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Internal Medicine
5. Seizure and Epilepsy
Learning objectives: at the end of this lesson the student will be able to:
1. Define Seizure and epilepsy.
2. Describe the international classification of Seizure.
3. Understand the epidemiology of Seizure and epilepsy.
4. List the etiologies or risk factors for Seizure disorder.
5. Identify the clinical manifestation of different types of Seizure disorders.
6. Understand the Evaluation and diagnostic approach to Seizure.
Identify complications of Seizure.
8. List differential diagnosis for Seizure.
9. Manage patients with Seizure or epilepsy.
10. Understand status epileptics and its management.
Definition: Seizure is a paroxysmal event due to abnormal excessive discharge of cerebral
neurons. The paroxysmal event may be subtle or dramatic. Depending on the distribution of the
discharge, the manifestations may be:
Autonomic or
Psychiatric manifestation.
Epilepsy – is a syndrome characterized by recurrent (two or more) unprovoked seizure attacks,
due to a chronic, underlying process in the brain. This definition implies that a person with a
single seizure, or recurrent seizures due to correctable or avoidable circumstances, does not
necessarily have epilepsy.
International classification of seizures:
Epileptic seizures can be classified in many different ways. Commonly used classification is the
one developed by International League against Epilepsy.
1) Partial seizures: beginning locally
a) Simple partial seizure: (with motor, somatosensory, autonomic or psychiatric symptoms
b) Complex partial seizure
c) Partial seizures with secondarily generalization