Epilepsy
Seized by god/demons
Seizure: The physical or psychic changes that occur with abnormal brain activity
Provoked: fever, trauma, medication..
Epilepsy: recurrent (i.e. >1) unprovoked seizures
Prevelence: 1%
70% response to medication
Treatment gap 90% of developed get Rx, 10% of developing world
Affects development: physical, intellectual, social
Associated
Genetic 60% v Symptomatic (i.e. secondary) 40%
Focal 60% v Generalised 40%
GENETIC (half of these are cryptogenic i.e. unknown gene) (42% get control)
Benign Familial Neonatal Convulsions (single gene)
Autosomal Dominant Nocturnal Frontal Lobe Epilepsy (single gene)
Dravet Syndrome (single gene)
COMPLEX INHERITANCE
Juvenile myoclonic Epilepsy
Childhood Absence Epilepsy
Benign Focal Epilepsies of Childhood
SYMPTOMATIC genetic/devel
Childhood Epilepsy Syndromes
Progressive Myoclonic E
Neurocutaneous
Angelman
Lysosymal
Rett
Metabolic
Chromasomal
Malformations (24% get control)
AQUIRED SYMPTOMATIC
Hippocampal sclerosis (11% get control)
HIE
Hypoglycemia
Trauma (30% get control)
Neoplasm (46% get control): Ganglioglioma
Infection: meningitis, encephalitis, neurocystercercosis, abscess, malaria, TB, HIV
Cerebrovasc: bleed, ischema, (54% get control) AVM, cavernoma (50% get control)
Immune: Rasmussen encephalitis, SLE, VGKC antiNMDAR
MS
Hydrocephalus
Mx
AEDs
Prednisolone
Surgery
Ketogenic Diet
Vagus Nerve Stimulator
Seizure: The physical or psychic changes that occur with abnormal brain activity
Provoked: fever, trauma, medication..
Epilepsy: recurrent (i.e. >1) unprovoked seizures
Prevelence: 1%
70% response to medication
Treatment gap 90% of developed get Rx, 10% of developing world
Affects development: physical, intellectual, social
Associated
- Autism
- mood disorders
- death 3x background
- accidents 60% (drowning, burns, cold exposure
- Status 7%
- SUDEP 15%
Genetic 60% v Symptomatic (i.e. secondary) 40%
Focal 60% v Generalised 40%
GENETIC (half of these are cryptogenic i.e. unknown gene) (42% get control)
Benign Familial Neonatal Convulsions (single gene)
Autosomal Dominant Nocturnal Frontal Lobe Epilepsy (single gene)
Dravet Syndrome (single gene)
COMPLEX INHERITANCE
Juvenile myoclonic Epilepsy
Childhood Absence Epilepsy
Benign Focal Epilepsies of Childhood
- Benign Rolandic Epilepsy
SYMPTOMATIC genetic/devel
Childhood Epilepsy Syndromes
- West
- Lennox-Gastaut
Progressive Myoclonic E
- Mitochondrial
- Neuronal ceroid lipofuscinosis
Neurocutaneous
- TS: tubers and cortical dysplasia, subepyndymal nodules
- NF1
- SW
Angelman
Lysosymal
Rett
Metabolic
Chromasomal
- T21, Fragile X, microdeletion syndromes, ring chr 20
Malformations (24% get control)
- focal cortical dysplasia
- polymicrogyria
- periventricular nodular heterotopia
- microcephaly
- hemimegalencephaly
- subcortical band heterotopia aka double cortex syndrome (next gen at risk of lissencephaly)
AQUIRED SYMPTOMATIC
Hippocampal sclerosis (11% get control)
HIE
Hypoglycemia
Trauma (30% get control)
Neoplasm (46% get control): Ganglioglioma
Infection: meningitis, encephalitis, neurocystercercosis, abscess, malaria, TB, HIV
Cerebrovasc: bleed, ischema, (54% get control) AVM, cavernoma (50% get control)
Immune: Rasmussen encephalitis, SLE, VGKC antiNMDAR
MS
Hydrocephalus
Mx
AEDs
Prednisolone
Surgery
Ketogenic Diet
Vagus Nerve Stimulator