Epilepsy

Question 1

What is epilepsy?

Answer 1

Epilepsy is considered to be a disease of the brain defined by any of the following conditions:

1. At least two unprovoked (or reflex) seizures occurring more than 24 hours apart
2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years
3. Diagnosis of an epilepsy syndrome.

Question 2

What are the types of sezures?

Answer 2

General Seizures:
Tonic-clonic seizures: loss of consciousness -> muscle stiffening -> jerking/twitching -> deep sleep -> wakes up

Absence seizures: brief staring episodes with behavioural arrest

Tonic/atonic seizures: sudden muscle stiffening/sudden loss of muscle control

Myoclonic seizures: sudden, brief muscle contractions
Status epilepticus: > 5 min of continuous seizure activity

Partial/ focal Seizures
Simple: retained awareness/consciousness

Complex: impaired awareness/consciousness

Question 3

What are the risk factors for epilepsy?

Answer 3

> Age (young)
> FHx
> Head injury
> Stroke
> Brain infection
> Dementia
> Tumours

Question 4

What are the treatments for the different types of seizures?

Answer 4

> Tonic clonic/ partial- carbamazepine/ lamotrigine
> Absence- ethosuximide
> Myoclonic- Levetriacetam/ topiramate
> Status epilepticus- diazepam
> Valproate- all

Question 5

What are the signs and symptoms of epilepsy?

Answer 5

Temporary confusion.
A staring spell.
Uncontrollable jerking movements of the arms and legs.
Loss of consciousness or awareness.
Psychic symptoms such as fear, anxiety or deja vu

Question 6

How would you investigate epilepsy?

Answer 6

> EEG
MRI brain
CT brain

Question 7

What are the complications of epilepsy?

Answer 7

> Learning difficulty
> Aspiration pneumonia
> Injury
> Permanent brain damage
> Anti convulsants side effects 
> Status epilepticus

Question 8

What is the prognosis of people with epilepsy?

Answer 8

The overall prognosis for people with newly diagnosed epilepsy is good, with 60−70% becoming seizure-free, many of whom doing so in the early course of the condition.

Question 9

What is the epidemiology of epilepsy?

Answer 9

Prevalence between 2-7% of the population

Incidence increased over the last 30-40 years