What is it?
Epilepsy is defined by the International League Against Epilepsy (ILAE) and the Italian League Against Epilepsy (LICE) as a neurological disorder characterized by the recurrence of unprovoked seizures. Epileptic seizures are sudden, usually unpredictable and short lasting clinical occurrences characterized by signs and/or symptoms due to abnormal activity of brain neurons. A particular type of epileptic manifestation is the epileptic seizure state, a clinical situation in which a seizure is excessively prolonged in time or in which seizures are repeated at very short intervals so as to represent a continuous epileptic condition. The epileptic seizure state requires rapid neurological framing and therapy in the emergency room, which in our center follows a precise and rapid process pre-determined in coordination between the on-call neurologist and epileptologist reference.
Which are the symptoms?
Epileptic seizures can present variable characteristics, in relation to the brain networks involved. A distinction is made between generalized and focal seizures. Among the most frequent generalized seizures there are tonic-clonic seizures (or convulsions) and the so-called "absences". Focal seizures may have motor manifestations and/or alterations in awareness, but sometimes the symptoms can be difficult to identify. Some focal seizures may present evolution to bilateral tonic-clonic. Typically, seizures present with stereotypic symptomatology with each episode and are of short duration.
- Abnormal movements
- Loss of consciousness
- Motor arrest
- Abnormal sensations
- Déjà vu, déjà vecu and other cognitive alterations
- Any neurological symptoms
How is it diagnosed?
Epilepsy is not diagnosed in all individuals who have had a seizure in their life, but the diagnosis is defined by the neurologist or neurophysiologist specializing in epilepsy (also called "epileptologist"), based on the risk of seizure recurrence. The diagnosis is made on the basis of the patient's clinical history, neurological physical examination, and interpretation of instrumental data, including primarily baseline and sleep-deprived electroencephalography (EEG) and neuroimaging (computed tomography [CT] and magnetic resonance imaging [MRI]). Sometimes there is a multidisciplinary discussion and treatment of the case with neuroradiologists, geneticists, pediatricians, pediatric neurologists, neurosurgeons, neuropsychologists.
How is it treated?
Patients with epilepsy are usually offered pharmacological antiepileptic therapy. The purpose of these drugs is to reduce the risk of seizures recurrence, while improving the quality of life. In many cases it is possible to achieve complete control of seizures in the long term. In most cases it is also possible to identify a drug therapy with few or no side effects.
Where do we treat it?
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