Generalized epilepsy

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Generalized epilepsy
Other namesPrimary generalized epilepsy, idiopathic epilepsy
An electroencephalogram of a person with childhood absence epilepsy showing a seizure. The waves are black on a white background.
Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
SpecialtyNeurology

Generalized epilepsy is a form of epilepsy characterised by generalised seizures with no apparent cause.[1] Generalized seizures, as opposed to focal seizures, are a type of seizure that impairs consciousness and distorts the electrical activity of the whole or a larger portion of the brain (which can be seen, for example, on electroencephalography, EEG).[2] Generalized seizure occurs due to abnormalities in both hemispheres.

Generalized epilepsy is primary because the epilepsy is the originally diagnosed condition itself, as opposed to secondary epilepsy, which occurs as a symptom of a diagnosed condition.[3]

Generalized seizures happened when there were abnormal activities in both hemispheres at the same time.[4] Almost all areas of the brain are affected by electrical impulses.[5]

Manifestation[edit]

Generalized seizures can be either absence seizures, myoclonic seizures, clonic seizures, tonic-clonic seizures or atonic seizures.

Generalized seizures occur in various seizure syndromes, including myoclonic epilepsy, familial neonatal convulsions, childhood absence epilepsy, absence epilepsy, infantile spasms (West's syndrome), Juvenile Myoclonic Epilepsy, Lennox-Gastaut syndrome and Generalized epilepsy with occipital semiology.[6]

Symptoms[edit]

Symptoms of a generalized seizure can vary depending on the type of seizure. Symptoms may include:[5]

  • Stiff muscles
  • Loss of consciousness
  • cry
  • Jerking of the arms and legs
  • Loss of bladder or bowel control
  • Stopped breathing
  • Blue lips
  • Loss of muscle tone
  • Sudden collapse

Types[edit]

There are different types of generalized seizures, including: [5]

  • Absence seizures
  • Myoclonic seizures
  • Clonic seizures
  • Tonic seizures
  • Tonic-clonic seizures
  • Atonic seizures

Absence seizures[edit]

Absence seizures are more found in children than in adults.[7] Absence seizures involve Unexpected intervals of awareness, it almost looks like the person who is having the seizure only looking at blankly.[7] it is also known as petit mal seizures.[8] It is common pediatric epilepsy disorder accounting for 10% of all pediatric epilepsies.[9] The fundamental mechanisms are not yet fully understood.[9] AS is measured a self-limited epilepsy syndrome,[9] There is also an increased risk of academic difficulties related to specific cognitive disorders.[9]


These are other possible symptoms of an absence seizure: [7][8]

  • Sudden stop in motion
  • Lip smacking
  • Eyelid flutters
  • Chewing motions
  • Finger rubbing
  • Small movements of both hands
  • Being very still
  • Suddenly returning to activity when the seizure ends

Cause[edit]

The exact cause of Generalized epilepsy is unknown, the few are:-[10]

  • Genetics
  • Mesial temporal sclerosis.
  • Head injuries.
  • Brain infections.
  • Immune disorders.
  • Developmental disorders.
  • Metabolic disorders
  • Brain conditions abnormalities.

There are the certain reason that happens before the seizure[10]

  • Stress.
  • Sleep issues and sleep disorders.
  • Alcohol use, alcohol withdrawal,
  • Leisure drug abuse.
  • Hormonal changes or menstrual hormonal changes.
  • Illness, fever.
  • Flashing lights or patterns.
  • Not eating healthy and, skipping meals.
  • Physical overexertion.
  • Dehydration.
  • Certain times of the day or night.
  • Use of certain medication

Genetic Cause[edit]

There are no clear descriptions of the genetic cause of generalized epilepsy.[10] There are few pieces of evidence that show that it runs into the family, or have an underlying genetic cause.[10] Few researchers also said explained the involvement of a few specific genes which can trigger the cause along with other reasons.[10]

Brain infections[edit]

Brain infections such as meningitis, and encephalitis can also cause epilepsy.[10] Infection is most common preventable risk factor for epilepsy.[11] Infection related epilepsy can develop at any of people (ranging from childhood to adult).[11] there are various bacterial, parasitic, fungal and viral infections of the CNS which lead to epilepsy.[11] CNS Bacterial infection can lead to seizures and late acquired epilepsy.[11] CNS TB is extremely related to epilepsy.[11] Encephalitis resulting of virus-related contagion of the brain can be linked to generalized seizures.[11]

Common infections related to epilepsy are: -[12]

  • Neurocysticercosis
  • Cerebral malaria
  • TORCH infections
  • Bacterial meningitis
  • Viral encephalitis
  • Tuberculosis
  • Human immunodeficiency virus (HIV)

Immune disorders[edit]

Autoimmune diseases can lead to epilepsy.[10]

Developmental Disorders[edit]

Developmental abnormalities disturbing the brain are a recurrent cause of epilepsy.[10]

Metabolic Disorders[edit]

People with a metabolic disorder can have epilepsy.[10] There are more than 200 metabolic disorders which can cause epilepsy.[13] Few researchers has found the new link between the protein deficiency and epilepsy.[14]

Prognosis[edit]

Most generalized epilepsy starts during childhood. While some patients outgrow their epilepsy during adolescence and no longer need medication, in others, the condition remains for life, thereby requiring lifelong medication and monitoring.

Treatment[edit]

Seven anti-epileptic drugs are approved for use in cases of suspected primary generalized epilepsy:

Valproate, a relatively old drug, is often considered the first-line treatment. It is highly effective, but its association with fetal malformations when taken in pregnancy limits its use in young women.[16]

All anti-epileptic drugs (including the above) can be used in cases of partial seizures.

References[edit]

  1. ^ "Comprehensive Epilepsy Center | NYU Langone Medical Center". Med.nyu.edu. Retrieved 2016-12-16.
  2. ^ "Primary Generalized Epilepsy". Nervous-system-diseases.com. 2013-09-09. Retrieved 2016-12-16.
  3. ^ "Seizures or epilepsy". Pediatricservices.com. 2013-01-26. Retrieved 2016-12-16.
  4. ^ "Generalized Seizures". www.hopkinsmedicine.org. 8 August 2021.
  5. ^ a b c "Articles". Cedars-Sinai.
  6. ^ Gómez-Porro, Pablo; Serrano, Angel Aledo; Toledano, Rafael; García-Morales, Irene; Gil-Nagel, Antonio (October 2018). "Genetic (idiopathic) generalized epilepsy with occipital semiology". Epileptic Disorders. 20 (5): 434–439. doi:10.1684/epd.2018.0994. ISSN 1294-9361. PMID 30361187.
  7. ^ a b c "Absence seizure - Symptoms and causes". Mayo Clinic.
  8. ^ a b "Absence Seizures". www.hopkinsmedicine.org. 19 November 2019.
  9. ^ a b c d Garzon, P; Lemelle, L; Auvin, S (November 2016). "[Childhood absence epilepsy: An update]". Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 23 (11): 1176–1183. doi:10.1016/j.arcped.2016.08.005. PMID 27683026.
  10. ^ a b c d e f g h i "Epilepsy: What It Is, Causes, Symptoms, Diagnosis & Treatment". Cleveland Clinic.
  11. ^ a b c d e f Vezzani, A; Fujinami, RS; White, HS; Preux, PM; Blümcke, I; Sander, JW; Löscher, W (February 2016). "Infections, inflammation and epilepsy". Acta Neuropathologica. 131 (2): 211–234. doi:10.1007/s00401-015-1481-5. PMC 4867498. PMID 26423537.
  12. ^ "Specific Infections Associated with Epilepsy". Epilepsy Foundation.
  13. ^ Almannai, M; Al Mahmoud, RA; Mekki, M; El-Hattab, AW (2021). "Metabolic Seizures". Frontiers in Neurology. 12: 640371. doi:10.3389/fneur.2021.640371. PMC 8290068. PMID 34295297.
  14. ^ options, Show more sharing; URLCopied!, Copy Link (11 July 1996). "Protein Deficiency May Cause Epileptic Seizures, Scientist Say". Los Angeles Times.
  15. ^ Personal Use
  16. ^ Vajda, FJ; O'brien, TJ; Hitchcock, A; Graham, J; Cook, M; Lander, C; Eadie, MJ (November 2004). "Critical relationship between sodium valproate dose and human teratogenicity: results of the Australian register of anti-epileptic drugs in pregnancy". Journal of Clinical Neuroscience. 11 (8): 854–8. doi:10.1016/j.jocn.2004.05.003. PMID 15519862. S2CID 20262790.

External links[edit]