Epidemiology / NOS Genetic seizure disorders Flashcards
Rate of seizure recurrence after 1st unprovoked seizure:
- All-comers, without intervention
- With normal EEG and normal neurological status (1 year)
- With normal EEG and normal neurological status (2 year)normal EEG and normal neurological status (3 year)
Rate of seizure recurrence after 1st unprovoked seizure:
- All-comers, without intervention: 40-50%
- With normal EEG and normal neurological status (1 year) - 20%
- With normal EEG and normal neurological status (2 year)- 25%
- normal EEG and normal neurological status (3 year) - 30%
Factors increasing risk of epilepsy with first unprovoked seizure
status epilepticus, but specifically in patients with remote history of symptomatic seizures (not all)
Childhood Absence Epilepsy (CAE)
- Males vs Females
- Onset
Childhood Absence Epilepsy (CAE)
- Female > Males
- Onset 4-8 years
Juvenile Absence Epilepsy (JAE):
- Males vs Females
- Onset
- How seizures clinically differ from CAE (4)
Juvenile Absence Epilepsy (JAE):
- Males vs Females: No clear preference
- Onset: 9-13 years
- How seizures clinically differ from CAE (4)
- Clusters upon waking
- Less Frequent
-0 ocular / retropulsive movements less often seen
- 80% also have GTC or Myoclonic seizures
Myoclonic absences
- Age of onset
- Males vs Females
- Development
Myoclonic absences
- Age of onset: around 7
- Males > Females
- Development: delayed in 2/3 of patients
Factors that increase risk of recurrence in febrile seizures (3)
- Temperature low at time of onset
- younger children
- increased illness frequency
Incidence of Status epilepticus in USA
18 out of 100,000
Risk of SUDEP:
Drug resistant epilepsy patients
Non-drug resistant Epilepsy
Drug resistant epilepsy: 1/100
Non-drug resistant: 1/1000
% of US population with:
- Epilepsy
- History of seizure sometime in life
Epilepsy: 3.1%
history of at least 1 seizure: 5%
Epilepsy Statistics - Incidence rate for:
- Epilepsy
- 1st time unprovoked seizure
- acute symptomatic seizures
- all seizures (epilepsy and non-epilepsy)
Epilepsy: 44 / 100,000
1st time unprovoked: 61/100,000
Acute symptomatic: 39/100,000
All seizures: 100/100,000
Seizure recurrence rate after
- first unprovoked seizure
- two unprovoked seizure
- three unprovoked seizures
- after treating first unprovoked seizure
- first unprovoked seizure: 40%
- two unprovoked seizure: 73%
- three unprovoked seizures: 76%
- after treating first unprovoked seizure: 15%
Seizure recurrence after first seizure + modifiers
Etiology:
- Idiopathic
- Symptomatic
EEG
- Normal
- Epileptiform
Etiology + EEG
- Idiopathic and normal
- Symptomatic and abnormal
Etiology:
- Idiopathic: 32%
- Symptomatic: 57%
EEG
- Normal: 27%
- Epileptiform: 58%
Etiology + EEG
- Idiopathic and normal: 24%
- Symptomatic and abnormal: 65%
Seizure recurrence after first seizure + modifiers
- Focal vs Generalized
- Time of day
- duration / Timing (2)
Focal onset > generalized
More common if seizure was at night
More common if presents in status or with clusters of seizures at onset
Seizure recurrence after first SYMPTOMATIC seizure based on cause, acute (<1 week) and remote (>1 week)
- Stroke
- TBI
- CNS infection
Stroke: A= 33% R =71.5%
TBI: A = 13.4% R = 46.6
CNS infection: A=16.6%, R=63.5%
Epilepsy statistics:
Total estimated people worldwide with epilepsy
40 million
Epilepsy statistics:
Worldwide mortality from epilepsy:
0.2%
Small pedantic criteria from ILAE regarding “seizure Free” status
Must be 3 times the pretreatment interseizure interval
Percentage of patients who will become seizure free for one year after
- first AED
- Second AED
- third AED
1st: 47%
2nd/3rd: 14%
ILAE criteria for which seizure is resolved (2)
1) past age-range of age-dependent epilepsy syndrome
2) remained seizure free for 10 years and off meds for 5 years
ADHD and Epilepsy:
How much more common is it than in the general population?
Prevelance in children with Epilepsy
Incidence of status epilepticus
7-41 cases per 100,000
Status epilepticus, peak incidence (2)
before age 1 and after 60 years
