Figure: The oldest detailed
account of epilepsy in
Babylonian treatise (Kinnier
Wilson and Reynolds, 1990)
• Epilepsy is a chronic disorder of the
brain that affects people in every
country of the world.
• It is characterized by recurrent
seizures - which are physical
reactions to sudden, usually brief,
excessive electrical discharges in a
group of brain cells.
• Different parts of the brain can be
the site of such discharges
Classification of
seizures
Generalized
seizures
Partial
seizures
Absence
Simple
Myoclonic
Complex
Tonic-clonic
Tonic
Atonic
Unclassified
During the seizure, the person is not aware of what's
happening and afterward usually does not realize
that it has occurred.
seizures are usually last less than 15 seconds.
tonic phase :
increase in the natural tension
or "tone" of muscles.
clonic phase :
rapidly alternating tightening
and relaxation of a muscle.
Tonic-clonic seizures begin with loss of
consciousness.
The seizure usually lasts a minute or two.
The period immediately after a
seizure-called the postictal periodvaries depending on the type,
duration, and intensity of the seizure.
Some patients may feel some
discomfort from muscle soreness,
headache, and pain in the tongue or
cheek .
: require particular
triggers for seizures to occur.
• For example: reading epilepsy (triggered by
reading) Photosensitive epilepsy (triggered
by flashing lights).
• Emotional stress, sleep deprivation, heat
stress, alcohol and febrile illness are
examples of triggers cited by patients with
epilepsy. the menstrual cycle in women with
epilepsy can influence patterns of seizure
recurrence.
Different causes of epilepsy that are
common in certain age groups:
1) Hypoxic-ischemic encephalopathy.
2) CNS infections.
3) Trauma.
4) Central Nervous System abnormalities.
5) Metabolic disorders.
Test for brain function:
The electroencephalogram (EEG) is a measure
of brain waves. It is a readily available test that
provides evidence of how the brain functions
over time.
Epilepsy controlled by using one or, at most, two
AEDs.
Drugs used in Epilepsy
In general:
•Sodium Valproate is the drug of choice for
generalised seizures.
•Carbamazepine is the drug of choice for
partial seizures.
• Lamotrigine is increasingly popular and a
useful alternative drug for both seizure types.
Examples of alternative therapies
include:
• Supplementation with kava, biotin
and herbal remedies (traditional
Chinese medicine),.
• Techniques
such
as
yoga,
acupuncture, chiropractic, massage
therapy, etc.
prevalence rates of epilepsy is 6.5/1000 in
Saudi Arabia .
The Epilepsy Registry, Multi-institutional
Cumulative Report 2000-2010. Stated that
geographically, Kingdom of Saudi Arabia is
divided into 13 regions and most of the
registered cases were residing at the time of
registration in Riyadh region (40.5%) followed
by Asir region (12.6%), Eastern Province
(11.0%), Makkah (7.5%) and in Jizan (3.6%).
Jazan:3.6%
Idiopathic epilepsy is not preventable. However,
preventive measures can be applied to the known causes
of secondary epilepsy.
Preventing head injury.
Adequate perinatal care.
The use of drugs and other methods to lower the body
temperature of a feverish child.
Central nervous system infections are common causes
of epilepsy in tropical areas and education on how to
avoid infections would be effective way to reduce
epilepsy.
The impact of epilepsy is not only on the person with
epilepsy but also the family and indirectly the
community is affected.
The burden of epilepsy could be due to:
• Physical hazards of epilepsy due to the
unpredictability of the seizures.
• Social exclusion because of negative attitudes of
others towards people with epilepsy.
• Stigma as children with epilepsy may be banned from
school, adults may be barred from marriage, and
employment is often denied, even when seizures
would not render the work unsuitable or unsafe
The Epilepsy Monitoring Unit performed
Collaborations with Riyadh Military
Hospital, King Abdulaziz Medical City
Riyadh, King Fahad Medical City Riyadh
and King Faisal Specialist Hospital &
Research Centre Jeddah have been
successfully established and the staffs have
been trained.