A tendency to recurrent, usually spontaneous, epileptic seizures

Aetiology

• Occurs at any age, most common in infancy and old age
• Genetic, aquired brain, metabolic, toxic and environmental factors
• Generalised epilepsy presents in childhood and adolescence, most have genetic predisposition
• Focal epilepsy - localisation-related, can generalise laterally

Pathophysiology

• An epileptic seizure is abnormal synchronisation of neuronal activity
  • Usually excitatory with high frequency action potentials
  • Sometimes predominantly inhibitory
• Interruption of normal brain activity - focally or generalised
• Usually brief (secs-mins)

Primary generalised epilepsy

• Often presents in childhood/teens
• Early morning jerks
• Generalised seizures
• Risk factors - sleep deprivation, flashing lights

Focal onset epilepsy

• Underlying structural cause
• Focal onset, can then generalise
• Onset at any age
• Hippocampal sclerosis can occur