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Source: Nguyen VHV, Baca CB, Chen JJ, Rogers SJ. Epilepsy. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146062782. Accessed May 16, 2017.
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CONDITION/DISORDER SYNONYM
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(1) Occurrence of at least two unprovoked seizures with or without convulsions separated by at least 24 hours, (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; or (3) diagnosis of an epilepsy syndrome.
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Categories of identified etiologies.
Genetic.
Structural.
Infectious.
Metabolic.
Immune.
Unknown.
Seizure onset in elderly may be associated with strokes, neurodegenerative disorders (eg, Alzheimer’s disease), and other conditions.
Unprovoked seizures without identifiable cause are called idiopathic or cryptogenic epilepsy.
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Epilepsy is the fourth most common neurologic disorder globally and in the United States following stroke, migraine, and Alzheimer’s disease.
Incidence: 44 per 100,000 person-years.
Approximately 125,000 new epilepsy cases occur in United States each year.
Only 30% in people younger than 18 years at time of diagnosis.
Bimodal distribution in occurrence of first seizure, with one peak in newborn and young children and second peak in patients older than 65 years.
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Premature birth with small gestational weight, perinatal injuries (eg, anoxia), history of alcohol withdrawal seizures, history of febrile seizures, family history of seizures.
Seizures can be precipitated by:
Drugs that may provoke seizures include:
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CLINICAL PRESENTATION
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