Epilepsy is a common chronic neurological disorder that is characterized by recurrent unprovoked seizures.^[1][2] These seizures are transient signs and/or symptoms due to abnormal, excessive or synchronous neuronal activity in the brain.^[3] About 50 million people worldwide have epilepsy at any one time.^[4] Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as a group of syndromes with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain. Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ... Veterinary medicine is the application of medical, diagnostic, and therapeutic principles to companion, domestic, exotic, wildlife, and production animals. ... Epilepsy can occur in animals other than humans (see main article Epilepsy). ... lAscension du Haut Mal, Tome 1 Epileptic is the English title of Lascension du haut mal, an autobiographical graphic novel by David B., originally published in French by LAssociation in six volumes from 1996 to 2003. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ... This article is about epileptic seizures. ... “Surgeon” redirects here. ...

Classification

Epilepsies are classified five ways:

1. By their first cause (or etiology).
2. By the observable manifestations of the seizures, known as semiology.
3. By the location in the brain where the seizures originate.
4. As a part of discrete, identifiable medical syndromes.
5. By the event that triggers the seizures, as in primary reading epilepsy.

In 1981, the International League Against Epilepsy (ILAE) proposed a classification scheme for individual seizures that remains in common use.^[5] This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy and is outlined later on in this article. In 1989, the ILAE proposed a classification scheme for epilepsies and epileptic syndromes.^[6] This can be broadly described as a two-axis scheme having the cause on one axis and the extent of localisation within the brain on the other. Since 1997, the ILAE have been working on a new scheme that has five axes: ictal phenomenon, seizure type, syndrome, etiology and impairment.^[7] This article is about the medical term. ... In medicine, the term syndrome is the association of several clinically recognizable features, signs, symptoms, phenomena or characteristics which often occur together, so that the presence of one feature alerts the physician to the presence of the others. ...

Diagnosis

The diagnosis of epilepsy requires the presence of recurrent, unprovoked seizures; accordingly, it is usually made based on the medical history. EEG, brain MRI, SPECT, PET, and magnetoencephalography may be useful to discover an etiology for the epilepsy, discover the affected brain region, or classify the epileptic syndrome, but these studies are not useful in making the initial diagnosis. The medical history of a patient (sometimes called anamnesis [1][2] ) is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis). ... “EEG” redirects here. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ... SPECT (Single Photon Emission Computed Tomography) is a nuclear medicine tomographic imaging technique using gamma rays. ... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three-dimensional image or map of functional processes in the body. ... Magnetoencephalography (MEG) is the measurement of the magnetic fields produced by electrical activity in the brain, usually conducted externally, using extremely sensitive devices such as SQUIDs. ... This article is about the medical term. ...

Long-term video-EEG monitoring for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost, low availability and inconvenience. Long-term video-EEG monitoring, also known as video telemetry, is a diagnostic technique used in certain patients with epilepsy or seizures. ...

Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions. These non-epileptic seizures can be hard to differentiate and may lead to misdiagnosis. Non-epileptic seizures are paroxysmal events that mimic an epileptic seizure but do not have a primary neurological cause within the brain. ...

Epilepsy covers conditions with different aetiologies, natural histories and prognoses, each requiring different management strategies. A full medical diagnosis requires a definite categorisation of seizure and syndrome types.^[8]

Triggers

The diagnosis of epilepsy requires that the seizures be unprovoked, with the implication that the provocant is assumed to be something obviously harmful. However, in some epilepsy syndromes, the provocant can reasonably be considered to be part of normal daily life. Examples of these normal provocants include reading, hot water on the head, hyperventilation, and flashing or flickering lights. This last provocant is a special type of reflex epilepsy called photosensitive epilepsy. Although assumed to be a common trigger for epilepsy, among both patients and the public, only around 5% of people with epilepsy are affected by flickering lights. In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Reflex Epilepsy (also known as environmental epilepsy) is the cognomens to seizures which are generated by a person’s acuteness to sensor stimulation caused by the environment. ... Photosensitive epilepsy is a form of epilepsy in which seizures are triggered by visual stimuli that form patterns in time or space, such as flashing lights, bold, regular patterns, or regular moving patterns. ...

Certain environmental factors can lead to an increased likelihood of seizures in someone with epilepsy or in certain syndromes, for example:

• being asleep
• the transition between sleep and wakefulness (hypnogogia)
• tiredness and sleep deprivation
• illness
• constipation
• menstruation
• stress or anxiety
• alcohol consumption.

Hypnogogia, also spelled hypnagogia and hypnopompia, are the names of experiences a person can go through when falling asleep in the case of hypnogogia, or waking up, in the case of hypnopompia. ... Illness (sometimes referred to as ill-health) can be defined as a state of poor health. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Not to be confused with Mensuration. ...

Epidemiology

Epilepsy is one of the most common of the serious neurological disorders.^[9] Genetic, congenital, and developmental conditions are mostly associated with it among younger patients; tumors are more likely over age 40; head trauma and central nervous system infections may occur at any age. The prevalence of active epilepsy is roughly in the range 5–10 per 1000 people. Up to 50 per 1000 people experience nonfebrile seizures at some point in life; epilepsy's lifetime prevalence is relatively high because most patients either stop having seizures or (less commonly) die. Epilepsy's approximate annual incidence rate is 40–70 per 100,000 in industrialized countries and 100–190 per 100,000 in resource-poor countries; socioeconomically deprived people are at higher risk. In industrialized countries the incidence rate decreased in children but increased among the elderly during the three decades prior to 2003, for reasons not fully understood.^[10] A genetic disorder is a condition caused by abnormalities in genes or chromosomes. ... A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... Developmental disorders are disorders that occur at some stage in a childs development, often retarding the development. ... For malignant tumors specifically, see cancer. ... Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ... Central nervous system infections are those infections of the central nervous system (CNS). ... In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... The incidence of disease is defined as the number of new cases of disease occurring in a population during a defined time interval. ...

Seizure types

Main article: Seizure types

Seizure types are organized firstly according to whether the source of the seizure within the brain is localized (partial or focal onset seizures) or distributed (generalized seizures). Partial seizures are further divided on the extent to which consciousness is affected. If it is unaffected, then it is a simple partial seizure; otherwise it is a complex partial (psychomotor) seizure. A partial seizure may spread within the brain - a process known as secondary generalization. Generalized seizures are divided according to the effect on the body but all involve loss of consciousness. These include absence (petit mal), myoclonic, clonic, tonic, tonic-clonic (grand mal) and atonic seizures. The numerous epileptic seizure types are most commonly defined and grouped according to a scheme proposed by the International League Against Epilepsy (ILAE) in 1981. ... Focal seizures (also called partial seizures) are seizures which are characterized by: preserved consciousness in simple focal seizures impaired consciousness (dream-like) in complex focal seizures experience of unusual feelings or sensations sudden and inexplainable feelings of joy, anger, sadness, or nausea altered sense of hearing, smelling, tasting, seeing, or... Simple partial seizures are seizures which affect only a small region of the brain, often the temporal lobes and/or hippocampi. ... A complex partial seizure is an epileptic attack that involves a greater degree of impairment or alteration of consciousness/awareness and memory than a simple partial seizure. ... Absence seizures are one of several kinds of seizures. ... Myoclonus is brief, involuntary twitching of a muscle or a group of muscles. ... Clonus (from the Greek for violent, confused motion) is a series of involuntary muscular contractions due to sudden stretching of the muscle. ... Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... Atonic seizures (also called drop seizures, drop attacks, or akinetic seizures), are a minor type of seizure. ...

Seizure syndromes

There are many different epilepsy syndromes, each presenting with its own unique combination of seizure type, typical age of onset, EEG findings, treatment, and prognosis. Below are some common seizure syndromes:

• Infantile spasms (West syndrome) is associated with brain development abnormalities, tuberous sclerosis, and perinatal insults to the brain. It affects infants (as implied by its name), which by definition is between 30 days to 1 year of life. It carries a poor prognosis such that only 5-10% of children with infantile spasms will develop normal to near-normal function, while more than two-thirds will have severe deficits. The typical seizures are characterized by sudden flexor and extensor spasms of head, trunk, and extremities. The key EEG finding in these patients is a hypsarrhythmia, or a high-voltage slow wave with multifocal spikes. The first line treatment for these patients is adrenocorticotropic hormone (ACTH or corticotropin) since traditional antiepileptic drugs generally cannot adequately control seizure activity. Vigabatrin is also used in many countries, and is particularly effective when tuberous sclerosis is the cause of seizures.

Generalized 3 Hz spike and wave discharges in EEG

• Childhood absence epilepsy affects children between the ages of 4 and 12 years of age. These patients have recurrent absence seizures that can occur hundreds of times a day. On EEG, one finds the stereotyped generalized 3 Hz spike and wave discharges. A subset of these patients will also develop generalized tonic-clonic seizures. This condition carries a fairly good prognosis in that these children do not usually show cognitive decline or neurological deficits. First line treatment for pure absence seizures is ethosuximide. If patients do not respond or have mixed seizures along with their absence seizures, then valproic acid can be used.

• Dravet's syndrome Severe myoclonic epilepsy of infancy (SMEI). This very rare syndrome is delimitated from benign myoclonic epilepsy by its severity and must be differentiated from the Lennox-Gastaut syndrome and Doose’s myoclonic-astatic epilepsy. Onset in first year of life. Symptoms peak at about 5 months of age with febrile hemiclonic or generalized status epilepticus. Boys twice as often affected as girls. Prognosis is poor. In 2005, there were at least around 450 cases reported in the worldwide literature but, now, it is impossible to count the known cases because many probably have been published twice because of the genetic research. Most cases are sporadic. Family history of epilepsy and febrile convulsions is present in around 25 percent of the cases, but familial cases are exceptionnal. From: www.dravet.com

• Benign focal epilepsies of childhood The most common syndromes comprising the benign focal epilepsies of childhood include Benign Childhood Epilepsy with Centro-Temporal Spikes (or benign rolandic epilepsy), and Benign Childhood Epilepsy with Occipital Paroxysms. Benign rolandic epilepsy begins in children between the ages of 3 and 16 years. Apart from their seizure disorder, these patients are otherwise normal. Seizures typically occur at night, and are brief, focal motor events affecting facial and pharyngeal muscles, though may be generalized convulsions as well. Focal seizures may be less frequently reported than more obvious generalized seizures. Between seizures, patients have a stereotyped EEG pattern that includes di- or triphasic sharp waves over the central-midtemporal (Rolandic) regions. Prognosis is quite good overall with seizures disappearing by adolescence. There is no consensus on the first line treatment, however most cases respond well to most anticonvulsants.

• Juvenile myoclonic epilepsy (JME) begins in patients aged 8 to 20 years. These patients have normal IQ and are otherwise neurologically intact. JME is thought to be genetic, though that is not to say that JME will show in immediate family members. The seizures are morning myoclonic jerks often with generalized tonic-clonic seizures that occur just after waking. 'Petit mal' or absence seizures are less common in cases of JME, but are known to occur more often in young girls. EEG readings reveal generalized spikes with 4-6 Hz spike wave discharges and multiple spike discharges. Interestingly, these patients are often first diagnosed when they have their first generalized tonic-clonic seizure later in life when they experience sleep deprivation (e.g., freshman year in college after staying up late to study for exams). Alcohol is a major contributing factor and those with severe JME should monitor their intake of units. Valproic acid is the first line treatment, whereas carbamazepine can actually worsen symptoms. This condition is lifelong, thus patients must be taught appropriate sleep hygiene to prevent generalized tonic-clonic seizures. The severity of JME varies from person to person - some will experience full blown tonic-clonic seizures regularly, others will suffer only under sufficient stress from lack of sleep and intoxication.

• Temporal lobe epilepsy is the most common epilepsy of adults. In most cases, the epileptogenic region is found in the mesial temporal structures (e.g., the hippocampus, amygdala, and parahippocampal gyrus). Seizures begin in late childhood and adolescence. There is an association with febrile seizures in childhood, and some studies have shown herpes simplex virus (HSV) DNA in these regions, suggesting that perhaps this epilepsy has an infectious etiology. Most of these patients have complex partial seizures sometimes preceded by an aura, and some TLE patients also suffer from secondary generalised tonic-clonic seizures. If the patient does not respond sufficiently to medical treatment, surgery may be considered.

• Fetal alcohol syndrome (FAS) is caused by prenatal alcohol exposure and results in central nervous system (CNS) damage. Seizure disorders due to prenatal alcohol exposure are one of several possible criteria for diagnosing FASD; however, any seizure disorder due to postnatal insult does not qualify as a diagnostic criterion for FASD.^[11]
• Frontal lobe epilepsy
• Lennox-Gastaut syndrome
• Occipital lobe epilepsy

West syndrome, otherwise known as infantile spasms, is an uncommon to rare form of malign epilepsy in infants. ... West syndrome, otherwise known as infantile spasms, is an uncommon to rare and serious form of epilepsy in infants. ... Tuberous sclerosis is a rare genetic disorder characterized by a triad of signs: seizures, mental retardation, and small benign facial skin tumors (angiofibromas). ... Hypsarrhythmia is abnormal interictal high amplitude waves and a background of irregular spikes seen in electroencephalogram, mostly in infant diagnosed with Infantile spasms. ... Pronunciation (IPA): /əˈdrinoʊˌkɔrtɪkoʊˈtrɒpɪk ˈhɔrmoʊn, əˈdrinoʊˌkɔrtɪkoʊˈtroʊpɪk ˈhɔrmoʊn/ Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone produced and secreted by the pituitary gland. ... Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone secreted from corticotropes in the anterior lobe of the pituitary gland in response to corticotropin-releasing hormone (CRH) released by the hypothalamus. ... Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone secreted from corticotropes in the anterior lobe of the pituitary gland in response to corticotropin-releasing hormone (CRH) released by the hypothalamus. ... Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a receptor agonist. ... Image File history File links Spike-waves. ... Image File history File links Spike-waves. ... Childhood absence epilepsy (CAE) is a subtype of idiopathic generalized epilepsy and is characterized by brief impairment of consciousness (absence seizure), typically without convulsions. ... Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures. ... Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ... Generalized epilepsy with febrile seizures plus (GEFS+) is a syndromic autosomal dominant disorder where afflicted individuals can exhibit numerous epilepsy phenotypes. ... Benign familial neonatal convulsions (BFNC) is a rare autosomal dominant inherited form of epilepsy. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Juvenile myoclonic epilepsy (JME), also known as Janz syndrome, is a fairly common form of idiopathic generalized epilepsy affecting up to 10% of the population. ... Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ... This article does not cite any references or sources. ... For other uses, see Aura. ... Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... Fetal alcohol syndrome or FAS is a disorder of permanent birth defects that occurs in the offspring of women who drink alcohol during pregnancy. ... This article does not cite any references or sources. ... A diagram showing the CNS: 1. ... This condition is similar to temporal lobe epilepsy because it is a type of focal seizure, which means that the seizure starts in a focal area of the brain, and in this case that focus is in the frontal lobe. ... Lennox-Gastaut syndrome (LGS), also known as Lennox syndrome, is a difficult to treat form of childhood-onset epilepsy, that most often appears between the second and sixth year of life and is characterized by frequent seizures and different seizure types and is often accompanied by mental retardation and behavior...

Treatment

Epilepsy is usually treated with medication prescribed by a physician; primary caregivers, neurologists, and neurosurgeons all frequently care for people with epilepsy. In some cases the implantation of a stimulator of the vagus nerve, or a special diet can be helpful. Neurosurgical operations for epilepsy can be palliative, reducing the frequency or severity of seizures; or, in some patients, an operation can be curative. This article does not cite any references or sources. ... For other uses, see Doctor. ... Primary care may be provided in community health centres. ... Neurology is the branch of medicine that deals with the nervous system and disorders affecting it. ... Neurosurgery is the surgical discipline focused on treating the central and peripheral nervous system. ... The vagus nerve (also called pneumogastric nerve or cranial nerve X) is the tenth of twelve paired cranial nerves, and is the only nerve that starts in the brainstem (within the medulla oblongata) and extends, through the jugular foramen, down below the head, to the abdomen. ... Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ...

Responding to a seizure

In most cases, the proper emergency response to a generalized tonic-clonic epileptic seizure is simply to prevent the patient from self-injury by moving him or her away from sharp edges, placing something soft beneath the head, and carefully rolling the person into the recovery position to avoid asphyxiation. In some cases the person may seem to start snoring loudly following a seizure, before coming to. This merely indicates that the person is beginning to breathe properly and does not mean he or she is suffocating. Should the person regurgitate, the material should be allowed to drip out the side of the person's mouth by itself. If a seizure lasts longer than 5 minutes, or if the seizures begin coming in 'waves' one after the other - then Emergency Medical Services should be contacted immediately. Prolonged seizures may develop into status epilepticus, a dangerous condition requiring hospitalization and emergency treatment. Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... For other uses of the word head, see head (disambiguation). ... A form of the recovery position. ... Asphyxia is a condition of severely deficient supply of oxygen to the body. ... Snoring is the act of breathing through the open mouth in such a way as to cause a vibration of the uvula and soft palate, thus giving rise to a sound which may vary from a soft noise to a loud unpleasant sound. ... An Emergency medical service (abbreviated to initialism EMS in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency. ...

Objects should never be placed in a person's mouth by anybody - including paramedics - during a seizure as this could result in serious injury to either party. Despite common folklore, it is not possible for a person to swallow their own tongue during a seizure. However, it is possible that the person will bite their own tongue, especially if an object is placed in the mouth. For other uses, see Mouth (disambiguation). ... This article does not cite any references or sources. ... For other uses, see Tongue (disambiguation). ...

With other types of seizures such as simple partial seizures and complex partial seizures where the person is not convulsing but may be hallucinating, disoriented, distressed, or unconscious, the person should be reassured, gently guided away from danger, and sometimes it may be necessary to protect the person from self-injury, but physical force should be used only as a last resort as this could distress the person even more. In complex partial seizures where the person is unconscious, attempts to rouse the person should not be made as the seizure must take its full course. After a seizure, the person may pass into a deep sleep or otherwise they will be disoriented and often unaware that they have just had a seizure, as amnesia is common with complex partial seizures. The person should remain observed until they have completely recovered, as with a tonic-clonic seizure. A complex partial seizure is an epileptic attack that involves a greater degree of impairment or alteration of consciousness/awareness and memory than a simple partial seizure. ...

After a seizure, it is typical for a person to be exhausted and confused. Often the person is not immediately aware that they have just had a seizure. During this time one should stay with the person - reassuring and comforting them - until they appear to act as they normally would. Seldom during seizures do people lose bladder or bowel control. In some instances the person may vomit after coming to. People should not eat or drink until they have returned to their normal level of awareness, and they should not be allowed to wander about unsupervised. Many patients will sleep deeply for a few hours after a seizure - this is common for those having just experienced a more violent type of seizure such as a tonic-clonic. In about 50% of people with epilepsy, headaches may occur after a seizure. These headaches share many features with migraines, and respond to the same medications. Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ...

It is helpful if those present at the time of a seizure make note of how long and how severe the seizure was. It is also helpful to note any mannerisms displayed during the seizure. For example, the individual may twist the body to the right or left, may blink, might mumble nonsense words, or might pull at clothing. Any observed behaviors, when relayed to a neurologist, may be of help in diagnosing the type of seizure which occurred.

Pharmacologic treatment

Main article: Anticonvulsant

Mechanisms of Drug Action:- 1- Sodium channel blockers (voltage dependent) 2- Calcium channel blockers (T-type) 3- Potentiate the effect of GABA (inhibitory) 4- Decrease the excitatory transmission (glutaminic) Some medications can be taken daily in order to prevent seizures altogether or reduce the frequency of their occurrence. These are termed "anticonvulsant" or "antiepileptic" drugs (sometimes AEDs). All such drugs have side effects that are idiosyncratic and others that are dosage-dependent. It is not possible to predict who will suffer from side effects or at what dose the side effects will appear. The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ...

Some people with epilepsy will experience a complete remission when treated with an anticonvulsant medication. If this does not occur, the dose of medication may be increased, or another medication may be added to the first. The general strategy is to increase the medication dose until either the seizures are controlled, or until dose-limiting side effects appear; at which point the medication dose is reduced to the highest amount that does not produce undesirable side effects.

Serum levels of AEDs can be checked to determine medication compliance and to assess the effects of drug-drug interactions; some physicians do not use serum levels to fine tune medication, but other physicians believe that serum levels provide excellent data for tailoring medications to suit an individual's specific and relatively variable body chemistry. For example, therapeutic doses (the dose at which seizures are controlled and side effects are minimal and tolerable) may vary widely from among patients. The therapeutic ranges provided by pharmaceutical companies are only ranges and by using blood serum levels and seizures diaries, better seizure control can sometimes be reached. In some cases (such as a seizure flurry) serum levels can be useful to know if the level is very high or very low. Compliance (or Adherence) in a medical context refers to a patient both agreeing to and then undergoing some part of their treatment program as advised by their doctor or other healthcare worker. ...

If a person's epilepsy cannot be brought under control after adequate trials of two or three (experts vary here) different drugs, that person's epilepsy is generally said to be 'medically refractory.'

Various drugs may prevent seizures or reduce seizure frequency: these include carbamazepine (common brand name Tegretol), clobazam (Frisium), clonazepam (Klonopin), ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin (Cerebyx), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin), pregabalin (Lyrica), primidone (Mysoline), sodium valproate (Epilim), tiagabine (Gabitril), topiramate (Topamax), valproate semisodium (Depakote, Epival), valproic acid (Depakene, Convulex), vigabatrin (Sabril), and zonisamide (Zonegran). Carbamazepine (CBZ) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ... Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures. ... Felbamate (marketed as Felbamol by MedPointe) is an anticonvulsant drug used in the treatment of epilepsy. ... Fosphenytoin (Cerebyx®, Parke-Davis) is a water-soluble phenytoin prodrug used in only in hospitals for the treatment of epileptic seizures. ... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Levetiracetam (INN) (IPA: ) is an anticonvulsant medication used to treat epilepsy. ... Oxcarbazepine (marketed as Trileptal® by Novartis) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Phenobarbital (INN) or phenobarbitone (former BAN) is a barbiturate, first marketed as Luminal by Farbwerke Fr. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Pregabalin (brand name: Lyrica®) is a new anticonvulsant drug indicated as an add on therapy for partial onset seizures and for certain types of neuropathic pain. ... Primidone is an anticonvulsant of the pyrimidinedione[4] class whose active metabolites, phenobarbital (major) and phenylethylmalonamide (PEMA) (minor), are also anticonvulsants. ... Sodium valproate (INN) or valproate sodium (USAN) is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy. ... Tiagabine is an anti-convulsive medication produced by Cephalon and marketed under the brand name Gabitril. ... Topiramate (brand name Topamax) is an anticonvulsant drug produced by Ortho-McNeil Neurologics, a division of Johnson & Johnson. ... Valproate semisodium (INN) or divalproex sodium (USAN) consists of a compound of sodium valproate and valproic acid in a 1:1 molar relationship in an enteric coated form. ... Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ... Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a receptor agonist. ... Zonisamide (brand name Zonegran®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ...

Other drugs are commonly used to abort an active seizure or interrupt a seizure flurry; these include diazepam (Valium) and lorazepam (Ativan). Drugs used only in the treatment of refractory status epilepticus include paraldehyde (Paral) and pentobarbital (Nembutal). Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Paraldehyde is the cyclic form of three acetaldehyde molecules (a trimer). ... Pentobarbital is a short acting barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol. ...

Bromides were the first of the effective anticonvulsant pure compounds, but are no longer used in humans^[12] due to their toxicity and low efficacy. Potassium bromide (KBr) is a salt, used as an anticonvulsant and a sedative in the 1800s. ... // Toxic and Intoxicated redirect here – toxic has other uses, which can be found at Toxicity (disambiguation); for the state of being intoxicated by alcohol see Drunkenness. ... Efficacy is the ability to produce a desired amount of a desired effect. ...

It has been found that taking valproates while pregnant can have high chances of reduced IQ towards children.^[13][14] Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ...

Surgical treatment

Surgical treatment can be an option for epilepsy when an underlying brain abnormality, such as a benign tumor or an area of scar tissue (e.g. hippocampal sclerosis) can be identified. The abnormality must be removable by a neurosurgeon. For malignant tumors specifically, see cancer. ... Hippocampal Sclerosis or Ammons horn sclerosis (AHS) is the most common type of neuropathological damage seen in individuals with temporal lobe epilepsy (TLE). ...

Surgery is usually only offered to patients when their epilepsy has not been controlled by adequate attempts with multiple medications. Before surgery is offered, the medical team conducts many tests to assess whether removal of brain tissue will result in unacceptable problems with memory, vision, language or movement, which are controlled by different parts of the brain. These tests usually include a neuropsychological evaluation, which sometimes includes an intracarotid sodium amobarbital test (Wada test) - although this invasive procedure is being replaced by non-invasive functional MRI in many centres. Resective surgery, as opposed to palliative, successfully eliminates or significantly reduces seizures in about 50-90% of the patients who undergo it (the exact percentage depends on the particulars of the case and surgeon in question.) Many patients decide not to undergo surgery owing to fear or the uncertainty of having a brain operation. For other uses, see Memory (disambiguation). ... In psychology, visual perception is the ability to interpret visible light information reaching the eyes which is then made available for planning and action. ... In a general sense, locomotion simply means active movement or travel, applying not just to biological individuals. ... Human brain In animals, the brain (enkephale) (Greek for in the skull), is the control center of the central nervous system, responsible for behavior. ... Neuropsychology is a branch of psychology and neurology that aims to understand how the structure and function of the brain relate to specific psychological processes and overt behaviors. ... The Wada test, also known as the intracarotid sodium amobarbital procedure (ISAP), is used to establish which cerebral functions are localised to which hemisphere. ... The Wada test, also known as the intracarotid sodium amobarbital procedure (ISAP), is used to establish which cerebral functions are localised to which hemisphere. ...

The most common form of resective surgical treatment for epilepsy is to remove the front part of either the right or left temporal lobe. A study of 48 patients who underwent this operation, anterior temporal lobectomy, between 1965 and 1974 determined the long-term success of the procedure. Of the 48 patients, 21 had had no seizures that caused loss of consciousness since the operation. Three others had been free of seizures for at least 19 years. The rest had either never been completely free of seizures or had died between the time of the surgery and commencement of the study.^[15] The temporal lobes are part of the cerebrum. ... Anterior temporal lobectomy is the complete removal of the anterior portion of the temporal lobe of the brain. ... Year 1965 (MCMLXV) was a common year starting on Friday (link will display full calendar) of the 1965 Gregorian calendar. ... Year 1974 (MCMLXXIV) was a common year starting on Tuesday (link will display full calendar) of the 1974 Gregorian calendar. ...

Palliative surgery for epilepsy is intended to reduce the frequency or severity of seizures. Examples are callosotomy or commissurotomy to prevent seizures from generalizing (spreading to involve the entire brain), which results in a loss of consciousness. This procedure can therefore prevent injury due to the person falling to the ground after losing consciousness. It is performed only when the seizures cannot be controlled by other means. Resective surgery can be considered palliative if it is undertaken with the expectation that it will reduce but not eliminate seizures. Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ... Split-brain is a lay term to describe the result when the corpus callosum connecting the two halves of the brain is severed to some degree. ... Surgical incision of a commissure in the body, as one made in the heart to relieve constriction of the mitral valve or one made in the brain to treat certain psychiatric disorders. ...

Hemispherectomy is a drastic operation in which most or all of one half of the cerebral cortex is removed. It is reserved for people suffering from the most catastrophic epilepsies, such as those due to Rasmussen syndrome. If the surgery is performed on very young patients (2-5 years old), the remaining hemisphere may acquire some rudimentary motor control of the ipsilateral body; in older patients, paralysis results on the side of the body opposite to the part of the brain that was removed. Because of these and other side effects it is usually reserved for patients who have exhausted other treatment options. Hemispherectomy is a medical procedure where one hemisphere (half) of the brain is removed. ... Rasmussens encephalitis is a rare, progressive neurological disorder, characterized by frequent and severe seizures, loss of motor skills and speech, hemiparesis (paralysis on one side of the body), encephalitis (inflammation of the brain), dementia, and mental deterioration. ...

Other treatment

Ketogenic diets may occasionally be effective in controlling some types of epilepsy; although the mechanism behind the effect is not fully understood, shifting of pH towards a metabolic acidosis and alteration of brain metabolism may be involved. Ketogenic diets are high in fat and extremely low in carbohydrates, with intake of fluids often limited. This treatment, originated as early as the 1920s at Johns Hopkins Medical Center, was largely abandoned with the discovery of modern anti-epileptic drugs, but recently has returned to the anti-epileptic treatment arsenal. Ketogenic diets are sometimes prescribed in severe cases where drugs have proven ineffective. The ketogenic diet is a very high fat diet that relies on inducing a state of ketosis. ... For other uses, see PH (disambiguation). ... In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ... Structure of the coenzyme adenosine triphosphate, a central intermediate in energy metabolism. ... For other uses, see FAT. Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. ... Lactose is a disaccharide found in milk. ... The 1920s is sometimes referred to as the Jazz Age or the Roaring Twenties, usually applied to America. ... The Dome of the Johns Hopkins Hospital as seen from Broadway. ...

A study conducted by Johns Hopkins reported that 50% of those patients starting the Ketogenic diet reported a decrease in seizures of 50% or more, with 29% of patients reporting a 90% reduction in symptoms; these patients had previously tried an average of six anticonvulsant drugs.

Vagus nerve stimulation (VNS) is a recently developed form of seizure control which uses an implanted electrical device, similar in size, shape and implant location to a heart pacemaker, which connects to the vagus nerve in the neck. Once in place the device can be set to emit electronic pulses, stimulating the vagus nerve at pre-set intervals and milliamp levels. Treatment studies have shown that approximately 50% of those treated in this fashion will show significant seizure frequency reduction. Vagus nerve stimulation (VNS) is an adjunctive treatment for certain types of intractable epilepsy and clinical depression. ... A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device designed by Nitish and Raheel to regulate the beating of the heart. ... The vagus nerve (also called pneumogastric nerve or cranial nerve X) is the tenth of twelve paired cranial nerves, and is the only nerve that starts in the brainstem (within the medulla oblongata) and extends, through the jugular foramen, down below the head, to the abdomen. ... For other uses, see Neck (disambiguation). ...

The Responsive Neurostimulator System (RNS) is currently undergoing clinical study prior to FDA approval. This system relies upon a device implanted just under the scalp. The leads attached to the device are implanted either on the brain surface or in the brain area itself and are located close to the area where the seizures are believed to start. When a seizure begins, small amounts of electrical stimulation are delivered to suppress it. This system is different from the VNS system in that the RNS relies on direct brain stimulation and the RNS is a responsive system. The VNS pulses at predetermined intervals previously set by medical personnel. The RNS system is designed to respond to detected signs that a seizure is about to begin and can record events and allow customized response patterns which may provide a greater degree of seizure control.^[16]

A seizure response dog is a form of service dog that is trained to summon help or ensure personal safety when a seizure occurs. These are not suitable for everybody and not all dogs can be so trained. Rarely, a dog may develop the ability to sense a seizure before it occurs.^[17] Seizure response dogs are a special type of service dog, specifically trained to help someone who has epilepsy. ... A service dog is a type of assistance dog, specifically trained to help people who have disabilities other than visual or hearing impairment. ...

A number of systematic reviews by the Cochrane Collaboration into treatments for epilepsy looked at acupuncture,^[18] psychological interventions,^[19] vitamins^[20] and yoga^[21] and found there is no reliable evidence to support the use of these as treatments for epilepsy. Further studies are needed on the subject. Systematic reviews are named as the highest level of medical evidence, by evidence based medicine professionals. ... The Cochrane Collaboration developed in response to Archie Cochranes call for systematic, up-to-date reviews (currently known as systematic reviews) of all relevant randomized clinical trials of health care. ... Acupuncture chart from Hua Shou (fl. ... Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Retinol (Vitamin A) Vitamins are nutrients required in very small amounts for essential metabolic reactions in the body [1]. The term vitamin does not encompass other essential nutrients such as dietary minerals, essential fatty acids, or essential amino acids. ... For other uses, see Yoga (disambiguation). ... Evidence-based medicine (EBM) or scientific medicine is an attempt to apply more uniformly the standards of evidence gained from the scientific method to certain aspects of medical practice. ...

Electrophysiology

Most epileptics seize without warning, and their seizures can have dangerous or fatal consequences, if they come at a bad time and lead to an accident. In the brain, identifiable electrical changes precede the clinical onset of a seizure by tens of seconds, and these changes can be recorded in an electroencephalogram (EEG). Many people have wondered if EEG’s might be used to predict seizures minutes or even hours ahead of time, but as of now, this sort of prediction has not been feasible.^[22] Many researchers are working, however, to create a system capable of detecting seizures before they clinically manifest themselves. This article is about the neurological disorder as it affects humans. ... Electroencephalography is the neurophysiologic exploration of the electrical activity of the brain by the application of electrodes to the scalp. ... EEG can mean: Electroencephalography - the method and science of recording and interpreting traces of brain electrical activity as recorded from the skull surface or the device used to record such traces Emperor Entertainment Group - A Hong Kong entertainment company. ...

The early detection of a seizure has many potential benefits. Advanced warning would allow patients to take action to minimize their risk of injury and, in some circumstances, would allow them to summon help. An automatic detection system could also be made to trigger pharmacological intervention in the form of fast-acting drugs or electrical stimulation. Functional electrical stimulation (commonly abbreviated as FES) is a technique that uses electrical currents to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury (SCI), head injury, stroke or other neurological disorders, restoring function in people with disabilities. ...

It is relatively easy to place the electrodes needed to record an EEG, but it has not been so easy to develop an algorithm to detect the onset of a seizure. For any given patient, assuming his or her seizures originate in one focus, seizure-onset EEG patterns are largely conserved from one seizure episode to the next. Unfortunately, there is great EEG variation between patients, both in terms of baseline and in terms of seizure-onset patterns. This variation has made the development of a generic, “one-size-fits-all” algorithm difficult. Alternative meanings: There is also an Electric-type Pokémon named Electrode. ... In mathematics, computing, linguistics, and related disciplines, an algorithm is a finite list of well-defined instructions for accomplishing some task that, given an initial state, will terminate in a defined end-state. ...

Patient-specific algorithms based on machine learning have shown more promise. Machine learning algorithms compute binary decision trees from manually labeled training sets of data. EEG data must be translated into a format that the computer can interpret. Important information must be kept while superfluous information must be discarded. Although there are many conceivable ways of performing this “feature extraction,” wavelet decomposition seems to be an effective way of extracting pertinent information from EEG signals. As a broad subfield of artificial intelligence, machine learning is concerned with the design and development of algorithms and techniques that allow computers to learn. At a general level, there are two types of learning: inductive, and deductive. ... In pattern recognition and in image processing, Feature extraction is a special form of dimensionality reduction. ...

The training set for the machine-learning algorithm must be labeled by hand. For an algorithm being developed by Dr. Schachter and Prof. Guttag of MIT, EEG recordings are split into two-second time windows, and each window is labeled as “seizure onset” or “not seizure onset.” Mapúa Institute of Technology (MIT, MapúaTech or simply Mapúa) is a private, non-sectarian, Filipino tertiary institute located in Intramuros, Manila. ...

The algorithm then takes the labeled training set and uses it to construct a decision tree capable of classifying unlabeled EEG patterns as “seizure onset” or “not seizure onset.” The training set is unavoidably unbalanced because most time windows do not involve seizures. Certain algorithms, such as the support vector machine algorithm chosen by Schachter and Guttag, are better suited than others to handle this unbalanced training set.

In the hospital, the patient-specific algorithm of Schachter and Guttag has worked fairly well. In one trial, it detected 131 out of 139 seizures in 36 patients. In another, it caught 53 out of 58 seizures. The algorithm outperformed generic algorithms.

In the future, Dr. Schachter and Prof. Guttag hope to improve their algorithm so that it is less sensitive to electrode placement and so that it functions effectively with input from fewer electrodes and with smaller training sets. Their goal is to create an unobtrusive device that can be worn continually by epileptics to detect impending seizures. Such a device would greatly enhance the ability of these people to safely go about their lives.

Pathophysiology

Mutations in several genes have been linked to some types of epilepsy. Several genes that code for protein subunits of voltage-gated and ligand-gated ion channels have been associated with forms of generalized epilepsy and infantile seizure syndromes.^[23] Several ligand-gated ion channels have been linked to some types of frontal and generalized epilepsies. Epilepsy-related mutations in some non-ion channel genes have also been identified. For linguistic mutation, see Apophony. ... For other uses, see Gene (disambiguation). ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Voltage-gated ion channel is a ion channel that is specifically activated, or gated, by the surrounding potential difference near the channel (or near the cell, neuron or synapse). ... Ligand-gated ion channel is a broad term that refers to any ion channel that is gated (i. ... Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells (see cell potential) by allowing the flow of ions down their electrochemical gradient. ...

One interesting finding in animals is that repeated low-level electrical stimulation to some brain sites can lead to permanent increases in seizure susceptibility: in other words, a permanent decrease in seizure "threshold." This phenomenon, known as kindling (by analogy with the use of burning twigs to start a larger fire) was discovered by Dr. Graham Goddard in 1967. Chemical stimulation can also induce seizures; repeated exposures to some pesticides have been shown to induce seizures in both humans and animals. One mechanism proposed for this is called excitotoxicity. The roles of kindling and excitotoxicity, if any, in human epilepsy are currently hotly debated. Kindling is material for starting a fire. ... Excitotoxicity is the pathological process by which nerve cells are damaged and killed by glutamate and similar substances. ...

Other causes of epilepsy are brain lesions, where there is scar tissue or another abnormal mass of tissue in an area of the brain.

History and stigma

The word epilepsy is derived from the Greek epilepsia, which in turn can be broken in to epi- (upon) and lepsis (to take hold of, or seizure)^[24] In the past, epilepsy was associated with religious experiences and even demonic possession. In ancient times, epilepsy was known as the "Sacred Disease" because people thought that epileptic seizures were a form of attack by demons, or that the visions experienced by persons with epilepsy were sent by the gods. Among animist Hmong families, for example, epilepsy was understood as an attack by an evil spirit, but the affected person could become revered as a shaman through these otherworldly experiences.[1] Various Religious symbols, including (first row) Christian, Jewish, Hindu, Bahai, (second row) Islamic, tribal, Taoist, Shinto (third row) Buddhist, Sikh, Hindu, Jain, (fourth row) Ayyavazhi, Triple Goddess, Maltese cross, pre-Christian Slavonic Religion is the adherence to codified beliefs and rituals that generally involve a faith in a spiritual... “Fiend” redirects here. ... Spiritual possession is a concept of supernatural and/or superstitious belief systems whereby gods, daemons, demons, animas, or other disincarnate entities may temporarily take control of a human body, resulting in noticeable changes in behaviour. ... “Fiend” redirects here. ... In religion, visions comprise inspirational renderings, generally of a future state and/or of a mythical being, and are believed (by followers of the religion) to come from a deity, directly or indirectly via prophets, and serve to inspire or prod believers as part of a revelation or an epiphany. ... This article is about the term Deity in the context of mysticism and theology. ... This article is in need of attention. ... Hmong may refer to: Hmong people, an ethnic group in China and Southeast Asia Hmong language, a cluster of closely related Hmong-Mien languages Hmong customs and culture Category: ... The shaman is an intellectual and spiritual figure who is regarded as possessing power and influence on other peoples in the tribe and performs several functions, primarily that of a healer ( medicine man). The shaman provides medical care, and serves other community needs during crisis times, via supernatural means (means...

However, in most cultures, persons with epilepsy have been stigmatized, shunned, or even imprisoned; in the Salpêtrière, the birthplace of modern neurology, Jean-Martin Charcot found people with epilepsy side-by-side with the mentally retarded, those with chronic syphilis, and the criminally insane. In Tanzania to this day, as with other parts of Africa, epilepsy is associated with possession by evil spirits, witchcraft, or poisoning and is believed by many to be contagious.^[25] In ancient Rome, epilepsy was known as the Morbus Comitialis ('disease of the assembly hall') and was seen as a curse from the gods. The Pitié-Salpêtrière Hospital is a hospital in Paris. ... Categories: People stubs | French physicians | 1825 births | 1893 deaths | History of medicine ... Syphilis is a curable sexually transmitted disease caused by the Treponema pallidum spirochete. ...

Stigma continues to this day, in both the public and private spheres, but polls suggest it is generally decreasing with time, at least in the developed world; Hippocrates remarked that epilepsy would cease to be considered divine the day it was understood.^[26] For other uses, see Hippocrates (disambiguation). ...

Notable people with epilepsy

Main article: List of people with epilepsy

Many notable people, past and present, have carried the diagnosis of epilepsy. In many cases, their epilepsy is a footnote to their accomplishments; for some, it played an integral role in their fame. Historical diagnoses of epilepsy are not always certain; there is controversy about what is considered an acceptable amount of evidence in support of such a diagnosis.-1...

Legal implications

Most people diagnosed with epilepsy are forbidden by their local laws from operating vehicles. However, there are usually exceptions for those who can prove that they have stabilized their condition. Those few whose seizures do not cause impairment of consciousness, or whose seizures only arise from sleep, may be exempt from such restrictions, depending on local laws. There is an ongoing debate in bioethics over who should bear the burden of ensuring that an epilepsy patient does not drive a car or fly an airplane. Bioethics is the ethics of biological science and medicine. ...

In the U.S., people with epilepsy can drive if their seizures are controlled with treatment and they meet the licensing requirements in their state. How long they have to be free of seizures varies in different states, but it is most likely to be between three months and a year.^[27][28] The majority of the 50 states place the burden on patients to report their condition to appropriate licensing authorities so that their privileges can be revoked where appropriate. A minority of states (including California) place the burden of reporting on the patient's physician. After reporting is carried out, it is usually the driver's licensing agency that decides to revoke or restrict a driver's license. Motto: (traditional) In God We Trust (official, 1956–present) Anthem: The Star-Spangled Banner Capital Washington, D.C. Largest city New York City Official language(s) None at the federal level; English de facto Government Federal Republic  - President George W. Bush (R)  - Vice President Dick Cheney (R) Independence - Declared - Recognized... This article is about the U.S. state. ...

In the UK, it is the responsibility of the patients to inform the Driver and Vehicle Licensing Agency (DVLA) if they have epilepsy.^[29] The DVLA rules are quite complex,^[30] but in summary,^[31] those continuing to have seizures or who are within 6 months of medication change may have their licence revoked. A doctor who becomes aware that a patient with uncontrolled epilepsy is continuing to drive has, after reminding the patient of their responsibility, a duty to break confidentiality and inform the DVLA. The doctor should advise the patient of the disclosure and the reasons why their failure to notify the agency obliged the doctor to act. The Driver and Vehicle Licensing Agency (the DVLA) is an agency of the Department for Transport in the United Kingdom. ... Confidentiality has been defined by the International Organization for Standardization (ISO) as ensuring that information is accessible only to those authorized to have access and is one of the cornerstones of Information security. ...

Important investigators of epilepsy

• Jean-Martin Charcot
• John Hughlings Jackson
• Hans Berger
• Herbert Jasper
• Wilder Penfield
• H. Houston Merritt
• William G. Lennox

Categories: People stubs | French physicians | 1825 births | 1893 deaths | History of medicine ... John Hughlings Jackson (1835–1911), was an English neurologist; born at Providence, Green Hammerton, Yorkshire. ... Hans Berger was born in May 21, 1873, in Neuses near Coburg, Thuringia, Germany. ... Herbert Henri Jasper (July 27, 1906 – March 11, 1999) was a Canadian psychologist, physiologist, anatomist, chemist and neurologist. ... Dr Wilder Graves Penfield, CC, OM, CMG, MD, FRS (January 25/26, 1891 – April 5, 1976) was a American-born Canadian neurosurgeon. ... H. Houston Merritt (1902-1979) was one of the pre-eminent academic neurologists of his day. ... William Gordon Lennox (1884–1960) was an American neurologist who was a pioneer in the use of electroencephalography (EEG) for the diagnosis and treatment of epilepsy. ...

See also

• Seizure
• Non-epileptic seizures
• Epilepsy in animals
• Seizure response dog
• Jacksonian seizure
• Photosensitive epilepsy
• Temporal lobe epilepsy
• Abdominal epilepsy
• Generalised epilepsy
• ISAS (Ictal-Interictal SPECT Analysis by SPM)

This article is about epileptic seizures. ... Non-epileptic seizures are paroxysmal events that mimic an epileptic seizure but do not have a primary neurological cause within the brain. ... Epilepsy can occur in animals other than humans (see main article Epilepsy). ... Seizure response dogs are a special type of service dog, specifically trained to help someone who has epilepsy. ... Jacksonian seizures are associated with a form of epilepsy. ... Photosensitive epilepsy is a form of epilepsy in which seizures are triggered by visual stimuli that form patterns in time or space, such as flashing lights, bold, regular patterns, or regular moving patterns. ... This article does not cite any references or sources. ... Abdominal epilepsy describes a group of gastrointestinal (GI) disturbances caused by epileptiform seizure activity seen on EEG tracing. ... Generalised epilepsy is a form of epilepsy, a chronic neurological condition characterized by recurrent seizures, which are a result of abnormal activity in both sides of the brain. ... There are very few or no other articles that link to this one. ...

Notes and references

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... WHO redirects here. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 165th day of the year (166th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 199th day of the year (200th in leap years) in the Gregorian calendar. ... The National Society for Epilepsy (NSE) is the largest medical charity in the field of epilepsy in the UK, providing services for people with epilepsy for over 100 years. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 30th day of the year in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 88th day of the year (89th in leap years) in the Gregorian calendar. ... is the 342nd day of the year (343rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 143rd day of the year (144th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 306th day of the year (307th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 289th day of the year (290th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 328th day of the year (329th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 156th day of the year (157th in leap years) in the Gregorian calendar. ... is the 281st day of the year (282nd in leap years) in the Gregorian calendar. ... Epilepsy Action is a UK based charity providing information, advice and support for people with epilepsy. ...

External links

Patient Resources

• Epilepsy information and advice from Epilepsy Action.
• Epilepsy Information Page from the National Institute of Neurological Disorders and Stroke.
• Health Topics: Epilepsy from MedlinePlus.
• Epilepsy.com from the Epilepsy Therapy Project.
• Information on epilepsy from the National Society for Epilepsy.
• Answerplace from the Epilepsy Foundation.
• Epilepsy clinical trial

Epilepsy Action is a UK based charity providing information, advice and support for people with epilepsy. ... The National Institute of Neurological Disorders and Stroke is a part of the U.S. National Institutes of Health. ... MedlinePlus (medlineplus. ... The National Society for Epilepsy (NSE) is the largest medical charity in the field of epilepsy in the UK, providing services for people with epilepsy for over 100 years. ...

Professional resources

• International League Against Epilepsy.
• e-epilepsy from the National Society for Epilepsy.
• Seizures and Epilepsy from eMedicine.
• Epilepsy Currents from PubMed Central

The National Society for Epilepsy (NSE) is the largest medical charity in the field of epilepsy in the UK, providing services for people with epilepsy for over 100 years. ... Epilepsy Currents (ISSN 1535-7597), the official journal of the American Epilepsy Society (AES), was founded in 2001. ...

Lists of organizations

Many organisations provide regional support for those with epilepsy, their families and professionals in the field. Lists of such groups can be found at:

• Epilepsy.com: Epilepsy Websites.
• International Bureau for Epilepsy (IBE) An umbrella group for various national and regional epilepsy support organisations. For local groups, see their list of chapters and friends.
• The International League Against Epilepsy (ILAE). A list of professional organisations at ILAE: Links.
• The Joint Epilepsy Council of the UK and Ireland - The JEC is an umbrella organisation which exists to represent the united voice of a number of UK and Irish based epilepsy charities.

The Human Nervous System. ... A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... A diagram showing the CNS: 1. ... Meningitis is the inflammation of the protective membranes covering the central nervous system, known collectively as the meninges. ... Arachnoiditis describes a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. ... Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. ... Myelitis is a human disease involving swelling of the spinal cord, which disrupts central nervous system functions linking brain and limbs. ... Encephalomyelitis is a general term for inflammation of the brain and spinal cord, describing a number of disorders: acute disseminated encephalomyelitis or postinfectious encephalomyelitis, a demyelinating disease of the brain and spinal cord, possibly triggered by vaccination or viral infection; encephalomyelitis disseminata, a synonym for multiple sclerosis; equine encephalomyelitis, a... Acute disseminated encephalomyelitis (ADEM) is an immune mediated disease of brain. ... Tropical spastic paraparesis (TSP) is an infection of the spinal cord by Human T-lymphotropic virus resulting in paraparesis or weakness of the legs. ... Atrophy is the partial or complete wasting away of a part of the body. ... Spinocerebellar ataxia (SCA) is a genetic disease with multiple types, each of which could be considered a disease in its own right. ... Friedreichs ataxia is a rare autosomal recessive disorder caused by a mutation in Gene X25 that codes for frataxin, located on chromosome 9. ... Ataxia-telangiectasia (AT) (Boder-Sedgwick syndrome or Louis-Bar syndrome) is a primary immunodeficiency disorder that occurs in an estimated incidence of 1 in 40,000 to 1 in 300,000 births (Lederman, 2000). ... Hereditary spastic paraplegia (HSP), also called familial spastic paraparesis (FSP), refers to a group of inherited disorders that are characterized by progressive weakness and stiffness of the legs. ... Spinal Muscular Atrophy (SMA) is a term applied to a number of different disorders, all having in common a genetic cause and the manifestation of weakness due to loss of the motor neurons of the spinal cord and brainstem. ... Werdnig-Hoffman disease (or Infantile spinal muscular atrophy, type I) is an autosomal recessive muscular disease. ... Kugelberg-Welander disease (or juvenile spinal muscular atrophy, type III) is an autosomal recessive muscular disease. ... Fazio Londe Syndrome is an inherited motor neuron disease found in children and young adults. ... The motor neurone diseases (MND) are a group of progressive neurological disorders that destroy motor neurones, the cells that control voluntary muscle activity such as speaking, walking, breathing, and swallowing. ... Amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrigs Disease, Maladie de Charcot or motor neurone disease) is a progressive, fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement. ... Progressive muscular atrophy (PMA) is a rare subtype of Motor neurone disease (MND) which affects only the lower motor neurones. ... Progressive bulbar palsy is a form of motor neuron disease characterized by dysfunction of the muscles controlled by the cranial nerves of the lower brain stem (the bulb) -- specifically, the glossopharyngeal nerve (IX), vagus nerve (X), and hypoglossal nerve (XII). ... Pseudobulbar palsy is a form of motor neuron disease which can be associated with paralysis. ... Primary lateral sclerosis (PLS) is a rare neuromuscular disease characterized by progressive muscle weakness in the voluntary muscles. ... In human anatomy, the extrapyramidal system is a neural network located in the brain that is part of the motor system involved in the coordination of movement. ... Neuroleptic malignant syndrome (NMS) is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. ... This disease is believed to have been caused by a viral illness, stimulating degeneration of the nerve cells in the substantia nigra, leading to clinical parkinsonism. ... PKAN: Pantothenate Kinase-Associated Neurodegeneration Symptoms Pantothenate kinase-associated neurodegeneration (PKAN) is one of many forms of neurodegeneration, or brain deterioration . ... Progressive supranuclear palsy (PSP) (or the Steele-Richardson-Olszewski syndrome, after the Canadian physicians who described it in 1963 ) is a rare degenerative disorder involving the gradual deterioration and death of selected areas of the brain. ... Striatonigral degeneration refers to a form of multiple system atrophy involving the loss of connections between two areas of the brain, the striatum and the substantia nigra, which work together to ensure smooth movement and maintain balance. ... Dystonia is a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. ... Torticollis, or wry neck, is a condition in which the head is tilted toward one side, and the chin is elevated and turned toward the opposite side. ... Meiges syndrome is a type of dystonia, also known as oral facial dystonia or hemifacial spasm, the main symptoms of which involve involuntary blinking and chin thrusting. ... A blepharospasm (from blepharo (eyelid) and spasm (uncontrolled muscle contraction)) is any abnormal tic or twitch of the eyelid. ... This article or section does not cite its references or sources. ... Myoclonus is brief, involuntary twitching of a muscle or a group of muscles. ... // Chorea sancti viti (Latin for St. ... Restless legs syndrome (RLS, or Wittmaack-Ekboms syndrome) is a condition that is characterised by an irresistible urge to move ones legs. ... Stiff person syndrome (SPS) (or occasionally, stiff-man syndrome) is a rare neurologic disorder of unknown etiology. ... A demyelinating disease is any disease of the nervous system in which the myelin sheath of neurons is damaged. ... Picks disease has two meanings that are often confused: 1) Pathology: Neurologists currently use the term Picks disease to mean specifically one of the pathological subtypes of frontotemporal lobar degeneration (FTLD). ... Alpers disease, also called progressive infantile poliodystrophy, is a progressive degenerative disease of the central nervous system that occurs in infants and children. ... Dementia with Lewy bodies is the second most frequent cause of hospitalization for dementia, after Alzheimers disease. ... Leighs Disease, a form of Leigh syndrome, is a rare neurometabolic disorder that affects the central nervous system. ... Devics disease, also known as Devics syndrome, neuromyelitis optica (NMO), or optic-spinal MS, is an autoimmune, inflammatory disorder in which a persons own immune system attacks myelin of the neurons of the optic nerves and spinal cord. ... Central pontine myelinolysis is a neurologic disease caused by severe damage of the myelin sheath of nerve cells in the brainstem, more precisely in the area termed the pons. ... Transverse myelitis is a neurological disorder caused by a loss of the myelin encasing the spinal cord, also known as demyelination. ... This article is about epileptic seizures. ... Focal seizures (also called partial seizures) are seizures which are characterized by: preserved consciousness in simple focal seizures impaired consciousness (dream-like) in complex focal seizures experience of unusual feelings or sensations sudden and inexplainable feelings of joy, anger, sadness, or nausea altered sense of hearing, smelling, tasting, seeing, or... Simple partial seizures are seizures which affect only a small region of the brain, often the temporal lobes and/or hippocampi. ... A complex partial seizure is an epileptic attack that involves a greater degree of impairment or alteration of consciousness/awareness and memory than a simple partial seizure. ... Generalised epilepsy is a form of epilepsy, a chronic neurological condition characterized by recurrent seizures, which are a result of abnormal activity in both sides of the brain. ... Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... Absence seizures are one of several kinds of seizures. ... Atonic seizures (also called drop seizures, drop attacks, or akinetic seizures), are a minor type of seizure. ... Benign familial neonatal convulsions (BFNC) is a rare autosomal dominant inherited form of epilepsy. ... Lennox-Gastaut syndrome (LGS), also known as Lennox syndrome, is a difficult to treat form of childhood-onset epilepsy, that most often appears between the second and sixth year of life and is characterized by frequent seizures and different seizure types and is often accompanied by mental retardation and behavior... West syndrome, otherwise known as infantile spasms, is an uncommon to rare and serious form of epilepsy in infants. ... Epilepsia partialis continua is a rare type of recurrent motor epileptic seizures that are focal (hands and face), and recur every few seconds or minutes for extended periods (days or years). ... Complex Partial Status Epilepticus (CPSE) is one of the non-convulsive forms of Status epilepticus, a rare form of epilepsy defined by its recurrent nature. ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Familial hemiplegic migraine (FHM) is an autosomal dominant classical migraine subtype that typically includes hemiparesis (weakness of half the body) during the aura phase. ... Cluster headaches are rare, extremely painful and debilitating headaches that occur in groups or clusters. ... A vascular headache is a headache where blood vessel swelling or disturbance is causing the pain. ... Tension headaches, which were renamed tension-type headaches by the International Headache Society in 1988, are the most common type of primary headaches. ... A transient ischemic attack (TIA, often colloquially referred to as mini stroke) is caused by the temporary disturbance of blood supply to a restricted area of the brain, resulting in brief neurologic dysfunction that usually persists for less than 24 hours. ... Amaurosis fugax is a type of transient ischaemic attack (TIA). ... Transient global amnesia (TGA), is an anxiety-producing temporary loss of short-term memory. ... Cerebrovascular disease is damage to the blood vessels in the brain, resulting in a stroke. ... Middle cerebral artery syndrome is a condition where the blood supply from the middle cerebral artery is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel. ... Anterior cerebral artery syndrome is a condition where the blood supply from the anterior cerebral artery is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel. ... Posterior cerebral artery syndrome is a condition where the blood supply from the posterior cerebral artery is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel. ... Fovilles syndrome is caused by the blockage of the perforating branches of the basilar artery in the region of the brainstem known as the pons. ... Millard-Gubler syndrome is a syndrome of unilateral softening of the brain tissue arising from obstruction of the blood vessels of the pons, involving the sixth and seventh cranial nerves and fibers of the corticospinal tract, and is associated with paralysis of the abducens (including diplopia, internal strabismus, and loss... Lateral medullary syndrome (also called Wallenbergs syndrome) is a disease in which the patient has difficulty with swallowing or speaking or both owing to one or more patches of dead tissue (known as an infarct) caused by interrupted blood supply to parts of the brain. ... Webers Syndrome (superior alternating hemiplegia) is characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis or hemiplegia. ... There are very few or no other articles that link to this one. ... This article is about the sleeping disorder. ... Hypersomnia, also known as excessive daytime sleepiness (EDS), is excessive amount of sleepiness. ... Sleep apnea, sleep apnoea or sleep apnœa is a sleep disorder characterized by pauses in breathing during sleep. ... Ondines Curse, Congenital Central Hypoventilation Syndrome or primary alveolar hypoventilation, is a respiratory disorder that is fatal if untreated. ... For other uses, see Narcolepsy (disambiguation). ... Cataplexy is a medical condition which often affects people who have narcolepsy, a disorder whose principal signs are EDS (Excessive Daytime Sleepiness), sleep attacks, and disturbed nighttime sleep. ... Kleine-Levin Syndrome, or KLS, is a rare sleep disorder characterized by episodes of near-constant sleep and altered behavior. ... Normal pressure hydrocephalus (NPH) is a chronic type of communicating hydrocephalus whereby the increase in intracranial pressure (ICP) due to accumulation of cerebrospinal fluid (CSF) becomes stable and that the formation of CSF equilibrates with absorption. ... Idiopathic intracranial hypertension (IIH), sometimes called benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC) is a neurological disorder that is characterized by increased intracranial pressure (ICP), in the absence of a tumor or other intracranial pathology. ... Encephalopathy literally means disease of the brain. ... Herniation, a deadly side effect of very high intracranial pressure, occurs when the brain shifts across structures within the skull. ... Cerebral edema (cerebral oedema in British English) is an excess accumulation of water in the intra- and/or extracellular spaces of the brain. ... Reyes syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver. ... An uncollapsed syrinx (before surgery). ... Syringobulbia is a medical condition when syrinxes, or fluid filled cavities, affect the brainstem. ... Spinal cord compression develops when the spinal cord is compressed by a tumor, abscess or other lesion. ...