Module 4.1 (Intro to Epilepsy)

Question 1

Summary of Epilepsy

Answer 1

Epilepsy is a disorder characterised by a tendency to experience recurrent seizures

• Usually >1 unprovoked seizure
• Can be resolved with time
• Can be the primary problem or the symptom of another brain disorder

> Role of GABA, NMDA, electrolytes and glucose

Question 2

What are some causes of acute symptomatic seizures?

Answer 2

Metabolic disorders

• hypoglycaemia
• hyponatraemia
• hypocalcaemia
• kidney failure

Intoxication with some drugs or poisons

Drug or alcohol withdrawal

Stroke

Brain trauma

Intracranial infection

• Meningitis
• Encephailitis
• Cerebral abscess

Autoimmune encephalitis

Hypertensive encephalopathy

Severe cerebral hypoxia ( cardaic arrest)

Eclampsia

Question 3

How to classify epilepsy?

Answer 3

Use a multi-level framework. ILAE classification at 4 levels

1. Seizure type

> Generalised onset - eg tonic-clonic, tonic, myoclonic, absence = both parts of the prain

> Focal onset – aware and impaired awareness and progressive = one part of the brain

> Unknown

> Unclassified

2. Epilepsy type

> Generalised

> Focal

> Generalised and focal (eg Dravet and Lenox-Gastaut)

> Unknown (eg epilpetic spasms)

3. Epilpesy syndrome

> Distinct clinical entity e.g. West syndrome, Dravet syndrome, Lennox-Gastaut syndrome

4. Epilepsy with etiology

> Genetic, structural, metabolic, immune, infectious, unknown

Question 4

Diagnosis of epilepsy

Answer 4

• Clinical diagnosis
• EEG, MRI, other testing