Possibilities for prevention

A developmental perspective is indicated as there is increasing evidence of there being a developmental period during which a structure or function can be developed most completely/66 For example, in tuberous sclerosis complex the cognitive impairment and autistic regression may be approached by way of early drug therapy and, in some instances, by the surgical removal of tubers. (67) A developmental understanding of epilepsy is now crucial in treatment planning. Research is continuing to clarify why, in some instances, epilepsy may have a severe developmental impact and in other instances be more benign. With greater understanding of genetic mechanisms appropriate family counselling will be needed, and perhaps, new drug treatments may emerge. An important treatment goal is to prevent adverse psychosocial outcome by correct diagnosis, early intervention for seizures, continual assessment for cognitive and behavioural disorders, appropriate schooling, as well as effective family support, guidance, and therapy. Careful prospective follow-up studies are needed to demonstrate which interventions are most appropriate to specific types of epilepsy.

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