Epilepsy
- dispelling the myths
Malisa Pierri
Clinical Nurse Specialist in Epilepsy
Welsh Epilepsy Unit
Cardiff and Vale University Health Board
029 20 745066
Malisa.pierri@wales.nhs.uk
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
can appear at any age
0.18
Incidence %
0.16
0.14
0.12
0.1
0.08
0.06
0.04
0.02
0
0
20
40
Age
60
years
80
100
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:
consciousness
behaviour
emotion
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)
International League Against Epilepsy (ILAE)
Classification of Epilepsy
Simple
Complex
International League Against Epilepsy (ILAE)
Classification of Epilepsy
Absence
Myclonic
Generalised
tonic-clonic
International League Against Epilepsy (ILAE)
Classification of Epilepsy
Typical Examples of Syndromes:
•Juvenile Absence Epilepsy
•Juvenile Myoclonic Epilepsy
Seizure Videos