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(Table 16-4 and Fig 16-3) Having concluded that the neurologic disturbance under consideration is one of seizure, the next issue is to identify the type of seizure; indeed, this determines in most cases the nature of treatment Since there are so many seizure types, especially in childhood and adolescence, each one tending to predominate in a certain age period, a clinical advantage accrues to considering seizure problems from just this point of view, ie, the problem of epilepsy as it presents in each period of life, along with the neurologic and EEG ndings, as well as the response to drugs, etiology, and prognosis Figure 16-3 displays the frequency of each seizure type and the main causes of seizures in each age group These data are assembled from various sources and are approximate, but they highlight several points of clinical importance First, implicit is the fact that the age of the patient greatly affects the incidence of certain seizure types; eg, absence and myoclonic seizures are relatively more common in children and adolescents Furthermore, the underlying causation varies greatly by age as discussed further on Neonatal Seizures The neonatologist is often confronted by an infant that begins to convulse in the rst days of postnatal life In most instances, the seizures are fragmentary an abrupt movement or posturing of a limb, stiffening of the body, rolling up of the eyes, a pause in respirations, lip-smacking, chewing, or bicycling movements of the legs Even the experienced observer may have dif culty at times in distinguishing seizure activity from the normal movements of the neonate If manifest seizures are frequent, the diagnosis is less dif cult The seizures correlate with focal or multifocal cortical discharges; however, as is the case with most EEG changes in neonates, these are poorly formed and less distinct than seizure discharges in later life Presumably the immaturity of the cerebrum prevents the development of a fully organized seizure pattern The EEG is nonetheless helpful in diagnosis Periods of EEG suppression may alternate with sharp or slow waves, or there may be discontinuous theta activity Unfortunately, electrical seizure activity may be unattended by.

Table 16-4 Causes of recurrent seizures in different age groups (see also Fig 16-3)

Infancy (1 6 months) Early childhood (6 months 3 years)

In this case, each category has its own value axis emanating from the middle The values of a data series are linked with lines Radar charts can be used to compare data series: The data series with the highest values occupies the most space The radar chart is a bit more direct than the doughnut chart, but still I can t think of many situations in which to use it There are definitely more types of charts that are easier to explain and understand

Childhood (3 10 years)

Adolescence (10 18 years) Early adulthood (18 25 years) Middle age (35 60 years) Late life (over 60 years)

Congenital maldevelopment, birth injury, anoxia, metabolic disorders (hypocalcemia, hypoglycemia, vitamin B6 de ciency, biotinidase de ciency, phenylketonuria, and others) As above; infantile spasms; West syndrome Infantile spasms, febrile convulsions, birth injury and anoxia, infections, trauma, metabolic disorders, cortical dysgenesis, accidental drug poisoning Perinatal anoxia, injury at birth or later, infections, thrombosis of cerebral arteries or veins, metabolic disorders, cortical malformations, LennoxGastaut syndrome, idiopathic, probably inherited, epilepsy (Rolandic epilepsy) Idiopathic epilepsy, including genetically transmitted types, juvenile myoclonic epilepsy, trauma, drugs Idiopathic epilepsy, trauma, neoplasm, withdrawal from alcohol or other sedative drugs Trauma, neoplasm, vascular disease, alcohol or other drug withdrawal Vascular disease (usually postinfarction), tumor, abscess, degenerative disease, trauma

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You can also depict the chart areas filled in Choose Radar | Filled to do so Depending on the size of the individual data series, the areas may overlap For the following series of chart types, understanding what types of data show up in specific chart types becomes very important For this series of chart types, we will be using a different data set The following illustration is the basis for these charts As you can see, the data provider has been changed to only one key figure for Material Group (note that in the initial query this is listed as the Product Group information and we have adjusted for reporting purposes to show as Material Group) Area charts Profile area charts Pie charts Polar charts Speedometers