Epilepsy
ICD-10 G40 · ICD-11 8A6Z
Treatment of Generalized Tonic-Clonic, Atonic, or Tonic Seizures in a Child Under 16
This protocol covers the management of epilepsy when a child younger than 16 years presents with generalized convulsive seizures — specifically tonic-clonic, atonic, or tonic types.
Clinical Scenario
The patient is a child younger than 16 years experiencing generalized convulsive (tonic-clonic), atonic, or tonic seizures. These seizures are typically bilateral and symmetric, although variants with asymmetry — including head and eye deviation — are possible.
Treatment Approach Partial preview
For children with medically refractory epilepsy, the protocol addresses both surgical and non-surgical interventional options. The full eligibility criteria, selection factors, and step-by-step decision pathway are available in the complete regimen.
References
- Typically bilateral and symmetric, although variants with asymmetry, including head and eye deviation, are possible
- Children (younger than 16 years)
- For patients with seizures that are not controlled with these agents, alternative treatments include surgical resection of the seizure focus, ketogenic diets, vagus nerve stimulators, and implantable brain neurostimulators.
- Surgical resection of the seizure focus in appropriately selected patients often results in decreased frequency or elimination of seizures with improvement in quality of life.
- The ketogenic diet, a high-fat, low-carbohydrate, and low-protein diet, induces ketone body formation.
- Vagus nerve stimulation may increase seizure-free time in patients with medically refractory epilepsy who are not candidates for surgery or in whom surgery has been ineffective.
- It is approved by the U.S. Food and Drug Administration for use in persons older than 12 years.