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Related Concept Videos

Seizures ll: Types01:19

Seizures ll: Types

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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...
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Seizures l: Introduction01:20

Seizures l: Introduction

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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,...
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Seizures: Classification01:13

Seizures: Classification

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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:
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Epilepsy ll: Types01:22

Epilepsy ll: Types

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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.
15
Subconsciousness and No Awareness01:15

Subconsciousness and No Awareness

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The concept of subconscious awareness refers to the processing of information below the level of conscious thought, which significantly influences both behaviors and decisions. It is also known as waking subconscious awareness. This complex level of cognition operates without the direct awareness of the individual, facilitating rapid and simultaneous handling of multiple information streams.
An illustrative example of subconscious processing is its role in problem-solving. Often, individuals...
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Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

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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...
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Focal seizures without awareness.

Michael E Langston1, William O Tatum2

  • 1University of Miami College of Medicine, Miami, Florida, USA.

Epilepsy Research
|December 20, 2014
PubMed
Summary

Patients experiencing seizures without awareness (SWA) are older at diagnosis and have distinct seizure characteristics. Despite fewer medication trials, they achieve seizure freedom similarly to those aware of their seizures.

Keywords:
Antiseizure drug trialCognitive declineSeizure awarenessTemporal lobeVideo-EEG

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Area of Science:

  • Neurology
  • Epilepsy Research
  • Clinical Neuroscience

Background:

  • Seizures occurring without awareness (SWA) represent a distinct clinical presentation within epilepsy.
  • Understanding the characteristics of SWA is crucial for accurate diagnosis and effective management.
  • Limited data exists on the specific demographic, clinical, and EEG features distinguishing SWA from seizures with awareness (SA).

Purpose of the Study:

  • To characterize patients with seizures that occur exclusively without their awareness (SWA).
  • To compare the clinical and electrophysiological features of SWA patients with a control group of patients who are always aware of their seizures (SA).

Main Methods:

  • Retrospective chart review identified 24 patients with SWA.
  • Eleven patients meeting strict SWA criteria underwent video-EEG monitoring (VEM).
  • A case-matched control group of SA patients was used for comparison; statistical analyses included Pearson's Chi-square, Fisher's Exact, and Mann-Whitney tests.

Main Results:

  • Patients with SWA were older at diagnosis (p=0.04) and less frequently referred for initial epilepsy evaluation (p=0.04).
  • SWA seizures were less likely to have motor manifestations (p=0.0004) but more often showed temporal lobe onset with left lateralization on ictal EEG (p<0.0001).
  • SWA patients tried fewer antiseizure drugs (p=0.03) but achieved seizure freedom as often as SA patients (p=0.4).

Conclusions:

  • Patients with SWA exhibit a unique epilepsy syndrome characterized by older age at diagnosis, later referral, fewer motor signs, and limbic localization.
  • Despite different treatment approaches, SWA patients achieve comparable seizure freedom rates to SA patients.
  • Clinical history can suggest SWA, but serial VEM is essential for confirming diagnosis and guiding effective management.