Pathology:           Transient seizures due to abnormal excessive or synchronous neuronal activity in the brain

Partial Seizures: Focal in onset and originate in one hemisphere.

Simple partial: consciousness preserved 

Complex partial: Consciousness impaired

Generalized Seizures: Begin in both hemispheres simultaneously



Aetiology:            Structural: Trauma, space occupying lesion, vascular malformation, stroke

Metabolic: alcohol withdrawal, high/low glucose, high/low sodium, low oxygen

Infection: HIV, encephalitis, syphilis


Neurodegenerative: Alzheimer’s/vascular dementia

Genetic diseases



Symptoms:               Dependent on seizure type


Signs:                          Dependent on seizure type


Investigations:      Bloods: FBC,U&E, LFTs, Glucose – to exclude infection or electrolyte imbalance

Imaging: MRI Brain: To exclude structural pathology

ECG: To assess for structural or valvular abnormalities

EEG: Assess for seizure activity


Treatment:              Partial focal seizures: 1st line lamotrigine, carbamazepine

Generalized and unclassified seizures: 1st line sodium valproate

Refractory epilepsy: Vagal nerve stimulation, epilepsy surgery

Status epilepticus:  1st line IV benzodiazepines, IV phenytoin/valproate, consider

 ICU admission for sedation for resistant episodes


Complications:      Injury, refractory seizures, sudden unexplained death in epilepsy, drug side effects


Prognosis:               50% will be seizure free after using first anti-epileptic medication

                                        15% mortality rate in status epilepticus












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