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Classification
The
International League Against Epilep
sy
1. ictal phenomenon,(pertaining to an
epileptic seizure)
2. seizure type,
3. syndrome,
4. etiology,
5. impairment.
Precipitants
Certain epilepsy
Photosensitive epilepsy
Emotional stress, sleep deprivation, sleep
itself, and febrile illness are examples of
precipitants cited by patients with epilepsy.
Catamenial epilepsy
Example of EEG
Epidemiology
Seizure types
Partial or focal seizures
Generalized seizures
Simple partial seizure
Complex partial (psychomotor) seizure
Generalized seizures: absence (petit mal),
myoclonic, clonic, tonic, tonic-clonic
(grand mal) and atonic seizures
Inattentive staring
Benign shudders (among children younger than
age 2, usually when they are tired or excited)
Self-gratification behaviors (nodding, rocking,
head banging)
Conversion disorder (flailing and jerking of the
head, often in response to severe personal
stress such as physical abuse)
Epilepsy syndromes
Absence seizures
atonic seizures
benign Rolandic epilepsy
childhood absence
clonic seizures
Juvenile Absence Epilepsy
lennox-gastaut syndrom
Landau-Kleffner Syndrome
myoclonic seizures
Partial epilepsy
., 2003
--Syndromes are
divided into
localization-related
epilepsies,
generalized
epilepsies, or
epilepsies of
unknown
localization.
-- Epilepsy
syndromes
are further divided by
presumptive cause:
idiopathic,
symptomatic, and
cryptogenic.
Catamenial epilepsy
Childhood absence epilepsy
Frontal lobe epilepsy
Juvenile myoclonic epilepsy
Lennox-Gastaut syndrome
Progressive myoclonic epilepsies
Symptomatic localization-related epilepsies
Temporal lobe epilepsy
West syndrome
Treatment
status epilepticus
Pharmacologic treatment
Treatment
Effectiveness - 50% of
the patient treatment
group had at least a 50%
improvement in the rate of
epileptic seizures. About
20% of patients with
epilepsy continue to have
breakthrough epileptic
seizures despite best
anticonvulsant treatment.
Surgical treatment
Epilepsy surgery is an
option for patients whose
seizures remain resistant
to treatment with
anticonvulsant
medications who also
have symptomatic
localization-related
epilepsy
Other treatment
Ketogenic diet
Electrical stimulation
Vagus nerve stimulation
Responsive Neurostimulator System
Deep brain stimulation
Noninvasive surgery
Avoidance therapy
Warning systems
Alternative or complementary medicine
Pathophysiology
Mutations in several genes
Epileptogenesis
Abnormal mass of tissue in an area of the
brain
Vascular Dementia
multiinfarct dementia
single-infarct dementia
Binswanger disease
lacunar state
vascular dementia
Frequency:
Sex:
The prevalence of vascular dementia
is higher in men than in women.
Age:
Incidence increases with age.
Binswanger disease
Cerebral autosomal
dominant arteriopathy
The onset of the disease occurs
between the third and fourth decades
of life.
The clinical picture is similar to
Binswanger disease but without a
history of hypertension and risk factors
for cerebrovascular disease.
Vascular dementia in
general
Patients with vascular dementia commonly have
mood and behavioral changes.
Severe depression is more common in persons
with vascular dementia than in those with AD.
In some patients with lacunar state and
Binswanger disease, such problems may be
more prominent than intellectual deficits.
Even psychotic symptoms, particularly
delusions, have been described in patients with
vascular dementia.
Orientation
Registration
Attention
Recall
Language
Scoring:
Causes:
Risk factors for vascular dementia
include
hypertension,
smoking,
hypercholesterolemia, diabetes, and
cardiovascular and cerebrovascular
disease.
Medical Care
Diet
Prognosis