Seizure

Functional / dissociative seizures (FDS), also known as psychogenic non-epileptic seizures (PNES) and non-epileptic attack disorder (NEAD), are one of the most prevalent types of functional neurological disorder (FND) [63]. FDS are episodes that behaviourally resemble epileptic seizures or syncope [59,62]. They can be conceptualised as an involuntary response to internal or external triggers associated with dysfunctional emotion regulation [17]. FDS are a common condition and account for approximately 15% of patients referred to neurology clinics with seizure-like events [3].

Electrical status epilepticus during sleep (ESES) is characterized by an abnormal electroencephalographic (EEG) pattern of nearly continuous epileptiform activity during non-rapid eye movement (NREM) sleep [1,2]. Patients presenting with EEG abnormalities in association with cognitive and/or behavioral regression has been defined as having developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep (DEE/EE-SWAS) [1]. DEE-SWAS and EE-SWAS are usually limited to childhood and account for approximately 0.5–0.6% of childhood epilepsy cases in tertiary care centers [1].

Epileptic Encephalopathy/developmental epileptic encephalopathy with Spike-and-Wave Activation in Sleep (EE/DEE-SWAS) is a childhood epilepsy syndrome characterized by neurocognitive, behavioral and motor regression following the appearance of continuous spike-and-wave on EEG during non-rapid eye movement (NREM) sleep(1). DEE-SWAS is seen in patients with pre-existing neurodevelopmental disorders, while patients with EE-SWAS have normal development preceding the onset of SWAS [1]. Clinical seizures often develop 1-2 years earlier and become more frequent and severe with the manifestation of SWAS on EEG.

Functional seizures (FS), also known as psychogenic non-epileptic seizures or PNES, are a type of functional neurological disorder characterized by seizure-like symptoms without associated epileptiform activity.[1] Pediatric FS account for approximately 10%-20% of patients presenting to outpatient neurology clinics in the United States,[2], [3] making it one of the most common diagnoses among those referred.[4] Pediatric FS are severely debilitating for patients and their families and are associated with significantly decreased quality of life.[5], [6] For example, children and adolescents ...

Adolescence is defined as the phase of life between childhood and adulthood (ages 10-19 years) and is important for establishing healthy behaviours for future well-being and health [1]. Annually, around 1.1 million young people with epilepsy (YPE) take the step into adulthood [2]. During adolescence, the consequences of epilepsy on daily life can become more pronounced; epilepsy often interferes with autonomy, social life, educational and career decisions, driving ability, and reproductive health [3].

Data from international studies suggest epilepsy prevalence in people with Intellectual Disability (PwID) is around 22.2% [1] and significantly higher than estimations of 0.8% for the general worldwide population. [2]. UK data shows similar distributions, with 17.9% of PwID having an NHS epilepsy diagnosis, compared to 0.6% of those with no ID. [3] Prevalence increases with severity, with 7.3%-9.8% of people with mild ID and 27%-41.6% with moderate to profound ID diagnosed with epilepsy. [1]

Epilepsy affects almost 1% of the general population [1]. Approximately 30-40% of epilepsy patients do not adequately respond to antiseizure medications (ASMs) [2,3]. They are considered ‘drug-resistant’, defined as failure of two tolerated and appropriately prescribed ASMs to achieve sustained seizure freedom [4]. One proposed mechanism for drug-resistance, relevant for epilepsy and many other CNS disorders, like depression, HIV and cancer, is encapsulated by the ‘transporter hypothesis [5-7], postulating that overactivity of drug efflux transporter(s) at the blood-brain barrier (BBB) ...

Posterior cingulate epilepsy (PCE) is a uncommon variant of focal epilepsy. From a clinical perspective, the identification of patients with PCE based on electroclinical characteristics poses a significant diagnostic challenge, as PCE can closely resemble various other epilepsy types [1]. The complexity of diagnosing PCE can often be attributed to the seizure onset zone (SOZ), which is situated in an anatomically deep and relatively inactive region that quickly disseminates activity to more expressive brain structures closely connected to the posterior ...

Many people with epilepsy (PWE) suffer from cognitive impairments, and neuropsychological investigations are an integral part of comprehensive epilepsy care [1]. Nevertheless, the overlap of subjective cognition (SC) and results of objective tests is often weak [2]. Previous studies found that discordance of SC and objective cognition (OC) occurs in 60-80% of PWE [3–5]. Cognitive dysfunction in PWE may have multifactorial reversible and irreversible causes that may impact SC and OC to different degrees.

Human onchocerciasis is a neglected tropical disease caused by the filarial nematode Onchocerca volvulus. The infection is transmitted by infectious bites of blackflies. Clinical manifestations caused by O. volvulus microfilariae include skin and eye disease (river blindness). In onchocerciasis-endemic regions with ongoing or past O. volvulus transmission, an increased prevalence of epilepsy and nodding syndrome (NS) has been observed [1]. Recent epidemiological studies suggest that onchocerciasis may directly or indirectly induce seizures, called onchocerciasis-associated epilepsy (OAE) [2].