Generalized epilepsy

Generalized epilepsy
Other names	Primary generalized epilepsy, idiopathic epilepsy
Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
Specialty	Neurology

Generalized epilepsy is a form of epilepsy characterised by generalised seizures with no apparent cause.^[1] Generalized seizures, as opposed to focal seizures, are a type of seizure that impairs consciousness and distorts the electrical activity of the whole or a larger portion of the brain (which can be seen, for example, on electroencephalography, EEG).^[2]

Generalized epilepsy is primary because the epilepsy is the originally diagnosed condition itself, as opposed to secondary epilepsy, which occurs as a symptom of a diagnosed condition.^[3]

Manifestation

Generalized seizures can be either absence seizures, myoclonic seizures, clonic seizures, tonic-clonic seizures or atonic seizures.

Generalized seizures occur in various seizure syndromes, including myoclonic epilepsy, familial neonatal convulsions, childhood absence epilepsy, absence epilepsy, infantile spasms (West's syndrome), Juvenile Myoclonic Epilepsy, Lennox-Gastaut syndrome and Generalized epilepsy with occipital semiology.^[4]

Prognosis

Most generalized epilepsy starts during childhood. While some patients outgrow their epilepsy during adolescence and no longer need medication, in others, the condition remains for life, thereby requiring lifelong medication and monitoring.

Treatment

Seven anti-epileptic drugs are approved for use in cases of suspected primary generalized epilepsy:

• Brand Name: Felbatol Generic Name: Felbamate^[5]
• Levetiracetam
• Zonisamide
• Topiramate
• Valproate
• Lamotrigine
• Perampanel

Valproate, a relatively old drug, is often considered the first-line treatment. It is highly effective, but its association with fetal malformations when taken in pregnancy limits its use in young women.^[6]

All anti-epileptic drugs (including the above) can be used in cases of partial seizures.

References

1. "Comprehensive Epilepsy Center | NYU Langone Medical Center". Med.nyu.edu. Archived from the original on 2009-11-08. Retrieved 2016-12-16.
2. "Primary Generalized Epilepsy". Nervous-system-diseases.com. 2013-09-09. Retrieved 2016-12-16.
3. "Seizures or epilepsy". Pediatricservices.com. 2013-01-26. Retrieved 2016-12-16.
4. Gómez-Porro, Pablo; Serrano, Angel Aledo; Toledano, Rafael; García-Morales, Irene; Gil-Nagel, Antonio (October 2018). "Genetic (idiopathic) generalized epilepsy with occipital semiology". Epileptic Disorders. 20 (5): 434–439. doi:10.1684/epd.2018.0994. ISSN 1294-9361.
5. Personal Use
6. Vajda, FJ; O'brien, TJ; Hitchcock, A; Graham, J; Cook, M; Lander, C; Eadie, MJ (November 2004). "Critical relationship between sodium valproate dose and human teratogenicity: results of the Australian register of anti-epileptic drugs in pregnancy". Journal of Clinical Neuroscience. 11 (8): 854–8. doi:10.1016/j.jocn.2004.05.003. PMID 15519862.

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