Malisa PierriClinical Nurse Specialist in Epilepsy

Welsh Epilepsy Unit Cardiff and Vale University Health Board

029 20 745066Malisa.pierri@wales.nhs.uk

Epilepsy

- dispelling the myths

Aim of the session:

To have an overview of epilepsy, its symptoms, treatment and impact on individuals and their loved ones.

Objectives:

•Summarise the definition of the terms epilepsy and seizure

•Identify some of the common differential diagnosis

•Define examples of different seizure types

•Identify commonly used medications

•Examine the impact of epilepsy in special groups (teenagers/older individuals / women)

•Recognise some of the major social implications of the diagnosis and some of the common misconceptions

Why Sacred?

70 A.D In the Gospel According to Mark (9:14-29)

Jesus Christ casts out a devil from a young man with epilepsy:

"Teacher, I brought you my son, who is possessed by a spirit that

has robbed him of speech. Whenever it seizes him, it throws him to the ground. He foams at

the mouth, gnashes his teeth, and becomes rigid. I asked your

disciples to drive the spirit out, but they could not." (NIV)

Raphael: The Transfiguration – www.epilepsiemuseum.de

1494: A handbook on witch-hunting

Written by two Dominican friars under papal authority, the book identifies the presence of seizures as a characteristic of

witches. Malleus Maleficarum brings a wave of persecution and torture, leading to the death of more than 200,000

women.

Epilepsy overview:

facts and figures

Epilepsy is the most common serious neurological disorder 450,000 people in the UK

umbrella term defined by:•development of recurrent unprovoked seizures•two or more seizures more than 24 hours apart

0

0.02

0.04

0.06

0.08

0.1

0.12

0.14

0.16

0.18

0 20 40 60 80 100

Age years

Incid

en

ce

%

can appear at any age

Figures in a British region 1,000,000 persons

• New cases of epilepsy annually 500

• New cases of febrile seizures 500

• New cases of single seizure 200

• Cases of active epilepsy (prevalence) 5000

• Lifetime prevalence 20000

Overall

•Incidence is annually 70/100,000

•Prevalence is 5-10 per 1000 of population excluding inactive epilepsy

•Lifetime prevalence of non febrile seizures is 2-5% (this rises to 10% in some studies)

A seizure being

• an abnormal, self limiting discharge from a group of

neurons

• sudden onset event presenting as a disturbance of:

consciousnessbehaviouremotion

motor, sensory or autonomic function

Pretty much anything…….

Many different types of seizures

Classically two patterns

1. Focal cortical disturbances (focal onset seizures)

2. Immediate synchronous spike and wave discharge from both hemispheres (generalised

seizures)

Simple

Complex

International League Against Epilepsy (ILAE)

Classification of Epilepsy

Absence

Myclonic

Generalised tonic-clonic

International League Against Epilepsy (ILAE)

Classification of Epilepsy

International League Against Epilepsy (ILAE) Classification of Epilepsy

Typical Examples of Syndromes:

•Juvenile Absence Epilepsy

•Juvenile Myoclonic Epilepsy

Seizure Videos