TY - JOUR T1 - Management of epilepsy JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 5 LP - 10 DO - 10.1136/adc.2003.032656 VL - 90 IS - 1 AU - T Deonna Y1 - 2005/01/01 UR - http://adc.bmj.com/content/90/1/5.abstract N2 - Can quality of care be improved? In the past 15 years, 16 reviews on new discoveries in epilepsy and on various aspects of its diagnosis and management, and 273 articles in which the keyword “epilepsy” appears, have been published in Archives of Disease in Childhood. So why another review article on management—are things moving so fast? One of these articles1 mentioned four areas of advances in epilepsy: (1) diagnostic precision; (2) drug therapy;2 (3) neuroimaging; and (4) “greater awareness of the central importance of patient and family perceptions of the condition with efforts to provide a ‘model of care’”. This last aspect is the most difficult to evaluate and translate into practice, and has received much less attention than discoveries in genetics,3 brain imaging, epilepsy surgery, and electrophysiology, but it can make a large difference in the impact of the disease on the child and his or her family. It is probably the most important aspect of management for the majority of children with epilepsy, who have no other handicap than occasional seizures, but whose family life, psychological wellbeing, and school progress can suffer greatly from an otherwise often benign condition with good prognosis. This review will show how this new knowledge can change the perception of the disease and its overall burden if they are integrated at all levels of care (box 1). Box 1: Summary of new data relevant for clinical practice Progress in genetics of epilepsy Several focal epilepsies, besides the classical rolandic epilepsies, can be hereditary, such as nocturnal frontal epilepsy4 or familial temporal epilepsy.5 They usually have a good prognosis or are easily treatable6 Children with febrile convulsions may also have afebrile seizures or belong to a family in which other members have epilepsy, usually benign.7,8 … ER -