Jeneralize Epilepsiler
Özet
Jeneralize başlangıçlı nöbetler, nöronal ağın bir noktasından başlayıp her iki hemisfere hızla yayılan ve genellikle bilinç kaybıyla seyreden olaylardır. Tanı süreci; nöbet tipi, epilepsi sınıflandırması, epileptik sendrom tanımlaması ve etiyolojik değerlendirme olmak üzere dört temel basamakta gerçekleştirilmektedir. Nöbetler motor veya motor dışı özelliklerine göre sınıflandırılırken, tedavi planı bu nöbet tiplerine ve belirlenen epileptik sendroma göre, kontraendikasyonlar gözetilerek özelleştirilmektedir. Genetik kökenli jeneralize epilepsilerde farmakolojik tedavi, ilacın etki mekanizması ve hastanın nöbet profili dikkate alınarak yönetilmektedir.
Generalized-onset seizures originate from a focal point in the neuronal network, rapidly spreading to both hemispheres and typically involving impaired consciousness. The diagnostic process follows a structured four-step approach: identifying the seizure type, classifying the epilepsy, defining any specific epileptic syndrome, and determining the underlying etiology. Seizures are categorized based on motor or non-motor characteristics, with treatment strategies tailored according to these classifications and the specific epileptic syndrome to avoid contraindicated medications. Pharmacological management for genetic generalized epilepsies is carefully selected based on individual drug mechanisms of action and the patient's specific seizure profile.
Referanslar
Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017;58(4):512-521.
Scheffer I, French J, Hirsch E, et al. Clasification of the epilepsies: new concepts for discussion and debate – special report of the ILAE Classification Task Force of the Commission for Classification and Terminology. Epilepsia Open 2016;1:37–44.
Panayiotopoulos CP. Generalised epileptic seizures. In: Panayiotopoulos CP, ed. A Clinical guide to Epileptic Syndromes and Their Treatment. 2nd ed.UK:Springer;2010. p32-63.
Mizrahi EM. Seizures in the neonate. In: Wallace SJ, Farrell K, editors. Epilepsy in Children. London: Arnold; 2004. p111–122.
Holmes GL. Generalised seizures. In:Swaiman FK, Ashwal S, Ferriero DM, editors. Swaiman’s Pediatric Neurology 6th ed. Philadelphia:Mosby Inc;2017. p524-530.
Xiang X, Fang J, Guo Y. Differential diagnosis between epileptic seizures and psychogenic nonepileptic seizures based on semiology. Acta Epileptologica 2019;1:1-6.
Hrachovy RA, Frost JD. The EEG in selected generalized seizures. J Clin Neurophysiol 2006;23(4):312-332.
Seneviratne U, Cook MJ, D'Souza WJ. Electroencephalography in the Diagnosis of Genetic Generalized Epilepsy Syndromes. Front Neurol 2017;8:499.
Sperling MR, Clancy RR. Ictal electroencephalogram. In: Engel J, Pedley TA, editors. Epilepsy: a comprehensive textbook, 2nd ed. Philadelphia: Wolters Kluwer-Lippincott Williams & Wilkins;2008. p825–854.
Usui N, Kotagal P, Matsumoto R, Kellinghaus C, Lüders HO. Focal Semiologic and Electroencephalographic Features in Patients with Juvenile Myoclonic Epilepsy. Epilepsia 2005;46:1668-1676.
Baraldi S, Farrell F, Benson J, Diehl B, Wehner T, Kovac S. Drop attacks, falls and atonic seizures in the Video-EEG monitoring unit. Seizure 2015;32:4-8.
Brigo F, Trinka E, Lattanzi S, Bragazzi NL, Nardone R, Martini M. A brief history of typical absence seizures - Petit mal revisited. Epilepsy Behav 2018;80:346-353.
Yoshinaga H, Ohtsuka Y, Tamai K, et al. EEG in childhood absence epilepsy. Seizure 2004;13:296-302.
Genton P, Bureau M. Epilepsy with myoclonic absences. CNS Drugs 2006;20(11):911-916.
Genton P.When antiepileptic drugs aggravate epilepsy? Brain and Dev 2000;22:75-80.
Stephen LJ, Brodie MJ. Pharmacological Management of the Genetic Generalised Epilepsies in Adolescents and Adults. CNS Drugs (2020) 34:147–161.
