Purpose of review: This article outlines a diagnostic and management approach to pediatric seizures and epilepsy syndromes, and delineates pharmacologic and nonpharmacologic treatment options.
Recent findings: Progress in tracking of seizures, identifying and addressing medication nonadherence, treatment with novel devices, and clinical decision support algorithms will provide additional management options in the future.
Summary: The management of pediatric seizures and epilepsies presents multiple challenges to the clinician because of nonepileptic imitators, evolving classification approaches, clinical presentations, limited clinical trial data for medications, and the toxicities of therapies. While certain pediatric seizures and epilepsy syndromes respond best to certain medications, early identification of pharmacologically resistant patients who may be candidates for epilepsy surgery is important. Alternative treatment options may include ketogenic diet or vagus nerve stimulation.