Anaesthesia and childhood epilepsy

Seizures are episodes of abnormal synchronized electrical brain activity. It is estimated that 2% of all people will experience a seizure during their lifetime. However, individuals who experience an isolated non-recurring seizure are not considered epileptic. Epilepsy has a prevalence of 1:200 in adults and is approximately twice as common in childhood. There is a U-shaped distribution, with the highest incidences in the first few months of life and in those aged more than 70 yr. Seizures may be primary (idiopathic) or more commonly secondary to other conditions. Primary epilepsy has a genetic predisposition with a 1.5‐3% risk of paternal inheritance and a 3‐9% risk of maternal inheritance. Secondary seizures may be caused by prenatal, perinatal, or post-natal events. Prenatal causes include inborn errors of metabolism and chromosomal abnormalities. There are more than 400 different chromosomal abnormalities associated with epilepsy. These include Down’s syndrome, fragile X, and Angelman’s syndrome. Infections during the prenatal period including toxoplasmosis, rubella, cytomegalovirus, and herpes simplex (TORCH) can give rise to epilepsy. Other causes arising in this period, although not symptomatic until later in childhood, include congenital malformations such as tuberous sclerosis, cortical dysplasia, and arteriovenous malformations. Neurocutaneous disorders such as neurofibromatosis may also be associated with seizures. During the perinatal period, the causes are dominated by neonatal hypoglycaemia, hypocalcaemia, hypoxic encephalopathy, and intracranial haemorrhage often associated with prematurity. Post-natal events responsible for epilepsy may include infections such as menin