antiepileptic drugs (anticonvulsants) Drugs with different modes of action that prevent epileptic seizures.

epilepsy surgery A surgical treatment that includes the removal or disconnection of epileptogenic tissue and that aims at complete seizure control.

focal (partial) seizures Epileptic seizures with clinical or electro-encephalographic changes indicating initial activation of neurons limited to one part of one cerebral hemisphere.

generalized seizures Epileptic seizures in which the first clinical changes indicate involvement of both hemispheres.

hippocampal sclerosis Typical pathology in mesial temporal lobe epilepsy characterized by loss of neurons in the CA1 region and endfolium (CA3/4) but with relative sparing of the C2 region.

Epilepsy is a heterogeneous condition characterized by recurrent seizures. Because the epileptic seizure is a nonspecific neurological symptom, it is important to distinguish epilepsy from isolated seizures and acute symptomatic seizures provoked by acute systemic or cerebral disorders. Epilepsy is one of the most common neurological disorders, with peak prevalence rates in early childhood and old age. Two international classification systems are used to differentiate seizure types and epileptic syndromes. The major distinction is between localization-related and generalized seizures. The former are most often symptomatic and caused by a circumscribed lesion, and the latter are typically idiopathic and associated with an inherited imbalance in excitatory and inhibitory mechanisms. There may be an association with learning disability or other neurological problems, particularly in symptomatic epilepsies. Idiopathic epilepsies are characterized by a specific age of onset, a good response to drug treatment, and a relatively benign course. The genes responsible for some rare syndromes have recently been identified; however, the suspected genetic background of the more common idiopathic epilepsies is complex and likely involves multiple susceptibility genes. The differential diagnosis of epilepsy includes a large spectrum of medical, neurological, and psychiatric disorders. The diagnosis of epilepsy is primarily based on history. Technical investigations include electroencephalography, functional and structural imaging techniques, and neuropsychological assessments. Treatment of epilepsies involves anticonvulsant drugs and behavioral recommendations and also surgery in suitable patients who are resistant to conservative strategies. Anticonvulsant drugs can be categorized into three groups according to their mode of action: GABAergic drugs, antiglutamatergic drugs, and membrane-stabilizing drugs that act through the modulation of the sodium channel. The choice of antiepiletic drugs depends on the type of epilepsy. The aim of drug treatment is complete seizure control without causing any clinical side effects.

Complications of active epilepsy are not only injuries but also psychiatric disorders such as depression. The social impact of epilepsy is more significant than with most other neurological disorders because of stigma-tization and discrimination of seizure disorders. Professional training and employment are further limited by restrictions with respect to driver's licenses, working night shifts, and handling potentially dangerous machines.

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