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These clinical states have been subjected to a variety of classifications, none universally accepted to date and, accordingly, the terminologies used to describe the different types of attacks remain purely descriptive and nonstandardized.
There are many different epilepsy syndromes, each presenting with its own unique combination of seizure type, typical age of onset, EEG findings, treatment, and prognosis.
Infantile spasms (West syndrome) is associated with brain development abnormalities, tuberous sclerosis, and perinatal insults to the brain. It affects infants, which by definition is between 30 days to 1 year of life.
Generalized 3 Hz spike and wave discharges in EEG Childhood absence epilepsy affects children between the ages of 4 and 12 years of age. These patients have recurrent absence seizures that can occur hundreds of times a day.
Benign focal epilepsy of childhood (Benign Rolandic epilepsy) begins in children between the ages of 4 and 13 years .
Juvenile myoclonic epilepsy (JME) begins in patients aged 8 to 20 years .
Temporal lobe epilepsy is the most common epilepsy of adults. In most cases, the epileptogenic region is found in the mesial temporal structures (e.g., the hippocampus, amygdala, and parahippocampal gyrus). Seizures begin in late childhood and adolescence .
The proper emergency response to a generalized tonic-clonic epileptic seizure is simply to prevent the patient from self-injury by moving him or her away from sharp edges, placing something soft beneath the head, and carefully rolling the person onto his or her side to avoid asphyxiation.
Should the person regurgitate, the material should be allowed to drip out the side of the patient's mouth by itself.
Some medications can be taken daily in order to prevent seizures or reduce the frequency of their occurrence.
These are termed "anticonvulsant" or "antiepileptic" drugs (sometimes AEDs).
All such drugs have side effects which are idiosyncratic and others which are dose-dependent; it is not possible to predict who will suffer from side effects or at what dose the side effects will appear.
Serum levels of AEDs can be checked to determine medication compliance and to assess the effects of drug-drug interactions; serum levels are generally not useful to predict anticonvulsant efficacy in an individual patient, though in some cases (such as a seizure flurry ) it can be useful to know if the level is very high or very low.
If a person's epilepsy cannot be brought under control after adequate trials of two different drugs, that person's epilepsy is generally said to be 'medically refractory.'
Before surgery is offered, the medical team conducts many tests to assess whether removal of brain tissue will result in unacceptable problems with memory, vision, language or movement, which are controlled by different parts of the brain.
These tests usually include a neuropsychological evaluation, which sometimes includes an intracarotid sodium amobarbital test (Wada test).
Many patients decide not to undergo surgery owing to fear or the uncertainty of having a brain operation.
Vagus nerve stimulation is a recently developed form of seizure control which uses an implanted electrical device , similar in size, shape and implant location to a heart pacemaker, which connects to the vagus nerve in the neck.
Once in place the device can be set to emit electronic pulses, stimulating the vagus nerve at preset intervals and milliamp levels.
Magnesium and vitamin B6 exerted a positive non-specific influence on the mental states of patients with epilepsy, depression and anxiety during an experiment.
A number of systematic reviews by the Cochran Collaboration into treatments for epilepsy looked at acupuncture, psychological interventions, vitamins and yoga and found there is no reliable evidence to support the use of these as treatments for epilepsy.
One interesting finding in animals is that repeated low-level electrical stimulation to some brain sites can lead to permanent increases in seizure susceptibility: in other words, a permanent decrease in seizure "threshold."
This phenomenon, known as kindling (by analogy with the use of burning twigs to start a larger fire) was discovered by Dr. Graham Goddard in 1967.
General considerations : People with epilepsy usually need long-term medication to prevent further seizures. Their physical condition and psychological states vary considerably and individual approach is advisable.
Contraindications : It is safer to avoid long yoga Nidra because of the risk of untimely sleep which may induce a seizure. On the other hand short-term muscle relaxation like Savasana is helpful. Kapalabhati and Bhastrika could induce a seizure and should probably be avoided.