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Classifying seizures and epilepsy: a synopsis.

Abstract

Seizures can have a number of clinical presentations. Epilepsy, the condition of recurrent unprovoked seizure, can also be categorized in a variety of ways and is associated with several conditions. Seizures and the epilepsies are classified most commonly by a system devised by the International League Against Epilepsy (ILAE) that employs clinical, electroencephalographic, and imaging data. The system has two broad divisions: focal and generalized for seizures and localization related and generalized for the epilepsies. This article surveys all seizure and epilepsy types according to the ILAE scheme. Limitations of the current categorization are discussed, and a recent new proposal for classifying seizures and epilepsy is demonstrated.

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BibTeXRIS

Joseph I Sirven. 2002. Classifying seizures and epilepsy: a synopsis.. https://doi.org/10.1055/s-2002-36644

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Long-term seizure outcomes and factors associated with response to adjunctive everolimus in TSC-associated epilepsy.

BACKGROUND: Everolimus, a mechanistic target of rapamycin (mTOR) inhibitor, is increasingly used in tuberous sclerosis complex (TSC)-associated epilepsy; however, long-term real-world outcomes and factors associated with favorable response remain unclear. This study aimed to evaluate the long-term seizure outcomes of adjunctive everolimus and explore clinical factors associated with treatment response. METHODS: We retrospectively recruited 21 patients with active TSC-associated epilepsy receiving adjunctive everolimus and assessed seizure outcomes during follow-up. Clinical characteristics were compared between responders and non-responders at 1 year after treatment initiation. RESULTS: Over a median treatment duration of 72 months, responder rates ranged from 53.8% to 64.7%, and seizure-free rates ranged from 33.3% to 41.2%. Responders had fewer involved organ systems at baseline (median 3 vs. 4, p = 0.020) and lower anti-seizure medication burden (median 2 vs. 4, p = 0.045). Younger age at treatment initiation showed a trend toward improved response. CONCLUSION: Adjunctive everolimus was associated with sustained long-term seizure reduction in this real-world cohort. In exploratory analyses, fewer involved organ systems and fewer baseline ASMs were associated with favorable treatment response. These findings require validation in larger prospective cohorts.

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