Seizure

Epilepsy is one of the most common neurological disorders affecting individuals worldwide [1]. Every year in Canada, 15,500 individuals are diagnosed with epilepsy [2]. The incidence of pediatric epilepsy in Canada is 41 per 100,000 children per year [3]. The diagnosis of childhood epilepsy can involve a lengthy waiting period between the first seizure and the first appointment with a medical professional (Brodie et al., 2012; Dragoumi et al., 2013). In emergency situations, patients can receive medical assessment by a ...

Epilepsy is a common and relatively treatable condition; about two thirds of people with it can have their seizures reduced using available medicines which are usually not excessively expensive[1]. When seizures continue, particularly if they are convulsive, people with epilepsy (PWE) are exposed to significant risks. They are up to six times more likely to die prematurely than people without epilepsy[2,3]. Burns and fractures are much more common. And very importantly, they, and their families, are subject to significant social ...

Absence seizures are generalized epileptic seizures with a characteristic ictal electroencephalographic (EEG) pattern of generalized, 3 Hertz (Hz) spike-and wave discharges.1,2 The mean duration of an absence seizure is 4-20 seconds (range 3-40 seconds), and it begins and ends abruptly, manifesting as cessation of activity, unresponsiveness, and staring with/without eye flutter, lip-smacking or head dropping.

Functional seizures (FS) or psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal and self-limited events that semiologically may resemble epileptic seizures, but without ictal epileptiform discharges; they are thought to have a psychological origin [1]. Many patients with FS (PNES) report loss of responsiveness with their events [2,3] and loss of responsiveness in FS (PNES) is significantly associated with seizure-related injuries [4]. In addition, drivers with neurological conditions or psychiatric disorders have been found to be more likely to cause ...

We read with interest the commentary “Could the 2017 ILAE and four-dimensional epilepsy classifications be merged to a new ‘Integrated Epilepsy Classification’?” [1]. This piece co-authored by a large group of top epilepsy luminaries discusses using comorbidity, epilepsy type, epilepsy syndrome, seizure type, and aetiologies in creating an Integrated Epilepsy Classification system (IEC). It considers merging the 2017 International League of Epilepsy (ILAE) classification and the four-dimensional epilepsy classification updated in 2019 [1].

Benign childhood epilepsy with centrotemporal spikes (BECTS), also known as Rolandic epilepsy, is the most commonly seen epileptic syndrome within the idiopathic group of epilepsies in childhood [1] and it constitutes 10%–20% of all childhood epilepsies [2]. Diagnosis is mainly established by a stereotypical interictal electroencephalography (EEG) pattern [3]. The hallmark of BECTS on EEG is centrotemporal spikes (CTS) that are typically activated by drowsiness and stage N2 sleep [4]. Within the same patient, CTS can be seen on right ...

Several studies have reported pathological coagulation parameters and platelet abnormalities in patients treated with various antiseizure drugs (ASDs), especially for Valproic acid (VPA) [1,2,3,4,5,6]. However, there is uncertainty whether these abnormalities result in a clinically relevant bleeding risk [2,7]. Studies on patients undergoing epilepsy surgery [1,4] have observed coagulopathies and platelet abnormalities, which have even led to the practice of stopping treatment with VPA before elective surgery in many centers [8], although this practice is discussed controversially in the literature ...

Several studies have indicated that active epilepsy is associated with an increased risk of motor vehicle accidents [1–6]. People with epilepsy (PWE) consider driving issues to be one of the concerns with the most impact on quality of life,[1,7] and a balance needs to be achieved between society’s need for traffic safety and patients’ wish for autonomy and independence by being able to hold a driving license. In 2003, an “Epilepsy and driving working group” was established to harmonize regulations ...

Around 20% of people with epilepsy (PWE) visit a hospital emergency department (ED) each year [1–4]. Nine out of 10 PWE arrive at ED by ambulance [5,6]. Such visits are expensive, with around half of them resulting in admission [7]. The annual cost to the National Health Service (NHS) for these visits in England alone is ∼£70–90 M [7–9].

In case of seizure disorders, the key to the correct diagnosis is an accurate past history. Normally, details of the patient’s personal history and specific risks factors related to the condition under scrutiny are collected through open interviews and reported in the permanent record as free narrative, at the discretion and judgement of the interviewer. Symptom lists and structured questionnaires of various types and format have been proposed to facilitate the diagnostic process and guarantee its completeness.