Ternopil State Medical University named I.Horbachevsky Chair of neurology, psychiatry, narcology and medical psychology Prep. by Roksolana Hnatyuk M.D., Ph.D.

EPILEPSY

Epilepsy term for number of disorders characterized by various combinations of the following: periodic sensory or motor seizures (or epileptic equivalent) accompaned by an abnormal encephalogram (EEG), wich or with actual convulsions, clouding of or loss of consciousness, and motor, sensory or cognitive malfunctions

Age group by % all first seizures occurring in each age group AGE First seizures occurring (%)

Aura – a subjective experience that frequenty precede an epileptic seizer. The aura may occur any time from a few hours to several seconds prior to onset.

Psychic Auras § Type: Dysphasic (a) §Symptoms: Nonfluent § Probable Source: Left perisylvian language areas (a) Does not include speech arrest or simple vocalizations.

Psychic Auras (continuance) §Type: Dysmnesic §Symptoms: Déjà vu, déjà vécu, déjà pensé, déjà entendu, jamais vu, etc., prescience, illusion of memory (b) §Probable Source: Mesobasal temporal, b especially on right (b) Includes hippocampus, amygdala, and the parahippocampal gyrus.

Psychic Auras (continuance) §Type: Cognitive §Symptoms: Dreamy state, altered time sense, derealization, depersonalization §Probable Source: Mesobasal temporal and temporal neocortex §Type: Cognitive §Symptoms: Forced thinking, forced actions, and altered or obscure thoughts §Probable Source: Frontal association cortex

Psychic Auras (continuance) §Type: Affective §Symptoms: Fear, anxiety, apprehension, depression, pleasure, displeasure §Probable Source: Mesobasal temporal and temporal neocortex

Psychic Auras (continuance) §Type: Illusions (c) §Symptoms: Macropsia, micropsia, teleopsia, movement, metamorphopsia, increased color intensity, increased stereopsis intensity §Probable Source: Lateral superior temporal neocortex, especially on right for visual illusions ( c) Includes interpretive (size, motion, shape, and stereopsis) or experiential (elements of past experience or involvement).

Psychic Auras (continuance) §Type: Hallucinations (c) §Symptoms: Structured, hallucinatory remembrances, autoscopy §Probable Source: Mesobasal temporal and temporal neocortex c Includes interpretive (size, motion, shape, and stereopsis) or experiential (elements of past experience or involvement).

Table 2 International Classification of Epileptic Seizures § Partial (focal, local) seizures § Simple partial seizures §Motor, somatosensory, autonomic, or psychic symptoms §Complex partial seizures §Begin with symptoms of simple partial seizure but progress to impairment of consciousness

Table 2 International Classification of Epileptic Seizures (continue) § Begin with impairment of consciousness §Partial seizures with secondary generalization §Begin with simple partial seizure

Table 2 International Classification of Epileptic Seizures (continue) §Begin with complex partial seizure (including those with symptoms of simple partial seizures at onset) §Generalized seizures (convulsive or nonconvulsive) §Absence (typical and atypical)

Table 2 International Classification of Epileptic Seizures (continue) § Myoclonus §Clonic §Tonic §Tonic-clonic §Atonic/akinetic §Unclassified

Partial (focal, local) seizures

Generalized seizures

Anticonvulsant §Carbamazepine (Tegretol) §Phenytoin (Dilantin) §Phenobarbital (Barbita) and primidone (Myidone) §Valproic acid (Depakene) §Ethosuximide (Zarontin)

Anticonvulsant §Clonazepam (Klonopin) §Gabapentin (Neurontin) §Lamotrigine (Lamictal) §Vigabatrin (Sabril) §Tiagabine (Gabitril)

Thank you for your attention!