Abstract
Pediatric seizures are one of the most common neurological manifestations seen in
pediatrics. Unravelling the etiology, timely and appropriate investigations followed
by suitable therapies are essential for improving quality of life. During the pandemic,
focused group discussions were conducted among 50 pediatric neurologists across five
cities in India to gather insights on treatment practices in pediatric epilepsy and
to optimize therapeutic strategies and alternative approaches for rational use of
antiepileptic medications. These discussions were mainly aimed at reviewing current
literature on prevalence, etiology, diagnosis, and management of epilepsy in children
and subsequently rationalizing diagnostic and treatment approaches in routine clinical
practice. Epileptic encephalopathies comprise of childhood epilepsy with progressive
cerebral dysfunction. Genomics plays a vital role in identifying the underlying genetic
associations, empowering precision therapy. Currently, the ketogenic diet has become
a well-recognized modality for reducing severity of seizures. To overcome the high
incidence of adverse effects due to older antiepileptic drugs, newer drugs are being
developed to improve ease of use, diminish drug interactions, decrease adverse effects,
and identify drugs with unique mechanisms of action. Common lacunae in practice include
information gaps, educating parents, or caregivers about rational drug use and ensuring
compliance to antiepileptic medications. This article discussed the consensus clinical
viewpoint of expert clinicians, as well as insights on optimized treatment of pediatric
epilepsies in both infancy and childhood. It also discusses aspects, like reducing
drug burden, emerging therapies in the identification of the genetic basis of epilepsies,
and targeted therapy alternatives, for pediatric populations in the Indian scenario.
Keywords
pediatric epilepsy - epileptic encephalopathies - ketogenic diet - genomics
