Epilepsy. Symptoms

What epilepsy syndromes are there?

As in the descriptions of seizures, when describing the various types and syndromes of epilepsy a distinction is made between the focal and generalised forms. Focal epilepsy is also known as partial epilepsy.

Another criterion in the classification of epilepsy is a division into:

  • Idiopathic
  • Symptomatic
  • and Cryptogenic epilepsies

Idiopathic Epilepsy

Idiopathic epilepsy is a form of the condition for which there is no other cause than a certain inherited predisposition to it. Despite the amazing increase in knowledge in the field of genetics it has so far been possible to identify a specific disorder of a person's genes as being the cause of epilepsy in only a very small percentage of cases in which there is increased incidence of epilepsy within a family.

Symptomatic Epilepsy

Symptomatic in this context means that the epilepsy is caused by a demonstrable pathological change in the brain, such as a brain tumour, the consequences of inflammations, severe head injuries, strokes or cortical dysgenesis, which is either congenital or which has arisen in the early stages of the brain's development. This change may affect only a very tiny region of the brain which may be possible to identify only with the aid of microscopic investigations. With the continued improvement of medical investigative and diagnostic techniques, in particular in the field of magnetic resonance imaging (also called nuclear magnetic resonance imaging), it is becoming increasingly often possible to demonstrate the presence of structural changes in the brain, especially in patients with focal epilepsy.

Cryptogenic Epilepsy

Epilepsies are described as being cryptogenic if it is thought that they are not idiopathic but symptomatic even though the actual cause of the seizures has not yet been identified.

Examples of various epilepsy syndromes

- focal generalised
Idiopathic - Benign childhood epilepsy with centrotemporal spikes" (BCECT)
- Benign childhood epilepsy with occipital paroxysms 		- Benign familial neonatal convulsions (BFNC) - Absence epilepsy in school-age children
Juvenile myoclonic epilepsy
symptomatic - Temporal lobe epilepsy with hippocampal sclerosis
- Frontal lobe epilepsy with focal cortical dysplasia. 		Epilepsy in lissencephalia (= developmental disorder affecting the entire cerebral cortex)
Cryptogenic - West syndrome with a probable symptomatic cause - Epilepsy with myoclonic astatic seizures

At what age does epilepsy begin?

Epilepsy may appear for the first time in someone's life at any age, but it usually first manifest during childhood. Many childhood epilepsies stop of their own accord during puberty. These epilepsies are described as being "benign" (=good natured) and they are overwhelmingly epilepsies of the focal type. The most commonly found type of epilepsy in children is called "benign childhood epilepsy with centrotemporal spikes" (BCECT) which is also known as (benign) Rolando epilepsy. The development of children who have benign focal epilepsy cannot itself always be described as "benign" however. In addition to suffering so-called learning disabilities, some of these children also have disorders affecting their speech, behaviour or intelligence. As an example of these we may mention "epileptic aphasia" (loss of speech), the so-called "Landau-Kleffner syndrome".

Professional care

Kluger

PD Dr. med.

Gerhard Kluger


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