p.13
Genetic Causes of Epilepsy
What financial implications may arise from genetic testing?
Insurance and financial implications related to the testing and potential findings.
p.9
Evaluation of First Seizure
What caution should be taken regarding normal EEG variants?
Caution must be taken to not overinterpret normal variants as pathogenic.
p.15
Management and Counseling for New-Onset Seizures
What is the consensus regarding treatment in children with new-onset seizures?
A similar consensus was reached as in adults, but few data are available from studies limited to children.
p.15
Evaluation of First Seizure
What is crucial for excluding seizure mimics and provoked seizures in new-onset seizures?
A careful clinical history.
p.7
Comorbidities Associated with Epilepsy
Why is it important to address cognitive and psychological comorbidities in epilepsy management?
They can have a greater impact on quality of life than seizures.
p.1
Distinguishing Features of Seizure Types
What is the frequency of focal impaired awareness seizures in untreated patients?
Typically less than daily to monthly.
p.2
Genetic Causes of Epilepsy
Which genes are associated with single-gene disorders in genetic epilepsy?
KCNQ2, CDKL5, and STXBP1.
p.1
Distinguishing Features of Seizure Types
What other seizure types may evolve from focal impaired awareness seizures?
May evolve to bilateral tonic-clonic seizure.
p.14
Management and Counseling for New-Onset Seizures
What counseling should be provided to individuals presenting with a first unprovoked seizure?
Counseling on lifestyle issues, seizure safety, and what to do if further seizures occur.
p.2
Unknown Causes of Epilepsy
What percentage of patients with new-onset unprovoked seizures have no clear etiology found?
Approximately 30% to 50%.
p.10
Evaluation of First Seizure
What can routine EEG recordings capture?
Both epileptic and nonepileptic events.
p.14
Management and Counseling for New-Onset Seizures
When is antiseizure medication typically started?
In cases of new-onset epilepsy, but not in most cases of first unprovoked seizure with normal EEG and imaging.
p.15
Classification of Epilepsies
Why is accurate classification of epilepsy important?
It assists with the choice of cost-effective investigations, optimal treatment, and accurate prognosis.
p.7
Comorbidities Associated with Epilepsy
What types of cognitive disorders are common in people with epilepsy?
Cognitive disorders that often precede seizure onset.
p.7
Evaluation of First Seizure
What did the EEG show for the boy in the case study?
Occasional right centrotemporal discharges that became more frequent in sleep.
p.2
Genetic Causes of Epilepsy
What is the underlying etiology of idiopathic generalized epilepsies?
Polygenic, with or without environmental factors.
p.8
Evaluation of First Seizure
Why is an EEG recommended for patients with a first unprovoked seizure?
It may impact management decisions.
p.12
Genetic Causes of Epilepsy
What are some clinical features that suggest an autoimmune etiology in seizures?
Frequent, drug-resistant seizures, cognitive/behavioral dysfunction, dysautonomia, and specific seizure types like faciobrachial dystonic seizures.
p.15
Management and Counseling for New-Onset Seizures
What is the effect of immediate antiseizure medication treatment in adults with a first unprovoked seizure?
It reduces the absolute risk of recurrence by about 35% for a subsequent seizure within the next 2 years.
p.15
Management and Counseling for New-Onset Seizures
What should be addressed in all cases of new-onset seizures?
Counseling regarding seizure safety and first aid.
p.7
Comorbidities Associated with Epilepsy
Which neuropsychiatric disorders are more prevalent in individuals with epilepsy?
Attention deficit hyperactivity disorder and mood disorders.
p.1
Distinguishing Features of Seizure Types
What are some clinical features of focal impaired awareness seizures?
Often contralateral head or eye deviation, contralateral dystonic posturing with ipsilateral automatisms.
p.2
Infectious Etiologies of Epilepsy
What are common infectious etiologies of epilepsy?
Neurocysticercosis, HIV, cerebral malaria, Zika virus, and cytomegalovirus.
p.14
Genetic Causes of Epilepsy
What initial genetic tests are suggested for patients with epilepsy when the phenotype does not suggest a specific gene?
An epilepsy gene panel or whole-exome sequencing study.
p.14
Management and Counseling for New-Onset Seizures
What potential risks should patients be informed about regarding recurrent seizures?
Status epilepticus, aspiration, and sudden unexpected death in epilepsy (SUDEP).
p.5
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG show for Early infantile developmental and epileptic encephalopathy?
Severely abnormal with diffuse slowing, multifocal discharges, and/or burst suppression.
p.6
Classification of Epilepsies
What is the usual age at onset for Lennox-Gastaut syndrome?
Mostly preschool to school age; adolescent onset is rare.
p.6
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Rasmussen syndrome?
Progressive hemispheric dysfunction; acquired hemiparesis, visual field deficit, and possible language deficits.
p.9
Evaluation of First Seizure
Why must EEG interpretation be done in the context of clinical history?
Because approximately 3% of people without epilepsy may show epileptiform discharges, making an abnormal EEG not equate to epilepsy.
p.9
Evaluation of First Seizure
What is hypnagogic hypersynchrony often misinterpreted as?
Generalized spike and wave.
p.13
Genetic Causes of Epilepsy
What psychological implications should be considered before genetic testing?
The impact of potentially carrying an abnormal variant that could result in disease or increase risk in one's child.
p.1
Distinguishing Features of Seizure Types
What does the interictal EEG show in untreated patients with focal impaired awareness seizures?
Normal, focal slowing, or focal discharges.
p.1
Distinguishing Features of Seizure Types
What other seizure types may be associated with absence seizures?
May have associated myoclonic or generalized tonic-clonic seizures.
p.2
Metabolic Causes of Epilepsy
What is an example of a treatable metabolic disorder related to epilepsy?
Glucose transporter disorder, treatable with a ketogenic diet.
p.12
Evaluation of First Seizure
What should be done before a lumbar puncture if there are signs of increased intracranial pressure?
A brain imaging study should precede the lumbar puncture.
p.12
Genetic Causes of Epilepsy
When should genetic testing be considered in epilepsy?
If the result will likely lead to a change in evaluation procedures, treatment choice, or prognosis.
p.10
Evaluation of First Seizure
What does an EEG with epileptiform abnormalities indicate regarding seizure recurrence?
It is associated with a relative rate increase for seizure recurrence.
p.5
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Early infantile developmental and epileptic encephalopathy?
Moderate or greater intellectual disability, hypotonia.
p.3
Distinguishing Features of Seizure Types
What seizure types are seen in self-limited infantile epilepsy?
Focal impaired awareness or focal clonic seizures, which may evolve to bilateral tonic-clonic.
p.4
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Childhood Absence Epilepsy?
Learning problems and attention deficit hyperactivity disorder (ADHD).
p.4
Neuroimaging in Epilepsy Diagnosis
What is the interictal EEG finding for Epilepsy with Generalized Tonic-Clonic Seizures Alone?
>3-Hz generalized spike and wave or polyspike and wave.
p.4
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Myoclonic Absence Epilepsy?
Mild cognitive delay, ADHD, anxiety, depression.
p.13
Genetic Causes of Epilepsy
What is the yield of genetic testing in infants and young children with developmental and epileptic encephalopathies of unknown cause?
Approximately one-third to one-half of these patients have a pathogenic variant found.
p.9
Evaluation of First Seizure
What are wicket waves and rhythmic temporal theta of drowsiness often miscalled in adolescents and adults?
They are often miscalled as epileptiform.
p.7
Evaluation of First Seizure
What was the diagnosis for the 9-year-old boy in the case study?
Self-limited epilepsy with centrotemporal spikes.
p.1
Distinguishing Features of Seizure Types
What is the duration of absence seizures?
Usually less than 10-30 seconds.
p.14
Genetic Causes of Epilepsy
What factors may influence the choice of genetic testing in epilepsy cases?
Whole-genome sequencing and specific clinical features.
p.2
Immune-Mediated Epilepsy
What characterizes immune epilepsy?
It results directly from an underlying immune disorder.
p.14
Management and Counseling for New-Onset Seizures
What should patients be counseled about regarding driving after experiencing seizures?
Guidance varies depending on the place of residence; the Epilepsy Foundation provides updated driving laws for each state.
p.11
Evaluation of First Seizure
Why might MRI studies in children under 3 years be limited?
Ongoing brain myelination often limits detection of lesions.
p.8
Evaluation of First Seizure
What does the case illustrate about the diagnosis of specific syndromes?
It provides key information for choosing optimal investigations, treatment, and prognosis.
p.5
Distinguishing Features of Seizure Types
What type of seizures are associated with Genetic epilepsy with febrile seizures plus?
Febrile seizures, which may persist after 6 years, and other focal or generalized seizures.
p.5
Distinguishing Features of Seizure Types
What type of seizures are associated with Infantile epileptic spasms syndrome?
Clusters of epileptic spasms.
p.6
Distinguishing Features of Seizure Types
What type of seizures are characteristic of Rasmussen syndrome?
Focal/hemispheric seizures that increase in severity and frequency.
p.6
Distinguishing Features of Seizure Types
What types of seizures may occur in developmental and/or epileptic encephalopathy?
Focal motor, which may evolve to bilateral tonic-clonic seizures.
p.6
Management and Counseling for New-Onset Seizures
What is the prognosis for patients with progressive myoclonus epilepsies?
Progressive decline with time; myoclonus is drug-resistant.
p.15
Management and Counseling for New-Onset Seizures
Did immediate antiseizure medication treatment improve quality of life or sustained seizure remission in adults?
No, it did not alter quality of life or improve the chance of obtaining sustained seizure remission over the longer term.
p.13
Genetic Causes of Epilepsy
What are some conditions that may indicate a genetic-structural cause on neuroimaging?
Tuberous sclerosis complex or double cortex.
p.7
Comorbidities Associated with Epilepsy
Why is early identification of comorbidities critical in epilepsy?
They are treatable and can significantly worsen cognitive function if left untreated.
p.2
Genetic Causes of Epilepsy
What defines genetic epilepsy?
It is caused by a known or presumed genetic variant.
p.11
Evaluation of First Seizure
Why is MRI preferred over CT for imaging in new-onset seizures?
MRI avoids radiation exposure and enhances detection of lesions.
p.11
Evaluation of First Seizure
What clinical circumstances suggest a higher likelihood of underlying provoked seizures?
Failure to return to baseline alertness, vomiting, diarrhea, dehydration, and certain medical conditions.
p.8
Evaluation of First Seizure
When is the diagnostic yield of EEG highest?
If performed within the first 24 hours after a seizure.
p.8
Evaluation of First Seizure
How does sleep deprivation affect EEG yield?
It increases the yield, particularly for those with focal discharges.
p.10
Evaluation of First Seizure
When should prolonged video-EEG monitoring be considered?
To exclude frequent subtle seizures or status epilepticus in specific clinical scenarios.
p.5
Management and Counseling for New-Onset Seizures
What is the prognosis for Early infantile developmental and epileptic encephalopathy?
Usually drug-resistant and lifelong.
p.6
Distinguishing Features of Seizure Types
What types of seizures may occur in Lennox-Gastaut syndrome?
Tonic seizures; may also have generalized tonic-clonic, myoclonic, atonic, atypical absence, or focal seizures.
p.6
Management and Counseling for New-Onset Seizures
What is the prognosis for patients with Rasmussen syndrome?
Drug-resistant; often seizures resolve after hemispherotomy.
p.6
Distinguishing Features of Seizure Types
What is characteristic of seizures in progressive myoclonus epilepsies?
Progressive worsening of myoclonic seizures with time; often emergence of other seizure types.
p.13
Genetic Causes of Epilepsy
When should genetic testing be considered in patients?
In patients whose examination or investigations suggest a probable genetic cause.
p.13
Genetic Causes of Epilepsy
What reproductive implications arise from genetic testing?
The risk of passing on an abnormal variant.
p.1
Distinguishing Features of Seizure Types
What is the postictal state like for focal impaired awareness seizures?
Usually present with confusion and possible language dysfunction if it affects the dominant temporal lobe.
p.1
Distinguishing Features of Seizure Types
What does the interictal EEG show in untreated patients with absence seizures?
Usually shows generalized spike-and-wave discharge, which may activate with hyperventilation or photic stimulation.
p.2
Metabolic Causes of Epilepsy
What does a metabolic etiology imply in relation to epilepsy?
Epilepsy and seizures result from biochemical changes due to a known metabolic disorder.
p.12
Evaluation of First Seizure
When should toxicology screening be considered?
If toxin exposure or substance abuse is a concern or if clinical findings suggest possible exposure.
p.10
Evaluation of First Seizure
What is the role of a qualified electroencephalographer in interpreting EEG results?
They are key in interpreting temporal epileptiform discharges and distinguishing between epileptic and nonepileptic events.
p.10
Evaluation of First Seizure
What activation parameters are typically used during routine EEG?
Hyperventilation and photic stimulation.
p.8
Evaluation of First Seizure
What EEG findings were consistent with a diagnosis of self-limited epilepsy in the case study?
Very frequent right centrotemporal sharp waves.
p.6
Management and Counseling for New-Onset Seizures
What is the prognosis for most patients with Epilepsy with myoclonic-atonic seizures?
Two-thirds remit but may have mild attention or cognitive concerns; 1/3 do not remit and often have more severe learning and attention problems.
p.6
Management and Counseling for New-Onset Seizures
What is the prognosis for patients with Lennox-Gastaut syndrome?
Drug-resistant and lifelong.
p.6
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG show for Rasmussen syndrome?
Hemispheric background slowing and interictal discharge.
p.3
Distinguishing Features of Seizure Types
What type of seizures are characteristic of Panayiotopoulos syndrome?
Focal autonomic seizures (often retching or vomiting) with or without impaired awareness.
What is the prognosis for self-limited epilepsy with centrotemporal spikes?
Remission by early adolescence.
p.4
Distinguishing Features of Seizure Types
What type of seizures are associated with Childhood Absence Epilepsy?
Typical absence seizures occurring multiple times per day.
p.4
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Juvenile Myoclonic Epilepsy?
ADHD, depression, anxiety.
p.9
Evaluation of First Seizure
When can an EEG typically be performed?
On an outpatient basis when patients are otherwise well.
p.7
Comorbidities Associated with Epilepsy
What are the consequences of epilepsy according to the ILAE?
Neurobiologic, cognitive, psychological, and social consequences.
p.7
Comorbidities Associated with Epilepsy
What factors may contribute to cognitive disorders in epilepsy?
Underlying pathology, frequent seizures, and treatment-related effects.
p.7
Management and Counseling for New-Onset Seizures
What counseling was provided to the family regarding the boy's condition?
Teaching on seizure safety and counseling on the low risk of sudden unexpected death in epilepsy (SUDEP).
p.11
Evaluation of First Seizure
What should patients with new-onset seizures and focal neurologic deficits be considered for?
Urgent imaging, preferably MRI over CT.
p.2
Immune-Mediated Epilepsy
What is the distinction between immune-mediated epilepsy and acute symptomatic seizures?
Immune-mediated epilepsy has an enduring predisposition to seizures, while acute symptomatic seizures occur secondary to autoimmune encephalitis.
p.2
Genetic Causes of Epilepsy
What is an example of a condition that has both structural and genetic etiology?
Tuberous sclerosis complex.
p.2
Immune-Mediated Epilepsy
What is the significance of detecting specific antibodies in autoimmune encephalitis?
They result in acute symptomatic seizures and should be distinguished from immune-mediated epilepsies.
p.10
Evaluation of First Seizure
What is the risk of seizure recurrence after a first unprovoked seizure?
Approximately 40% to 50% within the next 2 years.
p.5
Distinguishing Features of Seizure Types
What type of seizures are seen in Early infantile developmental and epileptic encephalopathy?
Tonic and/or myoclonic seizures.
p.5
Management and Counseling for New-Onset Seizures
What is the prognosis for Infantile epileptic spasms syndrome?
High risk of drug-resistant epilepsy; may evolve to focal/multifocal epilepsy or Lennox-Gastaut syndrome.
p.3
Classification of Epilepsies
What is the usual age at onset for self-limited neonatal epilepsy?
First month of life, most in the first week.
p.6
Management and Counseling for New-Onset Seizures
What is the prognosis for patients with developmental and/or epileptic encephalopathy?
Continuous spike and wave in sleep typically resolves by adolescence; however, seizures may persist depending on etiology.
p.3
Classification of Epilepsies
What age range is associated with sleep-related hypermotor epilepsy?
Childhood and adolescence.
What is the prognosis for mesial temporal lobe epilepsy with hippocampal sclerosis?
High incidence of drug resistance but may become seizure-free after resective surgery or thermoablation.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Juvenile Myoclonic Epilepsy?
Often controlled with antiseizure medications, but remission is rare.
p.4
Distinguishing Features of Seizure Types
What types of seizures are associated with Myoclonic Absence Epilepsy?
Myoclonic absence seizures; generalized tonic-clonic seizures may be seen in some cases.
p.9
Evaluation of First Seizure
What misinterpretation can occur with vertex sharp waves in young children?
They may appear spiky and lead to misdiagnosis of central spikes.
p.9
Evaluation of First Seizure
What does rhythmic temporal theta of drowsiness indicate in an EEG?
It can be a normal variant seen during light sleep, especially in children with a history of absence epilepsy.
p.8
Evaluation of First Seizure
What is the purpose of investigations in the context of seizures?
To confirm epilepsy or provide information on the underlying cause.
p.14
Management and Counseling for New-Onset Seizures
What is the highest risk period for seizure recurrence after a first seizure?
The first 1 to 2 years after the seizure.
p.12
Evaluation of First Seizure
What is the recommendation for lumbar puncture in children aged 6 months to 5 years with simple febrile seizures?
It should be performed if meningeal signs are present or if there is a suggestion of central nervous system infection.
p.10
Evaluation of First Seizure
What EEG finding is consistent with generalized epilepsy?
Generalized spike-and-wave discharges.
p.5
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG typically show for Genetic epilepsy with febrile seizures plus?
Usually normal but may show generalized or focal discharge.
p.6
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG show for Epilepsy with myoclonic-atonic seizures?
Slow background with high-amplitude generalized spike and wave.
p.6
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Lennox-Gastaut syndrome?
Intellectual disability (often moderate to severe), behavior problems.
p.3
Distinguishing Features of Seizure Types
What type of seizures are seen in self-limited epilepsy with centrotemporal spikes?
Focal seizures with dysarthria, sialorrhea, and unilateral tonic or clonic movement of the lower face.
p.4
Distinguishing Features of Seizure Types
What types of seizures are associated with Juvenile Myoclonic Epilepsy?
Myoclonic seizures; most also have generalized tonic-clonic seizures.
p.4
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Epilepsy with Eyelid Myoclonia?
Mild cognitive delay, ADHD, anxiety, depression.
p.7
Comorbidities Associated with Epilepsy
What does the ILAE recognize as important in the definition of epilepsy?
The importance of comorbidities.
p.13
Genetic Causes of Epilepsy
What are the medical implications of genetic testing?
Some genes may have implications for symptoms other than epilepsy, affecting relatives as well.
p.13
Genetic Causes of Epilepsy
What types of genetic investigations are possible for epilepsy?
Karyotype, chromosomal microarray, single-gene sequencing, epilepsy gene panel, and whole-exome sequencing.
p.11
Evaluation of First Seizure
What is the sensitivity of CT for detecting small cortical epileptogenic lesions?
CT has low sensitivity for many small cortical lesions.
p.11
Evaluation of First Seizure
What laboratory studies are commonly done for patients with new-onset seizures?
Complete blood cell count, glucose, electrolytes, blood urea nitrogen, and creatinine.
p.11
Evaluation of First Seizure
What additional testing should be considered in children with concerning clinical features and seizures?
Screening for inborn errors of metabolism.
p.14
Management and Counseling for New-Onset Seizures
What should patients understand about seizure rescue medication?
When and how to administer it, especially in emergencies.
p.12
Neuroimaging in Epilepsy Diagnosis
What is the recommendation for neuroimaging in patients with new-onset, unprovoked seizures?
Neuroimaging is recommended for all patients except those with well-defined, drug-responsive idiopathic generalized epilepsy or self-limited focal epilepsy of childhood.
p.6
Distinguishing Features of Seizure Types
What are the characteristic seizure types in Epilepsy with myoclonic-atonic seizures?
Myoclonic-atonic seizures, generalized tonic-clonic, absence, myoclonic, atonic, and occasionally tonic seizures.
What is the prognosis for self-limited infantile epilepsy?
Most remit by early preschool years with normal development.
p.3
Distinguishing Features of Seizure Types
What type of seizures are seen in mesial temporal lobe epilepsy with hippocampal sclerosis?
Focal aware or impaired awareness seizures with features referable to mesial temporal lobe.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Juvenile Absence Epilepsy?
Often controlled with antiseizure medications, but remission is rare.
p.4
Distinguishing Features of Seizure Types
What types of seizures are associated with Epilepsy with Eyelid Myoclonia?
Eyelid myoclonia; many patients also have typical absence and generalized tonic-clonic seizures.
p.2
Infectious Etiologies of Epilepsy
What distinguishes infectious etiology from acute symptomatic seizures?
Infectious etiology implies epilepsy and seizures are core symptoms of the disorder.
p.8
Management and Counseling for New-Onset Seizures
What guidelines has the American Academy of Neurology developed?
An evidence-based guideline for managing a first seizure in adults and a practice parameter for evaluating a first nonfebrile seizure in children.
p.12
Evaluation of First Seizure
What clinical signs suggest the need for a lumbar puncture?
New, unexplained fever with seizures, encephalopathy, or meningeal signs such as nuchal rigidity.
p.11
Evaluation of First Seizure
What should be done if a lesion is found on MRI?
Establish whether it is the underlying etiology for the seizures using clinical and electrophysiologic data.
p.10
Evaluation of First Seizure
What does focal epileptiform discharges in an EEG suggest?
A diagnosis of focal epilepsy.
p.10
Neuroimaging in Epilepsy Diagnosis
What is the recommendation regarding MRI for patients with epilepsy?
All patients should undergo MRI, except those with clearly defined, drug-responsive idiopathic generalized epilepsy syndromes.
p.5
Distinguishing Features of Seizure Types
What type of seizures are associated with Dravet syndrome?
Often prolonged, hemiconvulsive, or generalized tonic-clonic seizures with fever.
What is the prognosis for self-limited epilepsy with autonomic seizures?
Remission by later childhood.
What is the prognosis for sleep-related hypermotor epilepsy?
Often drug-responsive; surgery may be an option if drug-resistant.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Epilepsy with Generalized Tonic-Clonic Seizures Alone?
Often controlled with antiseizure medications, but remission is rare.
p.12
Evaluation of First Seizure
What is the yield of routine blood and urine studies in new-onset, unprovoked seizures?
They are commonly obtained but of low yield.
p.5
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG show for Infantile epileptic spasms syndrome?
Severely abnormal; usually high-amplitude background slowing with focal or multifocal discharge or hypsarhythmia.
p.5
Management and Counseling for New-Onset Seizures
What is the prognosis for Dravet syndrome?
Drug-resistant and lifelong.
What is the prognosis for self-limited neonatal epilepsy?
Epilepsy remits by 6 months with normal development.
p.6
Neuroimaging in Epilepsy Diagnosis
What does the EEG show for developmental and/or epileptic encephalopathy?
Significant activation of spike discharges in sleep, with near continuous slow spike and wave in slow sleep.
p.3
Neuroimaging in Epilepsy Diagnosis
What is the common EEG finding in self-limited epilepsy with centrotemporal spikes?
High-amplitude centrotemporal discharges that increase in sleep; normal background.
p.3
Comorbidities Associated with Epilepsy
What comorbidities are associated with mesial temporal lobe epilepsy with hippocampal sclerosis?
Memory problems and depression.
p.4
Neuroimaging in Epilepsy Diagnosis
What is the interictal EEG finding for Juvenile Myoclonic Epilepsy?
Generalized polyspike-and-wave discharge, often activated with photic stimulation.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Epilepsy with Eyelid Myoclonia?
Eyelid myoclonia is often drug-resistant; remission is possible but rare.
p.10
Comorbidities Associated with Epilepsy
Why is it important to diagnose cognitive and psychiatric comorbidities in people with epilepsy?
They often have a greater impact on quality of life than seizures.
p.6
Neuroimaging in Epilepsy Diagnosis
What does the interictal EEG show for Lennox-Gastaut syndrome?
Slow background with high-amplitude, generalized slow (<2.5 Hz) spike and wave; generalized paroxysmal fast activity in sleep.
p.3
Distinguishing Features of Seizure Types
What type of seizures are associated with self-limited neonatal epilepsy?
Focal clonic or tonic seizures which may evolve to bilateral tonic-clonic.
p.6
Classification of Epilepsies
What is the usual age at onset for developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep?
Late preschool or school age.
p.6
Neuroimaging in Epilepsy Diagnosis
What does the EEG show for progressive myoclonus epilepsies?
Progressive background slowing and/or increased epileptiform discharges.
p.3
Classification of Epilepsies
What age range is associated with mesial temporal lobe epilepsy with hippocampal sclerosis?
2 years through adulthood.
p.3
Neuroimaging in Epilepsy Diagnosis
What is the common EEG finding in self-limited epilepsy with autonomic seizures?
High-amplitude focal or multifocal discharges that increase in sleep.
p.3
Distinguishing Features of Seizure Types
What type of seizures are characteristic of sleep-related hypermotor epilepsy?
Focal motor seizures with hyperkinetic or asymmetric tonic or dystonic features, occurring predominantly in sleep.
p.4
Neuroimaging in Epilepsy Diagnosis
What is the interictal EEG finding for Childhood Absence Epilepsy?
Generalized 3-Hz spike-and-wave discharge.
p.4
Classification of Epilepsies
What is the usual age at onset for Epilepsy with Generalized Tonic-Clonic Seizures Alone?
Adolescence to young adulthood.
p.4
Neuroimaging in Epilepsy Diagnosis
What is the interictal EEG finding for Myoclonic Absence Epilepsy?
3-Hz generalized spike and wave time-locked with myoclonic jerks.
p.3
Neuroimaging in Epilepsy Diagnosis
What is the common EEG finding in sleep-related hypermotor epilepsy?
Often normal but frontal discharges may be seen mostly in sleep.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Childhood Absence Epilepsy?
Two-thirds remit typically by later childhood or adolescence; may evolve to juvenile myoclonic epilepsy if it does not remit.
p.4
Comorbidities Associated with Epilepsy
What are common comorbidities associated with Epilepsy with Generalized Tonic-Clonic Seizures Alone?
ADHD, depression, anxiety.
p.4
Management and Counseling for New-Onset Seizures
What is the prognosis for Myoclonic Absence Epilepsy?
Remits in approximately 40% of cases.
p.3
Neuroimaging in Epilepsy Diagnosis
What is the common EEG finding in mesial temporal lobe epilepsy with hippocampal sclerosis?
Often focal slowing or discharges in frontotemporal leads.
p.4
Classification of Epilepsies
What is the usual age at onset for Juvenile Myoclonic Epilepsy?
Adolescence to young adulthood.
p.4
Neuroimaging in Epilepsy Diagnosis
What is the interictal EEG finding for Epilepsy with Eyelid Myoclonia?
3- to 6-Hz generalized polyspike or polyspike-and-slow-wave.
