A practical approach to epilepsy (2022 Edition)

Clarify the epilepsy definition, differentiate seizures from epilepsy, and present the 2014 ilae criteria, including potential resolution in age-dependent epilepsy or ten years seizure-free with five years off medication.

Explore the three epilepsy diagnostic scenarios: two unprovoked seizures more than 24 hours apart, one unprovoked or reflex seizure with more than 60% ten-year recurrence risk, or an epilepsy syndrome.

Examine case-based criteria for epilepsy across scenarios: post-stroke seizures, provoked nocturnal seizures from hypoglycemia, light-triggered reflex seizures, uncertain focal epilepsy, and late-onset epilepsy.

Examine seizure types, focusing on focal and generalized seizures, and the basics of seizure classification and mode terminology; review the frontal, temporal, priority and occipital lobes, and generalized seizures.

Explore the basics of seizure classification in epilepsy, distinguishing focal onset and generalized onset seizures per the 2017 ILAE framework, including unclassified seizures and earliest motor or non-motor features.

Review motor seizure terms: spasms (infantile and generalized), tonic seizures, clonic movements, tonic-clonic seizures, and dramatic drop attacks, with duration cues.

Learn to identify seizure onset by lobe, linking parietal, temporal, occipital, and frontal symptoms. Four patient scenarios illustrate onset patterns and set up deeper lobe analysis in the next lesson.

Explore frontal lobe seizures and how they manifest with motor features, impaired awareness, automatisms, aphasia, and autonomic symptoms, and distinguish them from nightmares.

Explore parietal lobe seizures, their rarity and causes such as dysplasia or tumors, and the spectrum from primary sensory area paresthesias to Jacksonian and cognitive features across neighboring regions.

Explore occipital lobe seizures and how primary visual cortex involvement causes visual alterations, such as multicolor shapes and contralateral field activation, with notes on migraine aura differences and spread patterns.

Explore generalized motor seizures: tonic, tonic-clonic, myoclonic, atonic seizures, and epileptic spasms, arising from generalized onset disturbances in both brain hemispheres.

Explore neonatal seizures, including the 2021 ILAE classification update, highlight secondary etiologies such as hypoxic ischemic encephalopathy, and stress EEG correlates and amplitude-integrated EEG for electrographic seizures.

Explore how neonatal seizures are identified, with an average 50% recognition in an observational study. Recognize focal chronic, myoclonic, tonic, and clonic seizures, their EEG suppression patterns, and associated etiologies.

Explore the epilepsy framework proposed by the IAEA, then examine genetics in epilepsy and inborn errors of metabolism, and conclude with practical work approaches across different epilepsy types.

Explore genetic causes of epilepsy and how mutations guide treatment choices. Learn how a multidisciplinary genetic workup selects tests—from panel and karyotype to whole exome sequencing—for patient-specific management.

Identify inborn errors of metabolism as a major cause of developmental and epileptic encephalopathies and emphasize targeted investigations, vitamin therapies, and genetic testing for treatable conditions.