going to sleep or before waking up, and daytime seizures are rare. They are easily triggered by stress, fatigue, or excessive alcohol consumption. In some children, seizures are easily triggered by movement or sound stimuli.
Photosensitive epilepsy
The clinical presentation varies widely from patient to patient depending on the specific type of epilepsy syndrome and the severity of photosensitivity. Seizures can be triggered by artificial or natural broads, and in order of commonness, video games, television, computer monitors, discotheque light, and natural flashing lights are more common.
Graphics-sensitive epilepsy
That is, their seizures are induced by graphics. The stimulus graphics can be stripes of clothing (e.g., T-shirts, ties) or elevators, wallpaper, furniture, blinds, or radiators with stripes, etc. Any activity of these graphics that visually produces motion, such as raising or lowering blinds, has the potential to cause seizures.
Complex reflex epilepsy
Reading epilepsy Silent reading or reading or writing aloud are clear stimulus triggers. Thinking triggers Occur when higher cognitive functions of the brain respond to stimuli. Triggering stimuli for mailboxes include number crunching, drawing, playing cards, chess, etc.
It is important to understand what different epilepsies require attention in terms of living with them, based on the clinician’s accurate judgment of seizure types and epilepsy syndromes. Broadly speaking, patients (children) with definite epileptic disorders need to pay attention to regular sleep, try not (less) to drink alcohol, avoid fatigue, and ensure adequate sleep. For those with photosensitive epilepsy, they can wear sunglasses when they go out, and watch less television, play video games, or go to entertainment places with flashing light.