Neurology & Pain Management Coding Alert

Intractable epilepsy: Seizures that do not respond to antiepileptic treatment with two or more drugs when treated for 12 months or more are said to be intractable.

Partial seizures: Also called focal or localization-related epilepsy, partial seizures are those that are localized to one area of the brain. Partial seizures are subdivided into simple and complex partial seizures.

Simple partial seizures do not affect awareness, memory, or behavior. Complex partial seizures affect awareness, memory, or behavior before, during, and immediately after the seizure.

Childhood absence epilepsy: Absence seizures account for 2 – 4 percent of epilepsy in children. These typically begin between 3 to 10 years of age. Absence epilepsy is characterized by brief staring spells. There is also a distinctive spike and wave pattern recorded on EEG. Forty percent of children with this epilepsy syndrome will outgrow it or go into remission by their teenage years.

Juvenile myoclonic epilepsy: This type of epilepsy typically begins during teenage years in otherwise healthy children. Generalized convulsions are usually the first symptom. These children may also have myoclonic seizures upon awakening, or absence seizures. Though it is unlikely that a child may outgrow this type of epilepsy, these seizures are usually well controlled with medication.

Lennox-Gastaut syndrome: This is a difficult-to-treat epilepsy syndrome. There are mixed seizures which include absence seizures, tonic seizures often leading to stiffening during sleep, drop attacks, convulsive seizures on wakening, and a distinctive EEG pattern. The Lennox-Gastaut syndrome may begin between one to five years of age and these children may also have developmental delay and some mental retardation.