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Epilepsy

This article is about epilepsy in humans. For information on epilepsy in other animals, see Epilepsy in animals. more...

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Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures. The condition is named from the Greek epilepsis ("to take a firm grip on"). It is commonly controlled with medication, although surgical methods are used as well.

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.

Long-term video-EEG monitoring for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost and inconvenience. It is, however, sometimes used to distinguish psychogenic non-epileptic seizures from epilepsy.

Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions, including:

  • psychogenic non-epileptic seizures (often wrongly called "pseudoseizures")
  • tics
  • syncope (fainting)
  • narcolepsy
  • cataplexy
  • parasomnias
  • breath-holding spells of childhood
  • non-epileptic myoclonus
  • hypoglycemia and associated neuroglycopenia
  • opsoclonus
  • hyperekplexia
  • paroxysmal kinesiogenic dyskinesia
  • infantile gratification / masturbation (onanism)
  • repetitive behaviors

Neurologists are often called upon to distinguish among the above diagnoses and epilepsy.

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.

Causes

All the causes (or etiologies) of epilepsy are not known, but many predisposing factors have been identified, including brain damage resulting from malformations of brain development, head trauma, neurosurgical operations, other penetrating wounds of the brain, brain tumor, high fever, bacterial or viral encephalitis, stroke, intoxication, or acute or inborn disturbances of metabolism. Hereditary or genetic factors also play a role.

Seizures may occur in any person under certain circumstances, including acute illness and drug overdoses, but these provoked seizures are not part of the definition of epilepsy. Epilepsy connotes that an individual has unprovoked seizures which recur over time. In about 50% of all cases, there is no cause for epilepsy that is currently detectable even with state of the art investigations. In about 50% of cases, evidence of a brain injury, scar or malformation is found, to which the epilepsy is attributed. In many, but not all cases, abnormal electrical activity can be detected in the brain with an electroencephalogram (EEG), either during or in between seizures.

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National Epilepsy Awareness Month—November 2005
From Morbidity and Mortality Weekly Report, 10/28/05

November is National Epilepsy Awareness Month. Epilepsy affects approximately 2.7 million persons in the United States and is characterized by unprovoked seizures. Delayed recognition of seizures and inadequate treatment greatly increase the risk for subsequent seizures, brain damage, disability, decreased health-related quality of life, and death from injuries incurred during a seizure. Epilepsy most often affects young children and older adults, although persons can have epilepsy at any age. The effects of epilepsy on children can be especially burdensome as they transition into adulthood (e.g., driving and working). The number of cases among older adults is increasing as the U.S. population ages. Outside the medical community, epilepsy is a poorly understood condition, even among families and friends of affected persons.

To improve social acceptance and understanding of epilepsy and to increase support for persons living with it, the Epilepsy Foundation, in partnership with CDC, is expanding its campaign to focus on providing information about epilepsy to the Hispanic community through national and local partnerships, including Hispanic Radio Network, local affiliates of the National Council of La Raza, and local groups of the Community Health Workers (Promotoras) National Network. Information about epilepsy and the campaign is available from the Epilepsy Foundation, telephone 800-332-1000, or at http://www.epilepsyfoundation.org and in Spanish at telephone 866-748-8008 or at http://www.fundacionparalaepilepsia.org.

COPYRIGHT 2005 U.S. Government Printing Office
COPYRIGHT 2005 Gale Group

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