BÖLÜM


DOI :10.26650/B/CH32.2024.010.035   IUP :10.26650/B/CH32.2024.010.035    Tam Metin (PDF)

Epi̇lepsi̇si̇ Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Edibe Pembegül YıldızMeliha Mine Çalışkan

Epilepsi, çocukluk çağında en sık görülen kronik nörolojik hastalıktır. Yaşamın ilk yılında görülme sıklığı çocukluk ve ergenlik dönemine göre daha yüksektir. Tanıda önerilen adımlar nöbet tipinin, epilepsi tipinin (fokal, jeneralize, kombine jeneralize ve fokal, bilinmeyen) ve epilepsi sendromunun belirlenmesidir. Epilepsiyi sadece tekrarlayan nöbetlere yatkınlık durumu olarak değil, nöbetlerin bilişsel ve sosyal sonuçlarının toplamı olarak değerlendirip ele almak gerekir. Klinisyenlerin hem yeni tanı almış çocuklarda hem de tedavi sonrası düzenli takipleri olan çocuklarda olası nörolojik ve psikolojik komorbiditeleri taramaları ve değerlendirmeleri önerilir. Nöbetlerin başlangıç yaşı, uzun hastalık süresi, semptomatik neden, epileptik ensefalopati, yoğun elektroensefalogram (EEG) bulguları ve devam eden nöbet önleyici ilaçlar ile tedavisinin bilişsel prognozla ilişkili olduğu bildirilmiştir Ayrıca bu çocukların altta yatan nedenden veya tedavinin olumsuz etkilerinden kaynaklanabilecek sistemik sorunlarının farkında olup multidisipliner izlemleri sağlanmalıdır. Ebeveynler öğretmeni, okul hemşiresini, servis sürücüsünü, hatta çok yakın bazı arkadaşlarını çocuğun hastalığı ile ilgili mutlaka bilgilendirmelidirler. Çocukların izlemi bireyselleştirilmeli, fiziksel ve bilişsel etkilenimleri, kullanılan ilaçların özellikleri, özel gereksinim duydukları alanlar belirlenerek herhangi bir sosyal izolasyona yol açmadan takipleri yapılmalıdır. Aynı zamanda büyüme ve gelişme sürecinde olan bu çocukların beslenme, bağışıklama, sosyal hayat, fiziksel aktivite açısından izlemlerinin sağlıklı çocuklardan belirgin farklılıklarının olmadığı unutulmamalıdır. Bu yazıda epilepsi sorunu olan çocuklarda bilinen, birlikte görülen durumlar ve izlemleri sırasında dikkat edilecek hususlar gözden geçirilecektir


DOI :10.26650/B/CH32.2024.010.035   IUP :10.26650/B/CH32.2024.010.035    Tam Metin (PDF)

Follow-up and Community Care of the Child with Epilepsy

Edibe Pembegül YıldızMeliha Mine Çalışkan

Epilepsy is the most common chronic neurological disease in children. The incidence is higher in the first year of life than in childhood and adolescence. The recommended step in the diagnosis is identifying the seizure type, epilepsy type (focal, generalized, combined generalized, or focal, unknown), and epilepsy syndrome. Epilepsy is not only a predisposition for recurring seizures; it should be evaluated and managed as the total of the seizure’s cognitive and social consequences. Clinicians should screen and evaluate possible neurological and psychological comorbidities in children with epilepsy. The age of onset of seizures, long disease duration, symptomatic cause, epileptic encephalopathy, intense electroencephalogram findings, and ongoing antiseizure drug therapy have been associated with cognitive prognosis. In addition, these children should be made aware of any systemic problems that may occur due to the treatment’s etiology or side effects, and multidisciplinary follow-up should be provided. The teacher, school nurse, bus driver, and even some of the child’s close friends should be informed of the child’s condition. The follow-up of children should be tailored; their physical and cognitive effects, the characteristics of the drugs used, and the areas they require special attention should be monitored without causing social isolation. At the same time, it should be noted that the follow-up of growing and developing children is not significantly different from that of healthy children regarding nutrition, immunization, social life, and physical activity. In this section , known comorbid conditions in children with epilepsy and the points to be considered during their follow-up will be reviewed.



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