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Epilepsy in later childhood and adulthood 

Epilepsy in later childhood and adulthood
Epilepsy in later childhood and adulthood

G.D. Perkin

and M.R. Johnson



Definitions and classification—expanded discussion.

Pathophysiology—role of inflammatory mechanisms in focal epilepsy; enhanced discussion of genetic generalized epilepsies.

Clinical features—discussion of sudden unexpected death in epilepsy (SUDEP); comments on differential diagnosis from syncope and psychogenic nonepileptic seizures.

Management—comments on levetiracetam, and on use of valproate and carbamazepine in pregnancy.

A relevant case history from Neurological Case Histories: Case Histories in Acute Neurology and the Neurology of General Medicine has been added to this chapter.

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date: 19 September 2021

Case History—A 33 yr old woman, known to have epilepsy, now presenting with odd behaviour.

An epileptic seizure is a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Epilepsy is defined as a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure and evidence for an enduring alteration in the brain that increases the likelihood of future seizures such as an ‘epileptiform’ EEG abnormality, an appropriate lesion on structural brain imaging (CT or MRI), or the presence of recurrent (two or more) seizures. Epilepsy is a common, serious neurological disease, with prevalence 1% and a cumulative lifetime risk of 5%....

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