What is epilepsy?
Many (20:1000) children experience single seizures in early life. Not all provoked (ex fever,injury) seizures constitute epilepsy.
Epilepsy is the tendency to get recurrent unprovoked seizures by various mechanisms . It is not very uncommon and can be seen in 4-8 : 1000 children.
Epileptic encephalopathy is a specific subset of devastating pediatric epilepsy (like infantile spasms) in which by virtue of extensive recurrent electric disturbance, the motor and cognitive outcome of the baby is severely compromised.
Why do we need to focus on children?
Children are largely a dependent population for their care. since they are in the phase of acquiring growth and development; uncontrolled epilepsy can result in adverse developmental, behavioural, scholastic and personality outcomes . Also over and under-treatment along with environmental and parental factors can result in undesirable outcomes which may have long term consequences . It may be different than typical or adult seizures:

• Staring blankly / day dreaming like episodes.
• Sudden dropping of head or body parts.
• Stiffening of fists and body with or without impaired consciousness

1. a) Developmental malformations like polymicrogyria and dysplasias b) acquired causes by virtue of the injury to the brain in the form of trauma, infections, neoplasm, vascular events like stroke.

1. Delayed development 2. Birth complications like delayed cry and sepsis 3. NICU stay , prematurity and Low birth weight 4. Syndromes (Downs, Angelmans) and Autism 5. Brain injury due to mechanical factors like fall or trauma 6. Family history of seizure

• Detailed history of the event with possible videos and eye witness
• A thorough clinical examination with specific focus on developmental and motor deficits
• Detailed Family history of epilepsy

1. EEG (Electroencephalogram): It is cornerstone for diagnosis has to be done in very meticulous way, VEEG to demonstrate seizure and electric changes during the same. 
2. Neuro-imaging with preferable 3T MRI with specific epilepsy protocol to target the area of interest.
3. In resistant cases PET / SPECT scans.
4. In Selective PTS genetic tests, Advanced metabolic and immunological tests and genetic tests (these are mainly blood investigation).

1. It is very important to acknowledge that the child has epilepsy ruling out various other causes which may mimic epilepsy by an expert.
2. It is also necessary to know where the disorder lies on the mild to severe spectrum.
3. Constant counselling and awareness can help in the acceptance of the diagnosis and adherence for follow up.
4. First aid and precautions must be re-emphasised on multiple occasions preferably through AV medium.
5. The nasal midazolam spray should be kept handy in case of an episode.
6. List of do's and don'ts and triggers have be carefully given and explained to caregiver well.
7. Special attention to be given at environments like school, playgrounds and transport.

1. Diet modification like ketogenic diet
2. Epilepsy surgery like hemispherotomy to specific ressective surgery
3. Vagal nerve stimulation