Diagnosis and management of epilepsy in adolescents Volume 21, issue 2, avril-mai-juin 2009


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Service de pédiatrie, centre hospitalier de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex, France, Epilepsiezentrum, Uniklinikum, 64, Breisacher Strasse, 79106 Freiburg, Allemagne

An adolescent goes through a period of transformation and questioning. His quality of life may be modified if a paroxystic event compatible with an epileptic seizure occurs. The physician has to ascertain the diagnostic as soon as possible and to classify the seizure in an epileptic syndrome. The benign focal seizures, some reflex epilepsies and generalised idiopathic syndromes are specific to this age. Epilepsies of inborn origins can as well occur or be diagnosed first as this time. The adolescence is also the step when the treatment of a childhood epileptic disorder has to be questioned. Sometimes, medication can be stopped, as the epilepsy is no more active. On the contrary, treatment has to be increased when the consequences of the disease become to be troublesome. When the drugs interfere with oral contraception, or other social aspects, the treatment has to be modified. The management of generalised cryptogenic or symptomatic epilepsies has to be reassessed regularly during adolescence because even severe epilepsies may have a favourable outcome, spontaneously or with the help of new treatments.