Seizures and alterations of consciousness and thought

Epilepsy is most prevalent at each end of the age spectrum—the very young and the very old. Up to 1 per cent of the childhood population will have active epilepsy at any time. Of these 60–70 per cent will be controlled on medication or enter into spontaneous remission, however the remainder will continue to have seizures despite the range of treatment available. There will be associated comorbidity of learning and behaviour difficulties in a significant proportion, and these may take precedence in management over the seizures themselves. Careful evaluation of each individual child with regard to the possible diagnosis and associated comorbidities is required in all children presenting with recurrent paroxysmal episodes in order to optimize management.