Epilepsy Types

Epilepsy Syndrome’s

Benign Rolandic Epilepsy

Also referred to as Benign Rolandic Epilepsy of Childhood (BREC) or Benign Epilepsy with Centro-temporal Spikes (BECTS)

Who It Affects:

  • Represents approximately 15% of all childhood Epilepsies
  • Average onset between ages 6 and 8
  • More prominent in children who have close relatives with epilepsy
  • More likely to affect boys than girls

Seizure Characteristics:

  • partial (focal) seizures
  • twitching, numbness or tingling of the face or tongue
  • speech disruptions and drooling
  • low frequency and duration less than 2 minutes
  • primarily occur during sleep
  • Rarely generalize into a tonic-clonic seizure.

How It’s Diagnosed:

  • EEG (electroencephalogram)
    • spikes are observed in the motor and temporal lobe areas of the brain
  • MRI (Magnetic Resonance Imaging)
    • MRI’s usually reveal no abnormalities

Treatment:

  • Seizure medication usually isn’t prescribed unless one of the following occur:
    • Seizures start occurring during the day
    • Increase in frequency
    • Learning difficulties, behavioral and/or cognitive issues arise
  • Medications considered to be effective:
    • Tegretol or Carbatrol (Carbamazepine)
    • Keppra (Levetiracetam)
    • Trileptal or Trokendi XR (Oxcarbazepine)
    • Neurontin (gabapentin)
    • Zonegran (zonisamide) or Vimpat (lacosamide)

Prognosis:

  • Seizures stop approximately 2-4 years after onset
  • In most cases they stop on their own by age 15
  • Any learning, behavioral or cognitive issues will disappear and their EEG will return to normal

Doose Syndrome

Also referred to as Myoclonic Astatic Epilepsy (MAE)

Who It Affects:

  • Average onset between ages 1 and 5
  • No familial history of Epilepsy

Seizure Characteristics:

  • Generalized seizures affecting the entire brain
  • Tonic-clonic (grand mal)
  • Atonic (drop attacks)
  • Absence (petit mal’s)
  • Seizures happen suddenly and without warning (aura)

How It’s Diagnosed:

  • EEG (electroencephalogram)

Treatment:

  • Seizures are difficult to control and considered “medication resistant”
  • Some success has been found with:
    • Valproate (Depakote)
    • Keppra (Levetiracetam)
  • Ketogenic and modified Atkin’s diets have shown promise as an effective treatment

Prognosis:

Juvenile Myoclonic Epilepsy (JME)

Who It Affects:

  • Average onset between ages 5 and 16
  • Most common generalized epilepsy syndrome for this age group
  • Not gender specific
  • 50-60% of patients have an immediate family member with epilepsy

Seizure Characteristics:

  • Progressive epilepsy syndrome
  • Initial onset presents as absence (petit mal) seizures
  • Myoclonic jerks appear one to nine months after initial onset of absence seizures
  • Generalized Tonic can appear a few months after the onset of myoclonic jerks or may happen irrespectively
  • All seizure types usually happen within 30 minutes after awakening
  • Approximately 30% show photosensitivity

How It’s Diagnosed:

  • EEG (electroencephalogram)
    • Abnormal showing 3-6 Hz generalized polyspike and wave discharge
  • MRI (Magnetic Resonance Imaging)
    • MRI’s usually reveal no abnormalities

Treatment:

  • Adequate rest and stress reduction
  • Lifetime treatment required
  • Medications considered to be effective:
    • Valproate (Depakote)
    • Keppra (Levetiracetam)
    • Lamictal (Lamotrigine)
    • Klonopin (Clonazepam)
    • Phenobarbital
    • Topamax (Topriamate)

Prognosis:

  • Seizure occurrence decreases later in life
  • Stopping medications, even if well controlled, may cause rapid return of seizures

Landau-Kleffner Syndrome (LKS)

Who It Affects:

  • Average onset between ages 3 and 8
  • Rare childhood syndrome
  • More common in boys than girls

Seizure Characteristics:

  • Usually occur during sleep and are low in frequency
  • Simple partial seizures involving movement
  • Generalized tonic-clonic (grand mal)
  • Atypical Absence
  • Loss of speech and language comprehension; including what was previously learned

How It’s Diagnosed:

  • EEG (electroencephalogram)
    • Abnormalities seen during slow-wave sleep cycle (deep sleep)
    • Most accurate results found if performed sever hours after falling asleep
    • Results may not be accurate if performed while awake

Treatment:

  • Medications considered to be effective:
    • Valproate (Depakote)
    • Keppra (Levetiracetam)
    • Lamictal (Lamotrigine)
    • Valium/Diastat (Diazepam) if administered at bedtime
  • Surgical options are currently being researched

Prognosis:

  • Approximately 20% experience seizures past the age of 10
  • If treatment does not remedy the seizures there may be permanent language difficulties

Lennox-Gastaut Syndrome (LGS)

Who It Affects:

  • Represents approximately 2-5% of all childhood Epilepsies
  • Average onset between ages 2 and 6
  • Commonly found in children with brain development or acquired brain injuries

Seizure Characteristics:

  • Experience more than one type of seizure
  • Atonic (drop attacks)
  • Tonic
  • Atypical absence
  • Tonic-clonic

How It’s Diagnosed:

  • EEG (electroencephalogram)
    • Spike and wave bursts at less than 2.5 per second

Treatment:

  • Lifetime treatment required
  • Medications considered to be effective:
    • Valproic Acid (Depakote)
    • Lamictal (Lamotrigine)
    • Topamax (Topriamate)
    • Felbatol (Felbamate)
    • Klonopin (Clonazepam)
    • Banzel (Rufinamide)
    • Onfi (Clobazam)
  • Vagnus nerve stimulator (VNS)
  • Dietary therapies
  • Surgery

Prognosis:

  • Persists into adulthood with possible intellectual and behavioral issues 

Rasmussen's Syndrome

Also referred to as Rasmussen’s encephalitis. It is an autoimmune disorder causing inflammation and deterioration to one hemisphere (left or right) of the brain.

Who It Affects:

  • Average onset between ages 14 months and 14 years
  • Not gender specific

Seizure Characteristics:

  • Intractable simple partials are usually the first symptom
  • Approximately 20% will present in status epilepticus with simple partial or tonic-clonic
  • Onset of neurological, intellectual or learning difficulties will present 1-3 years after first seizure
  • Progressive hemiparesis (weakness affecting one side of the body that worsens over time)

How It’s Diagnosed:

  • EEG (electroencephalogram)
  • CT Scan (Computed Tomography)
    • Shows degeneration of brain matter
  • MRI (Magnetic Resonance Imaging)
    • Shows degeneration of brain matter

Treatment:

  • Medication resistant
  • Surgery to remove the affected hemisphere (hemisperectomy)

Prognosis:

  • Inflammation may resolve on its own, but damage is irreversible
  • Surgery shows high rate of success, especially if performed before age 6

Idiopathic Localization-Related (Focal) Epilepsy

Frontal Lobe Epilepsy

Who It Affects:

  • Those with abnormal brain tissue, abnormal blood vessels, stroke or traumatic brain injury
  • May be hereditary
  • Not gender or age discriminatory

Seizure Characteristics:

  • Simple or complex partials usually occurring at night and lasting less than 1 minute
  • Can quickly escalate to a secondarily generalized tonic-clonic

How It’s Diagnosed:

  • EEG (electroencephalogram)
  • MRI (Magnetic Resonance Imaging)

Treatment:

  • Usually well controlled with medication
  • Lifetime treatment required
  • VNS (Vagus Nerve Stimulation)
  • Surgery

Prognosis:

  • Varies depending on cause 

Temporal Lobe Epilepsy

Who It Affects:

  • Most common form of partial epilepsy
  • Not age or gender discriminatory
  • May be hereditary
  • Those with abnormal brain tissue, brain injury or scarring

Seizure Characteristics:

  • Simple partials lasting a few seconds with sensations including;
    • No loss of consciousness
    • Auditory hallucinations (ringing in ears, hearing voices)
    • Visual hallucinations and distortions (things that aren’t there, brighter, duller, bigger, smaller, etc…)
    • Olfactory distortions (burning smell)
    • Feelings of fear
    • Sudden change in mood
    • Déja vu (feeling I’ve been somewhere or done something before)
    • Jamais vu (no recognition of things done before)
    • Anxiety/panic
    • Heart palpitations
  • Complex partials lasting less than 1 minute with characteristics including;
    • Blank staring
    • Repeated movements (picking at clothing, lip smacking, etc…)
    • Loss of awareness
  • Also referred to as an “aura” meaning it can be a warning that a secondarily generalized tonic-clonic is imminent

How It’s Diagnosed:

  • EEG (electroencephalogram)
  • MRI (Magnetic Resonance Imaging)

Treatment:

  • Usually well controlled with medication
  • Lifetime treatment required
  • One-third of cases are considered intractable/refractory, meaning they are not controlled with medication
  • VNS (Vagus Nerve Stimulation)
  • RNS (Responsive neurostimulation)
  • Surgery

Prognosis:

  • Varies depending on cause and treatment success

Information Compilation

Sources

 

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