KARACHI, Sept 21: Precise classification of seizure types is very important for selecting the most appropriate anticonvulsant and providing an accurate diagnosis to epilepsy patients.

This was stated by Dr Arshalooz J. Rahman, consultant paediatrician, while delivering a presentation on "Epilepsy treatment in our reach", organized by the Neurology Department at the Liaquat National Hospital.

He said that all children with focal neurological deficit postictal or static, complex seizure of increasing frequency and all adolescents with first seizure needed MRI, as it helped in examination of temporal lobe hippocampl atrophy or sclerosis in resistant cases.

"If two or more unprovoked seizures occur in six to 12 months in children, treatment is indicated," he added. "Anticonvulsant treatment is not needed for neurologically normal child, with negative family history and normal EEG. Aura before seizure indicates focal origin. Counselling and regular follow up is needed for good medication compliance," he said.

Discussing classification of seizures, Dr Hazim Brohi of the Liaquat National Hospital said that according to international classification its Part-I was known as Partial (focal, local) Seizure; Part-II as Generalized Seizure; Part-III as Classified Seizure and Part-IV was known as Addendum.

He said that often physicians did not take appropriate history of patient and patient as a whole was not taken into account. "Appropriate epileptic syndrome was not labelled. For all these ignorance patient have to suffer medically, socially and economically," he added.

"Classification was needed for understanding epileptic phenomena, developing a rational plan for investigation, making decisions about when and for how long to treat patient, choosing the appropriate anti-epileptic drug and finally conducting appropriate scientific investigation like EEG and MRI," he said.

He said that the first seizure disorder should be labelled according to symptoms, age, neuro exam, practical approach to classification to a specific epilepsy syndrome and then work should be done to exclude a secondary cause.

Speaking on the management of status epilepticus, Dr Feroz Saleem said that it was the condition in which continuous seizure activity lasted more than 10 minutes. She said that it could be managed by general supportive care after controlling seizure and its complications could be prevented by assessing causes and risks.

Dr Naveeduddin Ahmed giving presentation on "Epilepsy in women: treatment options and considerations" said that women with epilepsy were considered to have high risk pregnancies and management issues of those taking anti-epileptic drugs during their reproductive years were numerous and complex. He said that the effect of pregnancy on seizure frequency could be avoided from control of epilepsy during the nine months preceding gestation. -PPI