Epilepsy Signs and Symptoms

Unprovoked Seizure 

• Seizures that occur without a potentially responsible clinical condition or beyond the interval estimated for the occurrence of acute symptomatic seizures
• Classified as either seizures of unknown etiology or seizures that occur due to preexisting brain lesion or progressive nervous system disorder

Epilepsy

• Epilepsy may be defined by any of the following conditions:
  • At least two unprovoked (or reflex) seizures occurring >24 hours apart
  • One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years
  • Diagnosis of epileptic syndrome

• In the United States, an estimated 150,000 adults annually present with an unprovoked first seizure
  • An estimated 40-50% of these incident seizures recur to be classified as epilepsy
  • Lifetime cumulative risk of developing recurrent unprovoked seizures or epilepsy by the age of 80 years ranges from 1.4-3.3%

• Epilepsy is a clinical multiaxial diagnosis 
  • Epileptic seizure is a transient occurrence of signs/symptoms brought about by abnormal excessive or synchronous neuronal activity in the brain
  • An epileptic seizure represents a disruption in the normal balance between excitatory and inhibitory currents or neurotransmission in the brain
    • Drugs or pathogenic processes that augment excitation or impair inhibition tend to be epileptogenic, while anti-seizure drugs tend to facilitate inhibition and dampen excitation
  • It is a disorder of the brain characterized by enduring predisposition to generate epileptic seizures, and by the neurobiologic, cognitive, psychological, and social consequences of this condition

Unprovoked Seizure
Clinical Symptoms (During Seizure)

• Aura
• Cyanosis
• Sudden falls
• Motor symptoms: Involuntary stiffening or jerky movements of limbs in an awake, unaware or asleep patient
• Cognitive symptoms: Blank spells, speech arrest with or without automatisms
• Sensory symptoms: Paresthesia or numbness, auditory, olfactory or visual hallucination
• Autonomic symptoms: Urinary incontinence or tongue biting with loss of awareness, or during sleep
• Alteration of mental status: Episodes of confused behavior with lack or loss of awareness and/or recollection