Overview of Seizure and Epilepsy Syndromes and Their Multidisciplinary Management

Abstract

Abnormal hyperexcitable electrical discharges of the cerebral cortex lead to the disturbance between the inhibitory and excitatory balance of the neural network. Seizure is caused by four main mechanisms, including metabolic, structural, inflammatory, and infectious mechanisms. Seizures are classified as partial and generalized based on the isolation in a specific area in one brain hemisphere or passing through the nerve fibers and spreading to the other hemisphere as well. Epilepsy is defined as the occurrence of more than two unprovoked and unpredicted repeated seizures. Epilepsy affects more than three million individuals in the United States and approximately 50 million individuals worldwide. Epilepsy may be of an unknown origin, while it could also be associated with certain syndromes. General and specific approaches to seizure treatment encompass a wide range of factors. The general approach should be focused on reassurance and raising the awareness of the patients and their family, and the specific treatment is focused on utilizing pharmacological and surgical approaches. In general, the surgical approaches used for medication-refractory seizures are both palliative and curative, showing promising results if the epileptogenic area is localized using a multidisciplinary approach via live video-electroencephalography monitoring or direct intracranial electrode placement. In addition, the utilization of live modern imaging modalities coupled with surgical approaches could enhance the success rate of the treatment and increase the seizure-free duration.