Seizure

Since the first comprehensive and impressive description of juvenile myoclonic epilepsy (JME) by Janz and Christian, JME has become a well-established disease entity [1]. Previous studies based on functional Magnetic Resonance Imaging (MRI), Positron Emission Tomography/ Computed Tomography (PET-CT) and scalp electroencephalogram (EEG) have illustrated at different levels that patients with JME exhibit significantly different functional and structural brain connectivity networks compared to healthy control subjects [2–5].

Epilepsia partialis continua (EPC) is a rare neurological disorder characterized by persistent focal-onset seizures with preserved awareness. These seizures can last for extended periods—ranging from hours to days or even years—and are often challenging to control [1]. EPC was first described by Aleksei Kozhevnikov in 1894, who attributed it to focal cortical encephalitis. In 1958, Rasmussen syndrome was identified as a related condition, and since then, multiple pathophysiological mechanisms have been proposed [2].

Seizures are an important cause of morbidity and mortality in autoimmune encephalitis (AE), reported in 50-70% of patients during their disease course [1–3], and electrographic seizures without clinical correlates are common [2,4–6]. While, with early and appropriate immunotherapy, the inflammatory response in acute symptomatic seizures secondary to AE can potentially be stopped and seizure freedom established [3,7–10]; failure to do so can lead to AE-associated epilepsy, an enduring predisposition to seizures [11,12].

Dravet syndrome (DS) is a developmental and epileptic encephalopathy, with significant risk of mortality due to sudden unexpected death in epilepsy patients (SUDEP) or status epilepticus [1]. Our previous work demonstrated 58% genetic yield of underlying variant in the alpha 1 subunit of the sodium channel encoded by the SCN1A gene in North Indian cohort [2]. Other important reported causative genetic variants in DS are SCN2A, SCN1B, PCDH19 [3].

The International League Against Epilepsy (ILAE) defines reflex seizures as those that are objectively and consistently induced by a specific afferent stimulus or patient activity [1]. When seizures are reproducibly triggered by specific exercises, they are termed as exercise-induced reflex seizures [2]. Previous literature has reported several cases diagnosed as exercise-induced reflex seizures, which typically occur in patients with a history of spontaneous epilepsy and are usually left-sided temporal lobe epilepsy (TLE) [3].

Few cases have been described of epileptic seizures (ES) with ictal semiology involving religious content [1]. Previous reports include motor manifestations such as the sign of the cross (Signum Crucis) [2,3], Islamic praying rituals [4], and ictal religious speech, typically associated with focal epilepsies of the non-dominant temporal lobe. In such cases, hyperactivation of the limbic system—particularly the amygdala-hippocampal network—has been implicated in the emergence of mystical and religious states, often manifesting as motor or verbal automatisms [1].

Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic option for a variety of neurologic and psychiatric disorders [1]. TMS is based on the principle of electromagnetic induction, in which an alternating electric current is passed through a stimulation coil, which is placed above the scalp. This stimulation coil serves as an electromagnet: by passing an alternating electric current through the coil, a time varying magnetic field is generated [2,3]. This varying magnetic field can penetrate soft tissue and bony ...

Refractory status epilepticus (RSE) is a neurological emergency characterized by persistent seizures despite two appropriate antiseizure medications [1]. New onset RSE (NORSE) represents a severe form of RSE occurring without preexisting neurological disorders. When no etiology is identified [2] a diagnosis of “cryptogenic “NORSE” (cNORSE) is established. Febrile infection-related epilepsy syndrome (FIRES) is now defined as the subcategory of cNORSE preceded by fever. FIRES accounts for the majority of cNORSE in children [3], but not in adults.

Epilepsy is a common long term neurological condition affecting children and young people (Royal College of Paediatrics and Child Health, 2020). According to the Royal College of Paediatrics and Child Health (2020), epilepsy affects about 1 in 220 children under 18 years. It is estimated that 63,400 children under 18years in the United Kingdom (UK) have epilepsy [42]. The World Health Organisation (2024) has stated that 50% of epileptic cases have an unknown cause with the remaining cases caused by ...

Status epilepticus (SE) represents a neurological emergency, which needs timely treatment to prevent the occurrence of major complications and to decrease the associated risk of mortality and morbidity1,2. The brain damage caused by SE includes neuronal necrosis, gliosis, and reorganization of brain networks, which can result in chronic epilepsy and a substantial reduction in the quality of life of surviving patients3-5.