With: Dr. Lionel Traverse
Lionel Traverse is one of the co-founders of The Fraser Valley Epilepsy
Society. He is the Medical Director of The Fraser Valley Child
Development Center, and a Clinical Assistant Professor of Pediatrics at
He has practiced Paediatrics in Abbotsford since 1986. He obtained his
Medical Doctorate in Paris in 1980 and trained in Montreal, Saskatoon,
and Vancouver. He holds degrees in Paediatrics in Canada, USA and
France. He studied epilepsy and EEG reading in the prestigious
Saint-Paul's center for Epilepsy in Marseilles, France in 1993.
“Children with epilepsy suffer more from a lack of understanding from
their seizures. The key to helping children with chronic health
conditions is awareness; the more everyone knows about seizures, the
happier and healthier my patients will be”.......
WHAT IS EPILEPSY ???
Epilepsy is a vast term
which encompasses a large variety of very different conditions. Epilepsy
manifests itself by seizures that will be different according to which
part of the brain is affected. Seizures are not synonymous with
epilepsy. Some epileptic syndromes have several seizure types, and one
seizure type can be seen in several different epileptic syndromes.
This ICE (International Classification of Epilepsies)
was adopted at the New Delhi Congress of the International League
against Epilepsy in October 1989.
It is based on 2
1) E. with generalized
seizures & E. with Partial Seizures, and
2) distinction between
known aetiology (cause) so-called symptomatic E. and unknown
aetiology, called idiopathic E.
Based on these 2
notions the classification of epilepsies and epileptic syndromes is as
classification of epilepsies, epileptic syndromes and related seizure
1.-Localization-related (focal, local, partial)
epilepsies and epileptic
1.1 - Idiopathic
1.1.1. Benign Rolandic Epilepsy
1.1.2 Benign Occipital Epilepsy
1.1.3 Primary Reading Epilepsy
1.2 - Symptomatic
1.2.1 Epilepsia Partialis Continua (Kojewnikow)
1.2.2 Specific mode of provocation
1.3 - Cryptogenic
epilepsies and epileptic syndromes
2.1 - Idiopathic
2.1.1 Benign Familial Neonatal Convulsions
2.1.2 Benign Neonatal Convulsions
2.1.3 Benign Myoclonic Epilepsy of the
2.1.4 Childhood Absence Epilepsy
2.1.5 Juvenile Absence Epilepsy
2.1.6 Juvenile Myoclonic Epilepsy
2.1.7 Other including Photosensitive epilepsies
2.2 - Cryptogenic and/or symptomatic
2.2.1 West Syndrome (Infantile Spasms)
2.2.2 Lennox-Gastaut Syndrome
2.2.3 Myoclonic Absences
2.3 - Symptomatic:
Early Myoclonic Encephalopathy and
Early Epileptic Encephalopathy
and epileptic syndromes undetermined whether focal or generalized
3.1 - With both generalized and focal seizures
3.1.1 Neonatal Seizures
3.1.2 Severe Infantile Myoclonic Epilepsy
3.1.3 Epilepsy with continuous Spikes Waves of Slow
3.1.4 Acquired Epileptic
3.2 - Without unequivocal generalized or focal features
4.1 - Situation-related seizures
4.1.1 Febrile Seizures
4.1.2 Seizures in the context of an acute metabolic imbalance
4.2 - Isolated seizures or isolated Status-Epilepticus.
IDIOPATHIC disorders are neither secondary to or caused by another disorder. There is no underlying cause other than a possible genetic
predisposition. Idiopathic epilpesies are defined by an age related
onset, specific clinical and EEG features and a presumed genetic
SYMPTOMATIC disorders are considered as a
consequence of a known or suspected disorder of the central nervous
One can notice that there is a group called CRYPTOGENIC
epilepsies. These are epilepsies whose
cause is hidden or occult. It is assumed to be symptomatic, but
the aetiology remains unknown
in spite of all the investigations.
Localization-related (focal, local, partial) epilepsies and
epileptic syndromes the clinical aspect of the seizures or the
results of investigations show a localized origin to the seizures.
These patients have a constant, well-circumscribed epileptogenic
"lesion". They may also have variable epileptogenic foci, without obvious
lesions, and with possible involvement of both hemispheres. Localization
related epilepsies can be idiopathic, symptomatic or cryptogenic.
In Generalized epilepsies the clinical manifestation of the
seizures indicates that both hemispheres are immediately involved, and
the initial EEG features are bilateral.
Some epilepsies remain undetermined whether focal or generalized. This
can be because they have both generalized and focal seizures, or because
the seizures are without unequivocal generalized or focal features. some
of these patients present with generalized tonico-clonic seizures but
clinical and EEG findings are unable to determine if the seizures are
generalized or localization related, e.g. generalized seizures during
syndromes have been described in each of these categories of epilepsies.
The most frequent are shown in the following schema:
You will be able to refer to each specific syndrome in this web site.
But first, here is some general advice that applies to all of us.
In whatever decision you have to make: Be
doctor can help you decide if the activity you are planning is
compatible with epilepsy. The only limitations are related to safety. An
activity that would put you or others at risk is not recommended. For
instance, children love to climb on trees and climbing trees is not to
be forbidden, but for any
child and especially one with epilepsy it is preferable they stay on the
the majority of epilepsies have their onset during childhood, it is
important to have a good cooperating relationship with the school. There
are two issues with regard to schooling:
What to do in case
of a seizure.
In fact the school should
follow the same recommendations as the ones outlined later in this web
site. There are however some unique cases and each child should have a
written plan of action for the school in case of seizures. If you do not
have a seizure management plan in place for your child, contact your
local health unit. Let them know you have a child with epilepsy and
within a day or two your school health nurse should contact you to
discuss a seizure management plan for your child.
What to expect in terms of learning abilities.