1. Seizure zSudden, abnormal electrical discharge zChanges in xsensation xbehavior xmovements xperception xconsciousness

2. Epilepsy zChronic disorder zRecurrent seizures z“Seized” or “struck down” z0.5% to 1.0%

3. Types of Epilepsy zIdiopathic yBegins before age 20, rarely after 30 yNo specific cause yAccounts for 2/3 of the cases z Secondary yCauses include: xtraumatic brain injury xbrain tumor xinfection yAccounts for 1/3 of the cases yHighest incidence of new onset epilepsy 65

4. Classification of Seizures zPartial Seizures zGeneralized Seizures

5. Partial Seizures zSimple partial yconsciousness not impaired yfour types: xmotor signs xsensory signs xautonomic signs xsubjective symptoms z Complex partial yconsciousness impaired yautomatisms: xlip-smacking xchewing xpatting a part of body xpicking at clothes ytemporal lobe or psychomotor seizure

6. Generalized Seizures zAbsence seizures zMyoclonic seizures zTonic-clonic seizures zAtonic seizures

7. Absence Seizures zFormerly petit mal seizures zAltered consciousness lasts 5 to 30 sec. zUsually childhood and early adolescence

8. Myoclonic Seizures zSudden uncontrollable jerking zPossible fall zMomentary loss of consciousness zPostictal confusion

9. Tonic-Clonic Seizures zFormerly known as grand mal zOnly 10% of all seizures zTonic phase--body rigid zClonic phase--rhythmic jerky contraction and relaxation z2 to 5 minutes zPostictal phase

10. Atonic Seizures zTotal loss of muscle tone zNodding the head zFall to the floor z“Drop attacks”

11. EEG zAssists in: yestablishing epilepsy diagnosis yidentifying specific type of seizure zNormal reading does not exclude diagnosis of epilepsy

12. Management of Seizures zAntiepileptics are effective for approx. 75% of people with seizures zRemaining 25% continue to have seizures zSurgery is a last resort for about 5% of people with epilepsy

13. Surgery zSafest and most effective surgical treatment yCortical resection of anterior temporal lobe for complex partial seizures

14. Phase 1 zContinuous audio/video EEG monitoring zCT scan zMRI zMedical, neurological, psychiatric exams zSPECT scan

15. Phase 2 zCerebral angiogram zWADA test yIntracarotid amobarbital procedure yTest of the speech and memory parts of brain

16. Phase 3 zPlacement of EEG electrodes in the temporal and frontal lobes zSurface EEG electrodes not sensitive enough to locate seizure focus

17. Phase 4 zMapping of speech and motor areas zCortical resection or callosal resection