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Ternopil State Medical University named I.Horbachevsky Chair of neurology, psychiatry, narcology and medical psychology Prep. by Roksolana Hnatyuk M.D., Ph.D. EPILEPSY Epilepsy term for number of disorders characterized by various combinations of the following: periodic sensory or motor seizures (or epileptic equivalent) accompaned by an abnormal encephalogram (EEG), wich or with actual convulsions, clouding of or loss of consciousness, and motor, sensory or cognitive malfunctions Age group by % all first seizures occurring in each age group AGE First seizures occurring (%) 0-9 10-19 20-29 30-39 40+ 47 30 13 6 4 Aura – a subjective experience that frequenty precede an epileptic seizer. The aura may occur any time from a few hours to several seconds prior to onset. Psychic Auras Type: Dysphasic (a) Symptoms: Nonfluent Probable Source: Left perisylvian language areas (a) Does not include speech arrest or simple vocalizations. Psychic Auras (continuance) Type: Dysmnesic Symptoms: Déjà vu, déjà vécu, déjà pensé, déjà entendu, jamais vu, etc., prescience, illusion of memory (b) Probable Source: Mesobasal temporal, b especially on right (b) Includes hippocampus, amygdala, and the parahippocampal gyrus. Psychic Auras (continuance) Type: Cognitive Symptoms: Dreamy state, altered time sense, derealization, depersonalization Probable Source: Mesobasal temporal and temporal neocortex Type: Cognitive Symptoms: Forced thinking, forced actions, and altered or obscure thoughts Probable Source: Frontal association cortex Psychic Auras (continuance) Type: Affective Symptoms: Fear, anxiety, apprehension, depression, pleasure, displeasure Probable Source: Mesobasal temporal and temporal neocortex Psychic Auras (continuance) Type: Illusions (c) Symptoms: Macropsia, micropsia, teleopsia, movement, metamorphopsia, increased color intensity, increased stereopsis intensity Probable Source: Lateral superior temporal neocortex, especially on right for visual illusions (c) Includes interpretive (size, motion, shape, and stereopsis) or experiential (elements of past experience or involvement). Psychic Auras (continuance) Type: Hallucinations (c) Symptoms: Structured, hallucinatory remembrances, autoscopy Probable Source: Mesobasal temporal and temporal neocortex c Includes interpretive (size, motion, shape, and stereopsis) or experiential (elements of past experience or involvement). Table 2 International Classification of Epileptic Seizures Partial (focal, local) seizures Simple partial seizures Motor, somatosensory, autonomic, or psychic symptoms Complex partial seizures Begin with symptoms of simple partial seizure but progress to impairment of consciousness Table 2 International Classification of Epileptic Seizures (continue) Begin with impairment of consciousness Partial seizures with secondary generalization Begin with simple partial seizure Table 2 International Classification of Epileptic Seizures (continue) Begin with complex partial seizure (including those with symptoms of simple partial seizures at onset) Generalized seizures (convulsive or nonconvulsive) Absence (typical and atypical) Table 2 International Classification of Epileptic Seizures (continue) Myoclonus Clonic Tonic Tonic-clonic Atonic/akinetic Unclassified Partial (focal, local) seizures Partial (focal, local) seizures Partial (focal, local) seizures Generalized seizures Generalized seizures Generalized seizures Anticonvulsant Carbamazepine (Tegretol) Phenytoin (Dilantin) Phenobarbital (Barbita) and primidone (Myidone) Valproic acid (Depakene) Ethosuximide (Zarontin) Anticonvulsant Clonazepam (Klonopin) Gabapentin (Neurontin) Lamotrigine (Lamictal) Vigabatrin (Sabril) Tiagabine (Gabitril) Thank you for your attention!