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Epilepsy

A group of disorders marked by problems in the normal functioning of the brain. These problems can produce seizures, unusual body movements, a loss of consciousness or changes in consciousness, as well as mental problems or problems with the senses.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Epilepsy

The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign.

In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.

The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors.

Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy.

A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. NIH - National Institute of Neurological Disorders and Stroke

What works? Research summarized

Evidence reviews

Clobazam as an add‐on in the management of refractory epilepsy

Only four randomised controlled trials have been undertaken assessing add‐on clobazam for refractory epilepsy. All are cross‐over studies of short duration; they used differing designs and were of poor methodological quality. Results suggest that clobazam reduces seizure frequency for drug refractory partial epilepsy. There are limited and inconclusive data for generalized epilepsy. Cloabazam was also associated with adverse events.

Cannabinoids for epilepsy

Epilepsy is a disorder of recurrent unprovoked seizures. More than half of seizures can be controlled by anti‐epileptic medications. For the remaining patients, they may wish to try other agents to obtain better control. Marijuana, or cannabinoids, may be one such agent. This review assessed the efficacy of marijuana, or cannabinoids, as a treatment for epilepsy. No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy. Further trials are needed.

Subpial transection surgery for epilepsy

Nearly 30% of patients with epilepsy continue to have seizures despite taking several antiepileptic drugs (AEDs). Such patients are regarded as having refractory, or uncontrolled, epilepsy. Uncontrolled epilepsy by itself directly affects the intellectual function and social status of children. It causes considerable morbidity and mortality, affecting the person's quality of life. Some people with refractory epilepsy benefit from surgical treatment. Multiple subpial transection (MST) is a surgical technique by which connections of the epileptic focus are partially cut without resection. MST is one type of surgery that can be performed for people with medically refractory epilepsy, for whom the epileptogenic zone cannot be resected because of high risk of neurological deficits. In this review, we planned to assess benefits and adverse effects of multiple subpial transection in patients with refractory epilepsy. We found no randomised controlled trials comparing subpial transection versus antiepileptic drug therapy or subpial transection versus another type of epilepsy surgery. Therefore, evidence is insufficient for assessment of benefits or adverse effects of subpial transection; additional studies are needed.

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Summaries for consumers

Perampanel (Fycompa) for epilepsy: Overview

Perampanel (trade name: Fycompa) has been approved since July 2012 as an add-on therapy for epileptic seizures in adults and children over the age of 12.

Brivaracetam (Briviact) for epilepsy: Overview

Brivaracetam (trade name: Briviact) has been approved in Germany since January 2016 as an add-on therapy for epileptic seizures in teenagers over the age of 16 and in adults.

Clobazam as an add‐on in the management of refractory epilepsy

Only four randomised controlled trials have been undertaken assessing add‐on clobazam for refractory epilepsy. All are cross‐over studies of short duration; they used differing designs and were of poor methodological quality. Results suggest that clobazam reduces seizure frequency for drug refractory partial epilepsy. There are limited and inconclusive data for generalized epilepsy. Cloabazam was also associated with adverse events.

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Terms to know

Brain
The part of the central nervous system that is contained within the skull (cranium).
Imaging Tests
A type of test that makes pictures of areas inside the body. Some examples of imaging tests are CT scans and MRIs. Also called imaging procedure.
Neurotransmitters
A chemical that is made by nerve cells and used to communicate with other cells, including other nerve cells and muscle cells.
Seizures
Sudden, uncontrolled body movements and changes in behavior that occur because of abnormal electrical activity in the brain. Symptoms include loss of awareness, changes in emotion, loss of muscle control, and shaking. Seizures may be caused by drugs, high fevers, head injuries, and certain diseases, such as epilepsy.

More about Epilepsy

Photo of a young adult

Also called: Epileptic attack, Epileptic convulsions, Epileptic disorder, Epileptic fits, Epileptic seizures, Epileptic, Seizure disorder, EP

Other terms to know: See all 4
Brain, Imaging Tests, Neurotransmitters

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