2026 Pediatric Update (On-Demand)-Dr. Venkataraman Diagnosis and Treatment of Seizures

Video Transcription

Video Summary

This talk reviewed practical updates in diagnosing and treating seizures and epilepsy, with a strong focus on pediatric care. Dr. Venkataraman emphasized that accurate diagnosis is essential because it guides the right treatment, reduces unnecessary medication, and improves quality of life.

Key distinctions included:
- <strong>Seizure vs. epilepsy</strong>: a seizure is a brief sudden change in brain activity; epilepsy is a chronic disorder with recurrent unprovoked seizures.
- <strong>Provoked vs. unprovoked seizures</strong>: provoked events may be triggered by fever, head injury, alcohol/drug withdrawal, or infection.
- <strong>Focal vs. generalized seizures</strong>: focal seizures start in one brain region, while generalized seizures involve both hemispheres.

She stressed the importance of <strong>history and caregiver video recordings</strong> in diagnosis, since clinicians rarely witness the event directly. Common seizure mimics include syncope, breath-holding spells, parasomnias, tics, reflux/Sandifer syndrome, migraine variants, and psychogenic non-epileptic events.

The talk covered diagnostic tools:
- <strong>EEG</strong> to detect abnormal electrical activity and help classify seizures
- <strong>MRI</strong> to look for structural causes, especially in focal epilepsy
- <strong>Genetic testing</strong> in early-onset, refractory, or developmentally associated epilepsies
- <strong>Video EEG</strong> for difficult cases and presurgical localization

Treatment priorities included <strong>seizure first aid</strong>, rescue benzodiazepines for seizures lasting over 5 minutes, and status epilepticus algorithms. Maintenance therapy depends on seizure type, recurrence risk, and syndrome. Drug-resistant epilepsy should prompt early referral to a neurologist or epilepsy center.

Finally, she reviewed safety counseling, SUDEP awareness, school seizure action plans, febrile seizures, infantile spasms, autoimmune epilepsies, adolescent reproductive issues, and lifestyle guidance.

Keywords

seizures

epilepsy

pediatric neurology

EEG

MRI

genetic testing

video EEG

status epilepticus

febrile seizures

SUDEP