P

P
E
IL

Y
S

A BRIEF HISTORY
Earliest record dates back as early as 2000 B.C
Hippocrates: epilepsy is a process in the brain.
Ancient writers: epilepsy is a work of supernatural forces:
Epilepsy - to be seized by forces from without.
John Hughlings Jackson : has formulated the modern
definition of epilepsy
An occasional, excessive , and disorderly discharge of
nerve tissue

DEFINING EPILEPSY
Brain disorder
Epileptics have an abnormal brain electrical activity
A condition in which there are repeated episodes of
seizures

Seizures and epilepsy.

A single seizure alone due to high fever or brain damage
does not equate to having epilepsy

WHAT IS A SEIZURE?
A seizure is a sudden surge of electrical activity in our brain
Normally, neurons follow a balance between excitatory and resting states.

When chemical balances responsible for these states go into a state of

disarray leading to little or too much activity, this then results into
electrical surges in our brain and causes the seizure to occur.
Three Stages:
Aura
Ictus
Postictal
NOTE: Seizure by itself, is NOT a disease.

OTHER CONDITIONS THAT CAN CAUSE SEIZURES:

head trauma
fever
brain infection
brain tumor
stroke
abnormal levels of glucose/sodium in
blood
and many more

SEIZURE EEG

EEG testing shows a 3 Hz generalized spike and waves.

TYPES OF SEIZURES

MAJOR GROUPS
I.

GENERALIZED SEIZURES

1. Absence (petit mal)

seizures
2. Myoclonic seizures
3. Clonic seizures
4. Tonic seizures
5. Tonic-clonic (grand
mal)seizures
6. Atonic seizures (drop
attacks)

II. P A R T I A L O R F O C A L
SEIZURES

1. Simple Partial Seizure

2. Complex Partial Seizure
3. Partial seizure that
secondarily generalize

GENERALIZED SEIZURES

V I E W E R D I S C R E T I O N I S A D V I S E D : V I D E O S S H O W N A R E P U R E LY F O R E D U C AT I O N A L P U R P O S E S

ABSENCE SEIZURE (PETIT MAL)

Lapses of
awareness for a
few seconds
Commonly found
in children
Usually returns to
being alert after
the seizure

Video source: https://www.youtube.com/watch?v=H3iLQ

MYOCLONIC SEIZURE
myo muscle,
clonic- jerk
Sudden increase in
muscle tone

Video source: https://www.youtube.com/watch?

TONIC AND CLONIC/ TONIC-CLONIC SEIZURES

(GRAND MAL)
Tonic Seizure/Phase- Tonic
seizures are characterized by
stiffening of the muscles, loss of
consciousness.
Clonic Seizure/Pahse- Clonic
seizures are repetitive, rhythmic
jerks that involve both sides of
the body at the same time
Usually a Tonic seizure is always
followed by a Clonic seizure it
rarely happens when only one
type is experienced

Video source: https://www.youtube.com/watch?

ATONIC SEIZURE (DROP ATTACK)

Its the opposite
of the tonic/clonic
seizure.
Consists of the
sudden loss of
muscle tone

Video source: https://www.youtube.com/watch?

PARTIAL (FOCAL) SEIZURES

ANOMALY STARTS AT ONE AREA AND MAY MOVE OR SPREAD OUT TO OTHER AREAS OF THE BRAIN

SIMPLE PARTIAL SEIZURE

Does not impede awareness
Divided into further sub
categories
Autonomic
Racing heartbeat, loss of bladder
control, and other autonomic functions
Motor
Jerking, muscle rigidity, spasms, head
turning
Sensory
Unusual sensations affecting the
senses
Psychological

Memory or emotional disturbance

Video source: https://www.youtube.com/watch?v=gbryS0

COMPLEX PARTIAL SEIZURE

Impairs patient
awareness
May include
Automatisms which are
involuntary coordinated
movements that are
purposeless and
repetitive such as: lip
smacking, picking at
clothes

Video source: https://www.youtube.com/watch?

PARTIAL SEIZURE THAT SECONDARILY GENERALIZE

A partial seizure occurs
when the seizures
begins at one area of the
brain.
If this partial seizure
spreads to the other side
of the brain then it is
known to secondarily
generalize.
Focal seizure to grand
mal seizure.

Video source: https://www.youtube.com/watch?

TYPES OF EPILEPSY
Temporal Lobe
Epilepsy

Arises from the temporal lobe; most experience a complex

partial seizure or rarely only a simple partial seizure

Frontal Lobe
Epilepsy

Begins at frontal lobe; most experience tonic-clonic

seizures or short complex partial seizures

Parietal Lobe
Epilepsy
Occipital Lobe
Epilepsy

At the parietal lobe; seizures involving sensory

functions and may slightly impair language and
simple math skill
Starts at the occipital lobe; can be genetic or due to a
lesion; seizures are hallucinations and other
symptoms related to vision

TYPES OF EPILEPSY
there is often, but not always, a family history of epilepsy;
Primary/
genetic causes
Ideopathic
Generalized
Epilepsy
Iodiopathic Partial partial epilepsy syndromes of unknown or idiopathic
cause . There are a few idiopathic partial epilepsy
Epilepsy

Symptomatic
Generalized
Epilepsy
Progressive
myoclonic
Epilepsy
Reflex Epilepsy

syndromes. Each individual syndrome generally has its

own characteristic seizure type(s), typical age of onset,
and specific EEG patterns.

Rare and are the result of hereditary metabolic

disorder; combination of tonic-clonic and myoclonic

Triggered by the environment (ex. flashing lights, specific

sounds, arithmetic, reading, writing or specific topics);
involves absence, tonic-clonic or myoclonic seizures;

Types of Epilepsy (common in Children)

Febrile Seizures

hereditary; tonic-clonic seizures may occur at children ages 6 months to 6 years

during high fever;

Benign Rolandic
Epilepsy

Herdiatry; 2-13 years old; simple partial(motor) seizure, sensory seizure or tonicclonic seizure

Juvenile Myoclonic
Epilepsy

Begins shortly before or after puberty, or sometimes at early adulthood;

myoclonic seizures with or without tonic-clonic seiuzres or absence seizres

Infantile Spasms

60% of cases are due to brain injury or O2 deprivation, 40% of cases are
idiopathic; Rare but mostly found in infants 3-12 months; seizures consist of a
sudden jerk followed by stiffening

Lennox-Gastaut
Syndrome

1-6 years; patients with mental handicap; difficult to control generalized

seizures; combination of tonic, atonic, absence, myoclonic, and tonic-clonic
seizures

Childhood Absence
Epilepsy

Ages 5-9 years; can be inherited are sporadically acquired; seizures involve
sudden cessation of movement, staring, sometimes blinking, and slightloss of
muscle tone (rarely); occurs without an aura or warning

Benign Occipital
Epilepsy

Ages 5-7 years; occipital lobe origin; seizures are visual hallucinations, vomit,
loss of vision or forced deviation of eyes; children may complain of intense
headaches; may be mistakenly diagnosed as migraine

Mitochondrial
Disorders

Abnormal mitochondrial DNA resulting in metabolic disorders affecting the brains

and muscle; two disorders are associated: mitochondrial encephalopathy, lactic

Types of Epilepsy (common in Children)

Landau-Kleffner
Syndrome (acquired
epileptic aphasia)

Rare; ages 3-7 years; child will experience progressive language problems
with or without seizure; mostly auditory impairment but it may affect
speaking; simple partial motor seizures are most common but tonic-clonic can
also occur

Rasmussen Syndrome

Age 14 months-14 years; slow progressive neurologic deterioration; commonly

simple partial motor seizures but 20% in most cases experience tonic-clonic
seizures.

Hypothalamic
Hamartoma & Epilepsy

Small tumors in the brain affecting the hypothalamus; abnormal early puberty,
partial seizures with laughing as a frequent nature; simple or complex and
may secondarily generalize into tonic-clonic seizures; affected individuals
have dysmorphisms

CAUSE OF EPILEPSY
In todays current knowledge , still no one really
knows what causes it.
Genetics
Head Trauma
Medical Conditions
Problems during the patients embryonic
development.

TREATMENT
Mostly through drug therapy
Side effects of these drugs may include: blurry or double vision, fatigue,
sleepiness, unsteadiness, stomach upset, skin rashes, low blood cell
count, and liver problems
Appropriate treatment depends on age, severity and frequency of
seizure, overall health, medical history and most importantly the type of
epilepsy diagnosed
Treatment may last to a few years to a lifetime. Discontinuation of
seizure drugs will be considered in patients who are seizure-free for 10
years
Surgery is also a common option if patients seizure is still not controlled
after a trial of 2-3 medications to treat partial epilepsies
Ketogenic diet- high fat, low carbohydrate plan

Classic medications used to treat

epilepsy include:
Dilantinor Phenytek
Phenobarbital
Tegretol or Carbatrol
Mysoline
Zarontin
Depakene
Depakote, Depakote ER
Valium and similar
tranquilizers, such as Tranxene
and Klonopin

Newer drugs to treat epilepsy

include:
Aptiom
Felbatol
Fycompa
Gabitril
Keppra
Lamictal
Lyrica
Neurontin
Oxteller XR
Topamax
Trileptal
Vimpat
Zonegran

REFERENCES
Juvenile Absence Epilepsy. (n.d.). Retrieved February 6, 2015, from http://www.chp.edu/CHP/juvenile
absence epilepsy
The Charlie Foundation - WHAT IS THE KETOGENIC DIET? (n.d.). Retrieved February 6, 2015, from
http://www.charliefoundation.org/explore-ketogenic-diet/explore-1/introducing-the-diet
Types of Epilepsy. (n.d.). Retrieved February 6, 2015, from http://epilepsy.med.nyu.edu/epilepsy/typesepilepsy#sthash.bkSW3YLA.dpbs
Seizures: Read About Symptoms and Types. (n.d.). Retrieved February 6, 2015, from
http://www.medicinenet.com/seizures_symptoms_and_types/article.htm
Seizures. (n.d.). Retrieved February 6, 2015, from
http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/seizures/
WebMD Epilepsy Guide - Better Information for Better Health. (n.d.). Retrieved February 6, 2015, from
http://www.webmd.com/epilepsy/guide/default.htm