Epilepsy is a neurological condition characterized by recurrent seizures caused by abnormal electrical activity in the brain. The types of epilepsy are classified based on the origin of the seizures and their clinical features, as per the International League Against Epilepsy (ILAE).
1. Generalized Epilepsy
Seizures begin in and affect both sides of the brain simultaneously.
Types of Generalized Seizures:
- Tonic-Clonic Seizures (Grand Mal):
- Loss of consciousness, muscle stiffening (tonic phase), followed by rhythmic jerking (clonic phase).
- Absence Seizures (Petit Mal):
- Brief loss of awareness, often mistaken for daydreaming.
- Common in children.
- Myoclonic Seizures:
- Sudden, brief muscle jerks, often in the arms or legs.
- Tonic Seizures:
- Sudden stiffening of muscles, often leading to falls.
- Atonic Seizures:
- Sudden loss of muscle tone, causing the person to collapse.
2. Focal Epilepsy
Seizures originate in a specific area of the brain and may remain localized or spread.
Types of Focal Seizures:
- Focal Aware Seizures:
- The person remains fully conscious and aware.
- Symptoms may include unusual sensations, emotions, or movements.
- Focal Impaired Awareness Seizures:
- Altered or lost consciousness, often with repetitive behaviors like lip-smacking or staring.
- Focal to Bilateral Tonic-Clonic Seizures:
- Seizures start in one area and spread to involve the entire brain.
3. Combined Generalized and Focal Epilepsy
Seizures can be both generalized and focal in the same individual.
4. Unknown Onset Epilepsy
When the origin of the seizures is not clear, they are classified as unknown onset.
5. Epilepsy Syndromes
Specific conditions characterized by age, type of seizures, and EEG findings.
Examples:
- Childhood Absence Epilepsy:
- Frequent absence seizures in children.
- Juvenile Myoclonic Epilepsy:
- Myoclonic seizures, typically occurring in the morning in teenagers.
- Lennox-Gastaut Syndrome:
- Severe epilepsy with multiple seizure types, often resistant to treatment.
- Dravet Syndrome:
- Rare, severe epilepsy beginning in infancy, often triggered by fever.
6. Reflex Epilepsy
Seizures triggered by specific stimuli, such as flashing lights (photosensitivity), reading, or eating.
7. Status Epilepticus
A severe and prolonged seizure lasting more than 5 minutes or repeated seizures without recovery in between.
Key Considerations:
- Diagnosis: Based on seizure history, EEG, and imaging studies (MRI/CT).
- Treatment: Includes antiepileptic drugs (AEDs), dietary therapies (e.g., ketogenic diet), and in refractory cases, surgical interventions.
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