Epilepsy

 DO

• Strive for classification of seizure type and epilepsy syndrome in all children. Involve a (paediatric) neurologist in this effort.

• As an additional means of diagnosing seizures, consider the use of film recordings by parents or caregivers.
• Consider performing an EEG. Keep in mind the child's condition and comfort.
• Consider performing blood tests for a possible cause of epilepsy such as hypoglycaemia or electrolyte disturbance.
• In children with intellectual disabilities, consider a multidisciplinary approach with a physician experienced in treating children with multiple disabilities, paediatric neurologist and/or behavioural health professional.

 DO

• Evaluate and if possible, treat triggering factors of seizures, such as electrolyte disturbance.

• In children with difficult-to-treat epilepsy, consider a ketogenic diet.

• In children with epilepsy, consider psychological interventions such as relaxation or cognitive behavioural therapy.

 DO

• In children known to have epilepsy, establish a seizure treatment plan and include any treatment restrictions.
• In children with first seizures: most seizures stop spontaneously within 2-3 minutes. After 3 minutes, give seizure treatment according to the step-by-step plan.
• Evaluate the effect after each step.
• If epilepsy cannot be controlled, consult with a paediatric neurologist.

• In the case of a refractory form of epilepsy from which the child suffers, consider administration of intravenous anaesthetics (see: palliative sedation).

 DO

• Evaluate the effect and side effects of the treatment instituted at the appropriate time, and adjust treatment as needed. Involve child and family in this process.