Epilepsi ve Pediatrik Epilepsi Sendromları

Epilepsi beyindeki nöronların anormal, aşırı ve eş zamanlı olarak uyarılmasına bağlı olarak ortaya çıkan epileptik nöbetlerle karakterize, tüm dünyada 10.000.000’dan fazla çocuğu etkileyen önemli bir nörolojik hastalıktır. Doğru tanı ve tedavinin yapılabilmesi, prognozun öngörülmesi ve tüm klinisyenlerin aynı dili kullanması amacı ile çeşitli sınıflama önerilerinde bulunulmuştur. Bu sınıflamalardan en güncel olanları Uluslararası Epilepsi ile Savaş Derneği (International League Against Epilepsy-ILAE) tarafından önerilen 2010 epilepsi sendromları 2017 nöbet ve epilepsi, 2021 yenidoğan nöbetleri sınıflamalarıdır. ILAE 2010 epilepsi sendromları sınıflamasında epilepsiler başlangıç yaşına ve diğer bazı ortak özelliklerine göre gruplandırılmıştır. ILAE 2017 nöbet ve epilepsi sınıflamasında nöbetler başlangıçlarına göre fokal, jeneralize ve bilinmeyen olarak üçe ayrılmış, ayrıca fokal nöbet sırasında farkındalığın korunup/korunmaması ayrı olarak değerlendirilmiştir. Sınıflamanın her basamağında etiyolojinin de değerlendirmesi önerilmiştir. Etiyolojik açıdan yapısal, genetik, enfeksiyöz, metabolik, immun ve bilinmeyen alt sınıflaması yapılmıştır. ILAE 2021 yenidoğan nöbetleri sınıflamasında nöbetler ikiye ayrılmış, ilk grupta klinik bir bulgunun eşlik etmediği elektrografik nöbetler, ikinci grupta elektroensefalografi bulguları ile birlikte klinik bulguların görüldüğü motor, non-motor, ardışık ve sınıflandırılamayan nöbetler yer almıştır. Bu derlemede nöbet ve epilepsi sınıflamaları gözden geçirilmiş ve sık görülen pediatrik epilepsi sendromları güncel yayınlar ışığında incelenmiştir.

Anahtar Kelimeler:

epilepsi, , nöbet, çocuk, epilepsi sendromları

Epilepsy and Pediatric Epilepsy Syndromes

Epilepsy is an important neurological disorder which affects more than 10.000.000 children around the world, characterized by epileptic seizures that occur due to abnormal, excessive and simultaneous stimulation of neurons in brain. Different classification schemes have been suggested in order to ensure correct diagnosis and treatment, predict prognosis and implement a standardized nomenclature among all clinicians. The International League Against Epilepsy (ILAE) has proposed several classifications, the most current ones are ILAE 2010 classification of epilepsy syndromes, ILAE 2017 classification of seizures and epilepsy, and ILAE 2021 classification of neonatal seizures. In the ILAE 2010 classification of epilepsy syndromes, different types of epilepsies were grouped according to the age of onset and other common characteristics. In the ILAE 2017 classification, seizures were grouped into three categories; focal, generalized and unknown, according to the onset of the semiology; furthermore, focal seizures were divided into two groups according to the level of awareness. Evaluation of the underlying etiology was recommended at every step. Etiologies were subclassified into structural, genetic, infectious, metabolic, immune and unknown causes. In the ILAE 2021 classification of neonatal seizures, seizures are divided into two groups, the first group includes electrographic seizures without clinical manifestations, and the second group covers motor, non-motor, sequential and unclassified seizures with clinical manifestations convergent with electroencephalography findings. Seizure and epilepsy classifications, and common pediatric epilepsy syndromes are revised in the light of current studies in this review.

Keywords:

epilepsy, seizure, child, epilepsy syndromes,

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