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I. Introduction A. Background B. Epilepsy is a brain disorder in which a person has repeated seizures over time that can be caused by birth defects, trauma or bad choices.

II.Causes, Incidence, and risk factors A. Causes 1. Epilepsy can be caused by stroke, transient ischemic attack (TIA), dementia (Alzheimer’s disease), traumatic brain injury, infections (brain abscess, meningitis, encephalitis, AIDS), brain problems present at birth ( congenital brain defect), metabolism disorders present at birth (phenylketonuria), brain tumor, abnormal blood vessels in the brain, and use of certain medications (antidepressants, tramadol, cocaine, amphetamines). 2. Some causes cannot be prevented while others are caused by negative choices. In 70% of new cases, no cause is apparent.

B. Incidence 1. Epilepsy affects nearly 3 million Americans of all ages, genders and races. Incidence of epilepsy is highest under age 2 and over age 65. Males are slightly more likely to develop epilepsy. 2. There are approximately 200,000 new cases of epilepsy each year. Ten percent of Americans will experience at least one seizure in their lifetime.

C. Risk factors 1. Some risk factors that are uncontrollable are your age, your sex, your family history, stroke, vascular disease, brain infections, bleeding in the brain, abnormal blood vessels in the brain, brain tumors, infections, cerebral palsy, fever related, and prolonged seizures in childhood. 2. Some risk factors that can be controllable in some instances are head injuries, some strokes, heavy alcohol use and illegal drug use.

II. Symptoms vary from person to person and can also vary seizure to seizure. A. Examples of symptoms 1. Some symptoms are convulsions, muscle rigidity, sporadic movements, muscle stiffness, loss of muscle tone, spasms, head turning, unusual senses involving one or more of the five senses, memory or emotional



References: 1. Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen 's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100. 2. French JA, Pedley TA. Clinical practice. Initial management of epilepsy. N Engl J Med. 2008;359(2):166-76. 3. Kornblau DH, Conway Jr EE, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen 's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009: chap 173. 4. Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007. 5. Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2). 6. Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71. 7. Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009;116(6):758-67. 8. C. L. Harden, J. Hopp, T. Y. Ting, et al. Practice Parameter update: Management issues for women with epilepsy --Focus on pregnancy (an evidence-based review). Neurology 2009;73;126.

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