Epilepsy / Seizures

Epilepsy Spike Waves

Epilepsy (from the Ancient Greek verb ἐπιλαμβάνειν meaning "to seize, possess, or afflict") is a group of long term neurological disorders characterized by epilepticseizures. These seizures are episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking. A seizure may last anywhere from few seconds to several minutes. In epilepsy, seizures tend to recur, and have no immediate underlying causewhile seizures that occur due to a specific cause are not deemed to represent epilepsy. In most cases the cause is unknown, although some people develop epilepsy as the result of brain injury, stroke, brain cancer, and drug and alcohol misuse, among others. A seizure may appear as a brief stare, an unusual movement of the body, a change of awareness, or a convulsion. The two categories are partial (this is when the seizure activity begins in a particular spot in the brain) and generalized (this is when the seizure activity affects the whole brain with no obvious starting point). Epileptic seizures are the result of excessive and abnormal cortical nerve cell activity in the brain. The diagnosis typically involves ruling out other conditions that might cause similar symptoms (such as syncope) as well as figuring out if any immediate causes are present. Epilepsy can often be confirmed with an electroencephalogram (EEG), a test where wires are glued to the scalp to record the electricity given off by the brain. Epilepsy cannot be cured, but seizures are controllable with medication in about 70% of cases. In those whose seizures do not respond to medication, surgery, neurostimulation or dietary changes may be considered. Not all epilepsy syndromes are lifelong, and a substantial number of people improve to the point that medication is no longer needed. About 1% of people worldwide (65 million) have epilepsy, and nearly 80% of cases occur in developing countries. Epilepsy becomes more common as people age. In the developed world, onset of new cases occurs most frequently in infants and the elderly; in the developing world this is in older children and young adults, due to differences in the frequency of the underlying causes. About 5–10% of all people will have an unprovoked seizure by the age of 80, and the chance of experiencing a second seizure is between 40 and 50%. In many areas of the world those with epilepsy either have their ability to drive restricted or disallowed, but most are able to return to driving after a period of time without seizures.

Types of seizures:

PARTIAL

1. Simple Partial (consciousness not impaired)
• with motor or sensory symptoms (ex. jerking of foot, face, arm, etc or involve the sense such as tingling or burning)
• with autonomic symptoms (involuntary body functions are affected: ex. heart rate, bowel function, and blood pressure: ex. face becomes flushed or pale, heart may beat fast, abdominal cramps, loss of bowel control)
• with psychic symptoms (ex. stimulates emotions such as fear, feeling of deja vu, voices may be heard)
2. Complex Partial (consciousness is impaired)

·         with simple partial onset (starts as a simple partial seizure but spreads quickly to areas that affect consciousness; staring, confusion, loss of alertness, or aimless movements)

·         with loss of consciousness at onset (does not start as a simple partial; no change in function before consciousness is impaired; ex. blank stare, wandering around room, repetitive movements, picking at clothes)

GENERALIZED (may or may not be convulsive)

1.      Absence Seizures

·         Simple (starts suddenly w/o warning; a glazed look on the face and stares, unaware of what is going on; sometimes there may be eye blinking or head bobbing; lasts just a few seconds and abruptly ends w/ no confusion, immediately alert; maybe mistaken for daydreaming)

·         Atypical (similar to simple absence but has more pronounced motor involvement; ie- tonic or clonic spells, involuntary behaviors such as in complex partial seizures)

2.      Myoclonic Seizures - abrupt jerks of muscle groups; foot may kick, hand may jerk, or entire body may jerk as if being hit with an electric shock, may be thrown to the ground; a series of myoclonic jerks several times a day is termed infantile spasms; very difficult to control

3.      Atonic Seizures - sudden loss of tone or posture, body goes limp and may fall to the ground

4.      Tonic-Clonic Seizures - most common seizure type in children; tonic phase - loss of consciousness, eyes roll, contracting (stiffening) of all the muscles including the chest making it difficult to breathe, face and lips may to blue, lasts for a few seconds - usually less than 30 seconds followed by clonic phase - rhythmic jerking, fists are clenched, usually lasts for a few seconds, jerking slows and stops, ended by a deep sigh; then enters the post-ictal state for a few minutes: not awake and doesn’t respond, after this, may sleep or be woken up, but may be tired and confused and sore

5.      Tonic Seizures - just the tonic (stiffening) phase of the tonic-clonic seizure lasting less than a minute followed by a post-ictal sleep

6.      Clonic Seizures – rare, just the clonic (jerking) phase of the tonic-clonic seizure

Epilepsy Links

Neurosciencefor Kids – Epilepsy

American Epilepsy Society

Epilepsy.com

Epilepsy:MedlinePlus

CDC – Epilepsy

CURE Epilepsy: CitizensUnited for Research in Epilepsy

Purple Day

Epilepsy Advocate

Epilepsy Foundation

Epilepsy SupportNetwork

International League Against Epilepsy

KetogenicDiet

Lennox-Gastaut Syndrom

• Living With Lennox-Gastaut Syndrome
• LGS Foundation

Dravet Syndrom

• Living With Dravets
• Dravet Syndrome Foundation
• Dravet Syndrome UK
• Dravet.org
• DravetData.com
• Our Dravet Butterfly