Epilepsy
1. Epilepsy refers to a condition in which a person has a risk of recurring epileptic seizures. Not everyone who has had a seizure has epilepsy. Non-epileptic seizures can be caused by other conditions such as low blood sugar, a fainting spell, or an anxiety attack.
2. Seizure types:
1. One of the most common seizure types is a convulsion. This may be called a “tonic-clonic” or “grand mal” seizure. In this type of seizure, a person may stiffen and have jerking muscle movements; during the muscle-jerking, the person may bite their tongue, causing bleeding or frothing at the mouth.
2. Other seizure types are less dramatic. Shaking movements may be isolated to one arm or part of the face. Alternatively, the person may suddenly stop responding and stare for a few seconds, sometimes with chewing motions or smacking the lips.
3. Seizures may also cause “sensations” that only the patient feels. As an example, one type of seizure can cause stomach discomfort, fear, or an unpleasant smell. Such subjective feelings are commonly referred to as auras. A person usually experiences the same symptoms with each seizure aura. Sometimes, a seizure aura can occur before a convulsive seizure.
3. Adult Epilepsy:
1. The Epilepsy & Seizure Clinic at Al Razi hospital in Pakistan is operated by American and French Board certified Neurologists and includes specific subspecialists in epilepsy treatment.
2. Multi-disciplinary teams are involved in advanced epilepsy programs for both children and adults, which include:
1. Epilepsy Disorder Management
2. Video-EEG Monitoring
3. Neuropsychology
4. Psychiatry
5. Genetics
6. Neurostimulation
7. Intraoperative Monitoring for Epilepsy Surgery.
4. Epilepsy in Children and Infants:
1. Children and young people may present with similar types of seizures and in similar ways to adults with epilepsy. Seizures and epilepsy affect infants and children more than any other age group. Epilepsy is about twice as common in children as in adults.
2. Presenting features in children are similar to those in adults. However, some syndromes occur exclusively in childhood and infancy. Examples include:
1. Typical absences (‘petit mal’ seizures): Childhood absence epilepsy is manifest by frequent (as many as 100 times per day or more) episodes of brief staring spells (lasting for few seconds at a time) in children of school age.
2. Infantile spasms:
1. Occur in infants aged 4-8 months and is usually part of West syndrome.
2. Consist of clusters of myoclonic spasms that occur when waking up.
3. Dravet syndrome:
1. It is a rare drug-resistant severe myoclonic epilepsy of infancy with the onset of recurrent febrile and/or afebrile seizures that begins in the first year of life in a previously healthy infant.
4. Benign Rolandic epilepsy:
1. Also known as benign focal epilepsy.
2. It occurs in children aged 4-10 years and is more common in boys.
3. Nocturnal seizures that are characterized by facial twitching and aphasia.
4. Resolves with puberty.
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