Epilepsy - dispelling the myths Malisa Pierri Clinical Nurse Specialist in Epilepsy Welsh Epilepsy Unit Cardiff and Vale University Health Board 029 20 745066 Malisa.pierri@wales.nhs.uk

Aim of the session: To have an overview of epilepsy, its symptoms, treatment and impact on individuals and their loved ones.

Objectives: Summarise the definition of the terms epilepsy and seizure Identify some of the common differential diagnosis Define examples of different seizure types Identify commonly used medications Examine the impact of epilepsy in special groups (teenagers/older individuals / women) Recognise some of the major social implications of the diagnosis and some of the common misconceptions

70 A.D In the Gospel According to Mark (9:14-29) Why Sacred? 70 A.D In the Gospel According to Mark (9:14-29) Jesus Christ casts out a devil from a young man with epilepsy: "Teacher, I brought you my son, who is possessed by a spirit that has robbed him of speech. Whenever it seizes him, it throws him to the ground. He foams at the mouth, gnashes his teeth, and becomes rigid. I asked your disciples to drive the spirit out, but they could not." (NIV) Raphael: The Transfiguration – www.epilepsiemuseum.de

1494: A handbook on witch-hunting Written by two Dominican friars under papal authority, the book identifies the presence of seizures as a characteristic of witches. Malleus Maleficarum brings a wave of persecution and torture, leading to the death of more than 200,000 women.

Epilepsy overview: facts and figures

umbrella term defined by: development of recurrent unprovoked seizures Epilepsy is the most common serious neurological disorder 450,000 people in the UK umbrella term defined by: development of recurrent unprovoked seizures two or more seizures more than 24 hours apart

can appear at any age

Figures in a British region 1,000,000 persons New cases of epilepsy annually 500 New cases of febrile seizures 500 New cases of single seizure 200 Cases of active epilepsy (prevalence) 5000 Lifetime prevalence 20000

Overall Incidence is annually 70/100,000 Prevalence is 5-10 per 1000 of population excluding inactive epilepsy Lifetime prevalence of non febrile seizures is 2-5% (this rises to 10% in some studies)

an abnormal, self limiting discharge from a group of neurons A seizure being an abnormal, self limiting discharge from a group of neurons

sudden onset event presenting as a disturbance of: consciousness behaviour emotion motor, sensory or autonomic function Pretty much anything…….

Many different types of seizures Classically two patterns Focal cortical disturbances (focal onset seizures) Immediate synchronous spike and wave discharge from both hemispheres (generalised seizures)

International League Against Epilepsy (ILAE) Classification of Epilepsy Simple Complex

Absence Myclonic Generalised tonic-clonic International League Against Epilepsy (ILAE) Classification of Epilepsy Absence Myclonic Generalised tonic-clonic

International League Against Epilepsy (ILAE) Classification of Epilepsy Typical Examples of Syndromes: Juvenile Absence Epilepsy Juvenile Myoclonic Epilepsy

Seizure Videos