By Jack Cazes; Raymond P W Scott
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Observation and description of the event determine classification of the seizure type. An inter-ictal EEG may show signs of an underlying epileptic tendency, which is present in many patients with epilepsy. However, many patients with epilepsy also show a normal EEG, most particularly between seizures. Thus, a normal EEG does not exclude the diagnosis of epilepsy. In addition to the basic neurologic examination, the neuropsychiatric assessment is based primarily on the clinical interview and requires expertise in general psychopathology in children and adolescents.
The latter is marked by various intensities of altered consciousness, symptoms of delirium, disorders of impulse and, in some instances, even psychotic features. A wide range of neurological features result from the infection. Generalized seizure activity occurring during the acute state of meningitis is not associated with subsequent development of epilepsy, whereas focal seizures tend to have a worse prognosis. r The chronic sequelae may include various behavioural symptoms and it is not uncommon for the symptoms constellation to be one of fairly typical hyperkinetic disorder, autism or even depression and schizophreniform psychosis.
In addition to the basic neurologic examination, the neuropsychiatric assessment is based primarily on the clinical interview and requires expertise in general psychopathology in children and adolescents. Information by caretakers and other educators may be obtained either by interview or standardized checklists, allowing for the screening of a large variety of behavioural abnormalities. The latter include the Child Behaviour Checklist (CBCL) for parents, the Teacher Rating Form (TRF) or the Strengths and Difficulties Questionnaire (SDQ, see Appendix to chapter on conduct disorders).