Seizure Disorders & Epilepsy

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About Seizure Disorders & Epilepsy

Seizure disorders encompass a broad spectrum of neurological conditions characterized by abnormal electrical activity in the brain, with epilepsy being the most common chronic seizure disorder affecting over 50 million people worldwide. Seizures can range from brief, barely noticeable episodes to prolonged convulsions and can significantly impact quality of life, cognitive function, and daily activities.

Pathophysiology

Seizures result from abnormal, excessive, and synchronized neuronal discharges in the brain, disrupting normal electrical activity and causing temporary dysfunction of affected brain regions. The underlying mechanisms involve imbalances between excitatory and inhibitory neurotransmission, often due to genetic mutations, structural brain abnormalities, metabolic disturbances, or acquired brain injuries that alter neuronal membrane properties and synaptic transmission.

Clinical Reasoning

Diagnosis requires careful history-taking to characterize seizure semiology, identify potential triggers, and distinguish epileptic from non-epileptic events, supplemented by EEG monitoring and neuroimaging to localize seizure foci and identify underlying pathology. Treatment selection depends on seizure type, epilepsy syndrome classification, patient age, comorbidities, and potential drug interactions, with the goal of achieving seizure freedom while minimizing adverse effects through individualized antiepileptic drug therapy or surgical intervention when appropriate.

References

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Imaging Reasoning

CT Head (acute) → MRI Brain

Key imaging focus: CT for acute (hemorrhage, mass); MRI epilepsy protocol for structural causes

📚 Radiopaedia Cases →
  1. Seizures. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK430765/
  2. AAN/AES Status Epilepticus Guidelines. Neurology 2023. https://doi.org/10.1212/WNL.0000000000201045
  3. AES/AAN Guideline for Status Epilepticus. Epilepsy Currents. https://doi.org/10.1177/1535759720949462
  4. ILAE Classification of Epilepsies. Epilepsia. https://doi.org/10.1111/epi.13670
  5. AAN/AES Guideline: Initial Epilepsy Treatment. Neurology. https://doi.org/10.1212/WNL.0000000000006049

Related Topics

Seizures and Status EpilepticusStatus EpilepticusFebrile Seizures