Etiology, clinical features, and therapeutic implications riccardo torta and roberto keller department of neurosciences, university of turin, turin, italy summary. The etiologic classification of epilepsy shorvon 2011. Therefore, incidence and prevalence of epilepsy is expected to rise, particularly in the elderly, a population with an everincreasing life span and a higher incidence of brain lesions that predispose to seizures, mainly secondary to cerebrovascular or. Idiopathic epilepsies are generally genetic, and while man such syndromes have been described, advances in molecular genetics will. Mesial temporal lobe epilepsy with hippocampal sclerosis mtle with hs secondary to specific metabolic or structural. The gene responsible for a particular genetic epilepsy can now be identified and localised to a specific chromosome region, allowing researchers to determine the. Etiology, seizure type, and prognosis of epileptic. Goldendoodle 2 small breed dogs in the genetic epilepsy age range much more commonly have. Particularly in patients with specific epilepsy syndromes or suspicion for an autosomal dominant inheritance, genetic testing and counseling should be considered. Tuberous sclerosis a rare condition that causes growths in organs including the brain. Etiology and pathogenesis of temporal lobe epilepsy jama. Epilepsy has numerous causes, each reflecting underlying brain dysfunction shorvon et al.
Pathophysiology and definitions of seizures and status epilepticus. Modified atkins diet to children and adolescents with medical intractable epilepsy. Approximately onethird of patients with epilepsy seek attention in the ed every year. It is still is not properly out of shadow and need more work at scientific background to know about the exact prevalence, incidence and etiology of epilepsy. For this reason a manual has been prepared to help those people. A retrospective analysis of 1170 cases of symptomatic epilepsy admitted to the first affiliated hospital of yangtze university from january 20 to june 2018 was conducted to analyze. Charts of the 111 patients undergoing hemidecortications at. Epilepsy can be defined as a chronic seizure disorder or group of disorders characterized by seizures. However, she can occasionally arise from extrafrontal areas. But in order to be able to start this treatment, the doctor or clinical officer needs to know the causes of the seizures and epilepsy, what type of seizure and epilepsy the patient has, and which drug should be used. The third level is that of epilepsy syndrome, where a specific syndromic diagnosis can be made. Classification of epilepsy by etiology electroclinical syndromes idiopathic i. Behavioral, psychotic, and anxiety disorders in epilepsy. A brain scan, such as magnetic resonance imaging mri, may show this.
As early treatment of convulsions and of epilepsy is very important, it is essential to start correct treatment immediately. In this article, a classification database of the etiologies of epilepsy is proposed. Hemispherectomy for intractable unihemispheric epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Surgical removal of one hemisphere has been performed for several decades to treat intractable unihemispheric epilepsy. Epilepsy deaths by age, raceethnicity, and gender in the united states significantly increased from 2005 to 2014 epilepsy surgery in the underserved hispanic population improves depression, anxiety and quality of life. Neurofibromatosis a genetic condition that can cause growths on the nerves. However, one commonality across epilepsies is a disrupted balance between excitatory via glutamatergic signaling and inhibitory via gabaergic signaling drive at the synaptic level that can result in seizure activity. Classification of seizure type and epilepsy type both take into account the results of investigations such as electroencephalography eeg and neuroimaging studies together with other studies exploring the underlying etiology of the epilepsy. The definition of epilepsy requires the occurrence of at. A structural sometimes called symptomatic change in the brain, such as the brain not developing properly, or damage caused by a brain injury, infections like meningitis, a stroke or a tumour. The word epilepsy is derived from latin and greek words for seizure or to seize upon. However, one commonality across epilepsies is a disrupted balance between excitatory via glutamatergic signaling and inhibitory via gabaergic signaling drive.
Evaluation of seizure etiology from routine testing to genet. The pathophysiology of epilepsy and seizures is diverse, accounting for the many different types of seizure disorders. The etiology of epilepsy is a major determinant of clinical course and prognosis, yet the current classifications of epilepsy do not list etiology in any detail. Please use one of the following formats to cite this article in your essay, paper or report. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Classification, etiology, and clinical features view in chinese infant, differs from the adult brain in the basic mechanisms of epileptogenesis and propagation of seizures it is more prone to seizures, but seizures are more apt to disappear as the child grows. Aug 18, 2003 the discovery of epilepsy genes has resulted largely from the success of the human genome project, a multinational endeavour that has produced detailed maps of the human chromosomes. In epilepsy, the seizures appear to occur spontaneously and are expected to recur in the absence of treatment.
Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures, and by the neurobiologic, cognitive, psychological, and social consequences of this condition. Ali babi, in pharmacology and therapeutics for dentistry seventh edition, 2017. Analysis of etiology and clinical characteristics of 1170. Patients less than 10 yearsold and alcoholism were excluded. Etiology of epilepsy and causes of death neurology. May 11, 2016 epilepsy is a group of related disorders in the brains electrical systems that are characterized by a tendency to cause recurrent seizures. Epilepsy and seizures explore the latest in epilepsy and seizures, including the epidemiology, etiology, diagnosis and management of seizure disorders. There is no known cure for idiopathic epilepsy, only prevention for attacks is striven for. The etiology, clinical manifestations and treatment of 1170 patients with symptomatic epilepsy were retrospectively analyzed and provided guidance for further treatment of symptomatic epilepsy. Charts of the 111 patients undergoing hemidecortications at the. Epilepsy is a central nervous system neurological disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. A chronic illness like epilepsy produces emotional and psychosocial disturbance. When a cause is found, it can include various structural lesions eg, traumatic scars, neoplasms, vascular malformations, strokes.
Epilepsy is a group of related disorders in the brains electrical systems that are characterized by a tendency to cause recurrent seizures. Veterans are at particular risk for developing epilepsy due to the frequency with which they. Most are either purebred or mixes of atrisk breeds think. What is the role of genetics in the etiology of epilepsy. Pathophysiology of epilepsy an overview sciencedirect. The treatment of seizures and epilepsy in the older patients is discussed separately. Causes of epilepsy and seizures epilepsy foundation. Epilepsy is a general term for the tendency to have seizures.
Therefore, incidence and prevalence of epilepsy is expected to rise, particularly in the elderly, a. Etiology of epilepsy a prospective study of 210 cases walter oleschko arruda summary the objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics 110 female, 100 male, aged 1482 years 34. The international league against epilepsy ilae diagnostic manuals goal is to assist clinicians who look after people with epilepsy to diagnose the epilepsy syndrome and if possible the etiology of the epilepsy. The most likely etiology for absence epilepsy syndromes is genetic, with complex, multifactorial inheritance. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis, as it often carries significant treatment implications. Pdf epilepsy is a heterogeneous disorder, the symptoms of which are preventable and controllable to some extent.
The incidence of epilepsy is higher in older patients, and the etiology is related with age. Epilepsy can also be divided into active and inactive epilepsy, with active epilepsy being defined as two or more epileptic seizures in the last five years that are unprovoked by any immediate identified cause. An acquired etiology can be identified in 30% of patients with established epilepsy. Structural changes due to genetic conditions such as tuberous sclerosis, or. Brain tumors, benign or malignant, are a common cause of epilepsy. A prior case series focused on the outcomes after 58 surgeries at johns hopkins hospital in 1997. Epilepsy is a chronic disorder that causes unprovoked, recurrent seizures. The remaining 70% of patients have a presumably genetic etiology. Sep 25, 2018 frontal lobe epilepsy frequently overlaps with sleeprelated hypermotor epilepsy she. For this reason a manual has been prepared to help those people medical officers, clinical officers and nurses who are responsible for the primary health care of these patients and who may be working in the rural areas. Arriving at the correct epilepsy syndrome andor etiology allows better decisionmaking about treatment and improves patient care. Etiology, seizure type, and prognosis of epileptic seizures. Considering and classifying cause in terms of causal mechanism, as was suggested by.
Epilepsy represents the most common chronic neurological condition in the dog. Seizure types, epilepsy syndromes, etiology, and diagnosis. Most adultonset localizationrelated epilepsies do not have an identifiable etiology ie, neuroimaging studies are most often normal. Aetiology of epilepsy 2003 epilepsia wiley online library. A seizure is a paroxysmal event characterized by abnormal, excessive, hypersynchronous discharge of cortical neuron activity. Epilepsy may be idiopathic, cryptogenic, or symptomatic. According to the international classification of epileptic. After stoke and dementias, epileptic seizures and epilepsies constitute the 3rd most frequent neurologic disorders encountered in elderly in developed countries.
Knowing the cause of epilepsy will also help patients. Epilepsy is a common medical and social disorder or group of disorders with unique characteristics. The basic premise of generalized tonicclonic seizure pathophysiology is that seizures start with a robust excitation of susceptible epileptic cerebral neurons, which. A seizure is a sudden rush of electrical activity in the brain. The definition of epilepsy requires the occurrence of at least one epileptic seizure. As our understanding of the underlying pathophysiology improves, we are better able to describe the neuroanatomical diagnosis, select the best medication for an individual patient and predict the potential for pharmacoresistance to antiepileptic drugs aeds.
Ilae classification of the epilepsies 2017 international. Mar 30, 2011 the etiology of epilepsy is a major determinant of clinical course and prognosis, yet the current classifications of epilepsy do not list etiology in any detail. Epilepsy incidence rates by age 10 100 0 10 20 30 40 50 60 70 80 all epilepsy types age years incidence per 100,000 data from rochester, mn 197584 hauser wa et al. Epileptic seizures are a common neurologic disorder attended in the emergency department ed. Epilepsy is a condition characterized by recurrent unprovoked seizures. Seizures cause changes in movement, behavior, sensation, or awareness, including loss of consciousness or convulsions, which last from a few seconds to a few minutes in most individuals. As you have previously learned, a seizure is an episode when neurons in your brain abnormally or excessively fire from a few seconds to minutes and cause clinical. Epilepsy is a major public health problem in kenya.
Frontal lobe epilepsy frequently overlaps with sleeprelated hypermotor epilepsy she. A physician must, therefore, give due consideration to them besides medical aspects such as drug therapy, side effects of drugs and identifying etiology. Some researchers now believe that the chance of developing epilepsy is probably always genetic to some extent, in that any person who starts having seizures has always had some level of genetic likelihood to do so. Evaluation of seizure etiology from routine testing to. Pathophysiology of epilepsy an overview sciencedirect topics. This topic will cover the clinical presentation, differential diagnosis, and etiology of seizures and epilepsy in older patients. Childhood absence, west syndrome, familial temporal lobe epilepsy, juvenile myoclonic epilepsy distinctive constellations i. It has not only medical but also psychosocial consequences. In this paper, therefore, we record the pathological findings in. As a result, the number of patients with epilepsy seeking treatment is increasing rapidly. Epilepsy is usually diagnosed only after a person has had more than one seizure when identifiable, the causes of epilepsy usually. Epilepsy is a neuronal disease which affects almost all groups of the society.