1. Epilepsy - dispelling the myths Malisa Pierri
Clinical Nurse Specialist in Epilepsy
Welsh Epilepsy Unit
Cardiff and Vale University Health Board

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

3. 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

4. 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 –

5. 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.

6. Epilepsy overview:
facts and figures

7. 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

8. can appear at any age

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

10. 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)

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

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

13. 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)

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

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

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

18. Seizure Videos