Continual muscle contractions can be found in tonic seizures.Can be found in focal impaired awareness seizures.Can be observed in absence seizures that may last 5 to 20 seconds in duration and are non-convulsive.Lip smacking found in frontal lobe seizures.
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To make a diagnosis of epilepsy, a neurologist may do a full neurological exam, conduct blood tests, monitor EEG activity, and obtain neuroimaging (CT/MRI).
Different types of epilepsy may result from abnormal patters of neuronal migration, cortical abnormalities resulting in hyperexcitability, periventricular heterotopia, increased plasma glutamate levels, focal abnormalities, mutated voltage-gated Na+ and K+ channels, temporal hippocampus atrophy, amygdala kindling, neurotransmitter imbalance (GABA, glutamate). The pathophysiology of epilepsy is not fully understood. The risk factors for epilepsy can include: stroke, family history of epilepsy, head trauma, CNS infection. KNCQ2 = potassium voltage-gated channel subfamily Q member 2, BFGE = benign familial genetic epilepsy, SCN1a = sodium voltage-gated channel alpha subunit 1, CAE = childhood absence epilepsy, JME = juvenile myoclonic epilepsy, GEFS+ = generalized epilepsy with febrile seizures plus, TB = tuberculosis, HIV = human immunodeficiency virus, CMV = cytomegalovirus, NMDA = N-methyl-D-aspartate, LGI1 = leucine-rich glioma inactivated 1 Risk Factors Examples of different etiologies of epilepsy. Usually, epileptogenesis involves some type of neurotransmitter imbalance (GABA, glutamate) with abnormal neuronal excitation and excessive synchronization. Epileptogenesis is the term used to describe how epilepsy develops. For example, a structural abnormality may be genetically inherited, so the etiology may be both structural and genetic. Įtiologies are not necessarily mutually exclusive and often happen in conjunction. The cause of epilepsy has not been definitively discerned and can be broadly categorized as structural, genetic, infectious, metabolic, immune, or unknown (Table 1). These observed ophthalmologic manifestations may be seen in epilepsy and will be discussed in this article.
Some characteristic ophthalmologic signs can also be observed including visual hallucinations, illusions, visual field loss, eye deviation, nystagmus, eyelid automatism and myoclonia. During seizure episodes, people can experience auras, muscle jerking, automatisms, altered level of consciousness and convulsions. Epilepsy types exist on a wide spectrum and often may present differently from person-to-person. Epilepsy is categorized into four main types: focal, generalized, combined generalized and focal, and unknown. Seizures are classified by their onset: focal, in which only one cerebral hemisphere is affected generalized, in which both hemispheres are affected and unknown onset per the 2017 International League Against Epilepsy (ILAE) classification. 2.4 Anti-epileptic drugs associated with ophthalmic findingsĮpilepsy is a condition characterized by recurrent, unprovoked seizures, which are episodes of abnormally hypersynchronous brain activity.2.3 Select epileptic syndromes with specific ophthalmic findings.
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