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epilepsy [2023/11/07 12:45] – andrewtaustinepilepsy [2023/11/10 14:50] (current) – kevin
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-====== Epilepsy: An Overview of Types ======+{{tag>Related}} ====== Epilepsy: An Overview of Types ====== 
 + 
 +Epilepsy is a neurological disorder[(Neurological disorder[[https://www.who.int/news-room/questions-and-answers/item/mental-health-neurological-disorders]])]  **characterised by the propensity for recurrent, unprovoked seizures**, which are transient occurrences of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The disorder encompasses a spectrum of conditions with varying aetiologies, clinical presentations, and seizure types.  
 + 
 +In the absence of expert medical advice and appropriate oversight, individuals with a documented history of epilepsy must be precluded from receiving any form of Integral Eye Movement Therapy (IEMT). This contraindication arises from the necessity to mitigate potential risks and ensure the safety and well-being of the client, as such therapies may provoke seizures in susceptible individuals.  
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-Epilepsy is a neurological disorder **characterised by the propensity for recurrent, unprovoked seizures**, which are transient occurrences of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The disorder encompasses a spectrum of conditions with varying aetiologies, clinical presentations, and seizure types.  
  
 ==== Classification Based on Seizure Type ==== ==== Classification Based on Seizure Type ====
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 The primary classification of epilepsy is determined by the **type of seizure**, which is categorised into two main groups: The primary classification of epilepsy is determined by the **type of seizure**, which is categorised into two main groups:
  
-  * **Focal Seizures**: Originating within networks limited to one hemisphere. These are subdivided based on the level of consciousness:+  * **Focal Seizures[(Focal Seizures[[https://epilepsysociety.org.uk/about-epilepsy/epileptic-seizures/seizure-types]])]**: Originating within networks limited to one hemisphere. These are subdivided based on the level of consciousness:
     * **With Retained Awareness**: Formerly known as simple partial seizures.     * **With Retained Awareness**: Formerly known as simple partial seizures.
     * **With Impaired Consciousness**: Previously referred to as complex partial seizures.     * **With Impaired Consciousness**: Previously referred to as complex partial seizures.
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   * **Generalised Seizures**: Engaging networks distributed across both hemispheres simultaneously. Types include:   * **Generalised Seizures**: Engaging networks distributed across both hemispheres simultaneously. Types include:
-    * **Absence Seizures**: Manifest as brief lapses in awareness. +    * **Absence Seizures**[(Absence Seizures [[https://epilepsysociety.org.uk/about-epilepsy/epileptic-seizures/absence-seizures]])]: Manifest as brief lapses in awareness. 
-    * **Myoclonic Seizures**: Characterised by sudden, brief muscle jerks. +    * **Myoclonic Seizures**[(Myoclonic Seizures [[https://epilepsysociety.org.uk/about-epilepsy/epileptic-seizures/myoclonic-seizures]])]: Characterised by sudden, brief muscle jerks. 
-    * **Tonic-Clonic Seizures**: Known for convulsive movements. +    * **Tonic-Clonic Seizures**[(Tonic-Clonic Seizures [[https://epilepsysociety.org.uk/about-epilepsy/epileptic-seizures/tonic-clonic-seizures]])]: Known for convulsive movements. 
-    * **Atonic Seizures**: Leading to sudden loss of muscle tone.+    * **Atonic Seizures**[(Atonic Seizures [[https://epilepsysociety.org.uk/about-epilepsy/epileptic-seizures/atonic-seizures]])]: Leading to sudden loss of muscle tone.
  
 ===== Focal Seizures ===== ===== Focal Seizures =====
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 ==== Evolution to Bilateral Tonic-Clonic Seizures ==== ==== Evolution to Bilateral Tonic-Clonic Seizures ====
-Some focal seizures can generalise, leading to bilateral tonic-clonic seizures. The initial focal onset may manifest as a warning or 'aura' before consciousness is lost and generalised convulsive movements begin. The tonic phase is characterised by a sudden loss of consciousness with muscle stiffening, while the clonic phase involves rhythmic jerking movements. Sudden cessation of respiration during the tonic phase may lead to cyanosis, and injuries can occur from falls or during convulsions.+Some focal seizures can generalise, leading to bilateral tonic-clonic seizures. The initial focal onset may manifest as a warning or 'aura' before consciousness is lost and generalised convulsive movements begin. The tonic phase is characterised by a sudden loss of consciousness with muscle stiffening, while the clonic phase involves rhythmic jerking movements. Sudden cessation of respiration during the tonic phase may lead to cyanosis[(Cyanosis [[https://www.nhs.uk/conditions/blue-skin-or-lips-cyanosis/]])], and injuries can occur from falls or during convulsions.
  
 ===== Generalised Seizures ===== ===== Generalised Seizures =====
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 ==== Epilepsy Syndromes ==== ==== Epilepsy Syndromes ====
  
-In addition to seizure type and aetiology, **epilepsy syndromes** are recognised by a cluster of features that occur together, which can include:+In addition to seizure type and aetiology, **epilepsy syndromes[(Epilepsy Syndromes [[https://epilepsysociety.org.uk/about-epilepsy/information-parents/childhood-epilepsy-syndromes]])]** are recognised by a cluster of features that occur together, which can include:
   * **Specific Seizure Types**   * **Specific Seizure Types**
   * **EEG Findings**   * **EEG Findings**
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 This concept is instrumental in directing specific management strategies. This concept is instrumental in directing specific management strategies.
 +
 +====== Management Strategies for Epilepsy ======
 +
 +The management of epilepsy is tailored to the individual, taking into account the type and frequency of seizures, epilepsy syndrome, and the patient's lifestyle and overall health. The overarching goal is to achieve seizure control with minimal side effects to enable a normal life as far as possible.
 +
 +==== Pharmacotherapy ====
 +Anti-seizure medications (ASMs) are the mainstay of epilepsy treatment. The choice of ASM is guided by several factors:
 +
 +  * **Seizure Type**
 +  * **Epilepsy Syndrome**
 +  * **Patient Age and Sex**
 +  * **Comorbid Conditions**
 +  * **Potential Side Effects**
 +  * **Patient's Personal Circumstances**
 +
 +Monotherapy is often the initial strategy, with combination therapy considered if monotherapy fails.
 +
 +==== Drug-Resistant Epilepsy ====
 +In cases of drug-resistant epilepsy, alternative treatment strategies are considered:
 +
 +  * **Surgical Options**: Resection, disconnection procedures, or hemispherectomy.
 +  * **Pre-surgical Evaluation**: To assess the potential benefits and risks.
 +
 +==== Neurostimulation Techniques ====
 +For those unsuitable for surgery, neurostimulation presents an alternative:
 +
 +  * **Vagus Nerve Stimulation[(Vagus Nerve Stimulation [[https://epilepsysociety.org.uk/about-epilepsy/treatment/vagus-nerve-stimulation]])] (VNS)**
 +  * **Deep Brain Stimulation (DBS)**
 +  * **Responsive Neurostimulation (RNS)**
 +
 +These techniques use electrical impulses to reduce seizure frequency and severity.
 +
 +==== Dietary Therapies ====
 +Specific dietary modifications have proven effective, especially in children:
 +
 +  * **Ketogenic Diet**: A high-fat, low-carbohydrate diet.
 +  * **Modified Atkins Diet**
 +  * **Low Glycaemic Index Treatment**
 +
 +==== Psychosocial Interventions ====
 +Addressing the psychological and social aspects is crucial:
 +
 +  * **Improvement of Mental Health**
 +  * **Social Integration**
 +  * **Enhancement of Quality of Life**
 +
 +==== Regular Follow-up ====
 +Monitoring and adjusting treatment over time is necessary due to:
 +
 +  * **Treatment Efficacy**
 +  * **Side Effects**
 +  * **Changes in Patient's Condition**
 +
 +Management must be individualised and often requires a multi-disciplinary approach. Regular review and adaptation to the patient's changing needs are essential for optimal outcomes.
 +
 +The continuous evolution of precision medicine and ongoing research promise more targeted and effective treatments for epilepsy.
 +
 +====== Online Resources for Epilepsy ======
 +
 +This list provides current online resources for individuals with epilepsy and healthcare professionals managing epilepsy, across both the USA and UK.
 +
 +==== For Patients and Therapists in the UK ====
 +
 +  * **Epilepsy Society**
 +    * Offers support, confidential helpline, information on living with epilepsy, safety, and free resources like ‘I have epilepsy’ cards.
 +    * [[https://www.epilepsysociety.org.uk|Epilepsy Society Website]]
 +
 +==== For Patients in the USA ====
 +
 +  * **Epilepsy Foundation**
 +    * A comprehensive resource including a seizure tracking app, educational materials, medication lists, toolkits, and a 24/7 helpline.
 +    * [[https://www.epilepsy.com|Epilepsy Foundation Website]]
 +
 +==== For Therapists in the USA ====
 +
 +  * **American Epilepsy Society (AES)**
 +    * A professional community focused on epilepsy research and treatment.
 +    * [[https://www.aesnet.org|AES Website]]
 +
 +  * **Epilepsy Self-Management Programs & Resources**
 +    * Encourages self-care and consistent routines to minimize seizure risk, part of AES resources.
 +    * [[https://www.aesnet.org|AES Self-Management]]
 +
 +  * **Career Center**
 +    * Offers job listings and resources for career advancement in epilepsy care.
 +    * [[https://www.aesnet.org|AES Career Center]]
 +
 +  * **Epilepsy Currents Journal**
 +    * Bi-monthly open access journal with research and treatment reviews.
 +    * [[https://www.aesnet.org|Epilepsy Currents Journal]]
 +
 +  * **AES eModules**
 +    * Self-paced online courses for enhancing knowledge on epilepsy.
 +    * [[https://www.aesnet.org|AES eModules]]
 +
 +  * **Clinical Guidance**
 +    * Provides current evidence-based clinical guidance for epilepsy care.
 +    * [[https://www.aesnet.org|AES Clinical Guidance]]
 +
 +
 +----
 +
  
  
  • Last modified: 2023/11/07 12:45
  • by andrewtaustin