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Epilepsy ll: Types

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.

Seizures: Classification

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:

Seizures ll: Types

Seizures ll: Types

Seizures are sudden bursts of abnormal electrical discharge in the brain that interfere with normal function. They are commonly divided into three groups: focal seizures, generalized seizures, and other types that do not fit neatly into either category.Focal SeizuresFocal seizures begin in a single brain region. When awareness is preserved, they are called focal aware seizures and may cause sensations such as tingling, unusual smells, or flashing lights. When awareness is impaired, they are...

Epilepsy and Seizures: Overview

Epilepsy and Seizures: Overview

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...

Seizures l: Introduction

Seizures l: Introduction

Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...

Antiepileptic Drugs: Glutamate Antagonists

Antiepileptic Drugs: Glutamate Antagonists

Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...

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Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

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Published on: December 18, 2016

Focal epileptogenic lesions.

Ahsan N V Moosa¹, Elaine Wyllie

¹Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Handbook of Clinical Neurology

|April 30, 2013

Summary

Pediatric epilepsy surgery candidates often have cortical malformations or tumors, unlike adults. Early lesion onset and age significantly impact children's epilepsy presentation, even with generalized features, benefiting from surgical evaluation.

Area of Science:

Pediatric Neurology
Epileptology
Neuroimaging

Background:

Focal epileptogenic lesions and their clinical impact differ between pediatric and adult epilepsy patients.
Mesial temporal sclerosis (MTS), common in adult epilepsy surgery, is infrequent in children, often presenting as dual pathology when present.
Pediatric epilepsy surgery candidates commonly exhibit lesions like cortical malformations, developmental tumors, or encephalomalacia.

Purpose of the Study:

To delineate the distinct spectrum of focal epileptogenic lesions in pediatric epilepsy surgery candidates.
To analyze how lesion characteristics, age at onset, and epilepsy onset influence the electroclinical phenotype in children.
To emphasize the importance of surgical evaluation for pediatric medically refractory epilepsy with focal lesions.

Main Methods:

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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

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Review of brain MRI characteristics to predict pathology.
Histopathological evaluation as the gold standard for mass lesion diagnosis.
Analysis of electroclinical phenotypes, considering lesion location, age at onset, and epilepsy onset.

Main Results:

Brain MRI analysis is highly predictive of pathology in most pediatric epilepsy cases.
Congenital or early acquired lesions in children can lead to generalized EEG features and seizure semiology.
A subset of children with generalized epilepsy phenotypes benefit from surgical intervention.

Conclusions:

Pediatric epilepsy surgery candidates present with distinct pathologies compared to adults.
Age at onset of both the lesion and epilepsy significantly shapes the electroclinical phenotype in children.
All children with medically refractory epilepsy and a focal lesion warrant surgical evaluation, regardless of EEG or semiology findings.