Epilepsy

Convulsion

A sudden, violent, irregular movement of a limb or of the body, caused by involuntary contraction of muscles.

seizure

A sudden uncontrolled electrical disturbance in the brain.

Epilepsy

A neurological disorder that is a predisposition to recurrent unprovoked seizures.

Lateral Tongue Biting

Sensitivity 24%, specifcity 99%, (lateral tongue biting = 100%!)

Seizure Precipitating Factors

Lack of sleep, stress, menstrual cycle, etc.

Generalized Tonic-Clonic Seizure

Also known as 'grand mal seizure'

1. Starts w tonic phase (risk for falling and hurting themselves)

2. Then clonic phase after 10-15secs → rhythmic, convulsive shaking, may froth at mouth, cyanosis (blue lips) bc they hold their breath more → not enough O2, eyes blinking

3. Lasts ~2-5mins then they go limp

4. If more than ~+5-10mins, it gets dangerous; comes and goes is called status epilepticus (medical emergency)

5. Become very weak, confused

6. “Post ictal”

Absence Seizure

petit mal

1. Blank out, gone for few mins

2. Vacant stare, eyes roll upward, 

3. Mostly in children

4. No awareness its happening

5. Fairly common

Tonic Seizure

A seizure characterized by stifening of the body

atonic seizure

A seizure characterized by loss of muscle tone

Myoclonic Seizure

A seizure characterized by brief sudden jerks

Clonic Seizure

A seizure characterized by jerking movements

Partial (Focal) Epilepsy

Involves structural lesions and may require medical or surgical treatment

Generalized Epilepsy

Involves ion-channel or metabolic disease and may worsen with certain medications.

Mixed Epilepsy

A combination of diferent types of epilepsy

Pre-ictal Phase

The phase before a seizure occurs.

Ictal Phase

The phase during a seizure.

Post-ictal Phase

The phase after a seizure.

Prodrome

An early symptom indicating the onset of a seizure

Aura

A perceptual disturbance experienced before a seizure

Normal MRI

An MRI scan that shows no abnormalities.

Abnormal EEG

An EEG that shows irregular brain activity

Case Study 17yro

A 17-year-old male with whole-body tonic and clonic activity for ~2 mins, confusion for ~15 mins after the event.

Out-of-body experience (Right)

A sensation of being outside one's physical body.

Macropsia

A visual perception disorder where objects appear larger than they are

Micropsia

A visual perception disorder where objects appear smaller than they are

Complex auditory hallucination

Hearing sounds or voices that are not present, often complex in nature.

Partial seizures

Seizures that originate in a specifc area of the brain.

Complex behavior (automatism)

Involuntary actions performed without conscious awareness

Anterior cingulate cortex

Brain region involved in emotion regulation and decision-making.

Insula

Brain region involved in consciousness and emotional awareness (ex: empathy)

Medial Temporal Lobe Epilepsy

A type of epilepsy originating in the medial temporal lobe

Experiential hallucination

Hallucination that involves any mode of sense related to personal experiences

Jamais vu

A feeling of not recognizing something that is familiar.

Prescience

A sense of knowing what is going to happen in the future.

Temporal lobe epilepsy

A form of epilepsy that originates in the temporal lobe

Gestaut-Geschwind syndrome

A syndrome characterized by behavioral changes associated with temporal lobe epilepsy

Partial epilepsy

Epilepsy characterized by partial seizures

Hippocampal sclerosis

A condition involving scarring of the hippocampus often associated with epilepsy.

Cortical dysplasia

Abnormal brain development that can lead to epilepsy

Surgical outcome

The result of surgical intervention for epilepsy, with ~60% becoming seizure-free

Pre-surgical Evaluation

Assessment process to determine suitability for epilepsy surgery