IM : epilepsy

What is epilepsy?

a chronic neurological disorder having recurrent, unprovoked seizures due to abnormal electrical activity in the brain.

What is a seizure?

a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.

What are the two main types of seizures?

Focal seizures and generalized seizures.

What are focal seizures?

originate in one hemisphere of the brain and can be aware (simple) or impaired awareness (complex).

What are generalized seizures?

involve both hemispheres of the brain and include tonic-clonic, absence, myoclonic, atonic, and tonic seizures.

What is a tonic-clonic seizure?

A generalized seizure with two phases: tonic (muscle stiffening) followed by clonic (rhythmic jerking).

What is an absence seizure?

A brief generalized seizure causing a sudden lapse in awareness without convulsions, common in children.

What is a myoclonic seizure?

A generalized seizure with sudden, brief, shock-like muscle jerks, usually without loss of consciousness.

What is an atonic seizure?

A seizure causing sudden loss of muscle tone, leading to falls or head drops.

What are common causes of epilepsy?

Causes include genetic mutations, brain injury (e.g., trauma, stroke), infections, developmental abnormalities, and tumors.

How is epilepsy diagnosed?

Based on clinical history, EEG findings, and neuroimaging (MRI preferred to detect structural causes).

What is the role of EEG in epilepsy?

EEG helps detect epileptiform activity and classify seizure types.

What imaging is preferred in epilepsy evaluation?

MRI is preferred to evaluate structural brain abnormalities associated with epilepsy.

What is the first-line treatment of epilepsy?

Antiepileptic drugs (AEDs) tailored to seizure type and patient profile.

Name some common antiepileptic drugs (AEDs).

Valproate, carbamazepine, lamotrigine, levetiracetam, phenytoin, topiramate, and ethosuximide.

Which AED is used for absence seizures?

Ethosuximide (first-line) or valproate.

Which AEDs are broad-spectrum?

Valproate, lamotrigine, levetiracetam, topiramate.

When is surgery considered in epilepsy?

For drug-resistant epilepsy, especially focal seizures with an identifiable resectable focus.

What are some non-pharmacological treatments for epilepsy?

Vagus nerve stimulation, ketogenic diet, and epilepsy surgery.

What is status epilepticus?

A medical emergency defined as seizure lasting >5 minutes or recurrent seizures without recovery between them.

How is status epilepticus managed?

Immediate benzodiazepines (lorazepam or diazepam), followed by IV antiepileptics (e.g., phenytoin, levetiracetam).

What is epilepsy syndrome?

A cluster of features including seizure type, age of onset, EEG pattern, and prognosis (e.g., Lennox-Gastaut, West syndrome).

What is Lennox-Gastaut syndrome?

A severe childhood-onset epilepsy with multiple seizure types, intellectual disability, and characteristic slow spike-wave EEG.

What is West syndrome?

An epilepsy syndrome in infants with infantile spasms, developmental delay, and hypsarrhythmia pattern on EEG.

Can epilepsy affect cognitive development?

Yes, especially in early-onset or poorly controlled epilepsy.

Can people with epilepsy live normal lives?

Yes, many can with appropriate treatment, though precautions are necessary regarding driving, swimming, and lifestyle